Leading surgical and medical organisations have warned that patients continue to face unnecessary risk because cosmetic surgery in England can still legally be performed by doctors without specialist surgical qualifications.
In an open letter to the Secretary of State for Health and Social Care, The Rt Hon Yvette Cooper MP, a coalition of royal colleges, specialist surgical associations, and patient safety organisations has called on the Government to publish the promised consultation and use it to strengthen protections for patients undergoing cosmetic surgery.
The letter is also signed by Professor Sir Bruce Keogh KBE, whose landmark independent review into cosmetic interventions first called for comprehensive reform of the sector more than a decade ago, in 2013.
The letter reads:
Dear Secretary of State,
One year on from the government’s announcement to act and regulate high-risk cosmetic procedures, the promised licensing scheme has yet to be established. More than a decade after the Keogh Review in 2013 called for comprehensive reform of both surgical and non-surgical cosmetic interventions, nothing has changed.
Meanwhile, calls for reform have only grown louder. The Women and Equalities Committee and the Science, Technology and Innovation Select Committee have both urged action. At the same time, campaigns such as the Mirror's Ban the Cosmetic Cowboys and the Royal College of Surgeons of England's Trust Your Treatment campaign have kept the issue firmly in the public eye. Patients have waited long enough for action.
While much of the debate has focused on non-surgical procedures, there remains a serious regulatory gap in cosmetic surgery itself. At present, any doctor registered with the General Medical Council (GMC) can legally perform cosmetic surgery, including procedures such as breast augmentation, rhinoplasty, facelifts and liposuction, even if they are not recognised as a specialist surgeon and are not on the GMC’s Specialist Register. Patients understandably expect that those carrying out invasive cosmetic procedures have the appropriate specialist training, qualifications and expertise. This is unacceptable.
We welcome the work undertaken over the past year to develop a proposed "red list" of high-risk cosmetic procedures. Identifying procedures that pose the greatest risk to patients is an important step forward. However, a list of high-risk interventions will offer little protection if it remains lawful for practitioners without the necessary expertise to perform them.
The solution is straightforward. Surgical procedures on the red list, at a minimum, should only be conducted by surgeons on the GMC Specialist Register with the appropriate surgical training and qualifications, or any equivalent successor framework following reform of the GMC. Without this change, patients will continue to be misled into believing they are in safe hands, even when the law does not adequately protect them. We also encourage patients to seek out surgeons certified through the Cosmetic Surgery Board Certification Scheme.
The consequences of failing to act are not theoretical. Cosmetic surgery involves complex, invasive procedures, and the human cost of inadequate regulation is evident in serious injuries and avoidable deaths, including those following high-risk procedures such as Brazilian Butt Lifts. When cosmetic surgery goes wrong, patients may require extensive corrective treatment and ongoing care, often placing additional pressure on already stretched NHS services.
The forthcoming consultation must therefore do more than restate the problem. It should propose and lead to clear legislative change to restricting cosmetic surgery to surgeons on the GMC Specialist Register who meet the appropriate specialist standards for the procedures they perform. Without this, the current system will continue to fail patients, and further harm is inevitable.
There is a clear consensus across our organisations: this issue deserves urgent regulation to ensure public protection and patient safety. We see firsthand the consequences when cosmetic procedures go wrong, and we are united on the action required to prevent avoidable harm. We are ready to work with you, the Department of Health and Social Care, the Care Quality Commission, the General Medical Council and others to urgently deliver the regulatory framework the public needs and expects.
Signatories include:
- Royal College of Surgeons of England (RCS England)
- Royal College of Physicians and Surgeons of Glasgow
- Royal College of Surgeons of Edinburgh (RCSEd)
- Association of Breast Surgery (ABS)
- British Association of Aesthetic Plastic Surgeons (BAAPS)
- British Association of Oral and Maxillofacial Surgeons (BAOMS)
- British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS)
- British Oculoplastic Surgery Society (BOPSS)
- British Society of Facial Plastic Surgery (BSFPS)
- Save Face
- Joint Council for Cosmetic Practitioners (JCCP)
- Plastic Surgery Trainees Association (PLASTA)
- Professor Sir Bruce Keogh KBE