Seòmar agus comataidhean

I thank the committee for giving me the opportunity to speak to the draft Civic Government (Scotland) Act 1982 (Licensing of Skin Piercing and Tattooing) Amendment Order 2026. The instrument will amend an order made in 2006 that is used by local authorities to license and inspect any business that provides skin piercing or tattooing in Scotland and which lays out a number of requirements that are aimed at reducing the health risks to the public when accessing such procedures.

The amending order will remove the requirements for acupuncture therapists to wear disposable non-latex gloves when treating someone whom they know to be living with a blood-borne virus. Removing those requirements will remove any doubt for those therapists. It will be clear that they should not feel that they need to ask their client whether they are living with a blood-borne virus, which is a question that some people feel uncomfortable to answer. The amendment will also help to reduce the stigma that people living with a blood-borne virus might feel when accessing acupuncture treatment.

Other existing requirements to wear disposable non-latex gloves in certain circumstances will remain in place. For example, should the therapist be handling items that are contaminated with blood or bodily fluids, or if they or their client have open lesions, the requirement to wear disposable non-latex gloves will remain. Therapists make the decision on any other reason to wear disposable non-latex gloves through individual risk assessments case by case.

Since the original order came into force in 2006, there have been many advances in the treatment of blood-borne viruses. Vaccinations and antiviral medication mean that people can maintain healthy lives through the treatment options that are available. Those advances mean that transmission of HIV has greatly reduced. The hepatitis B vaccination that is offered today for babies and people who are at high risk provides protection against acquisition, and hepatitis C can also now be cleared with medication in most cases.

I must highlight that acupuncture is considered a low-risk procedure. Should therapists continue to feel that they need to ask their client about blood-borne viruses and treat them differently if they confirm a positive status, that is no longer considered to be justified, given the advances in treatment and the low risk that is posed by the procedure.

Sadly, people living with blood-borne viruses still face forms of stigma every day. The Parliament’s Equalities, Human Rights and Civil Justice Committee held a focused inquiry in 2024 on the importance of reducing HIV stigma. It heard from people living with HIV in Scotland, who spoke about the stigma that they encounter and its effects, particularly in healthcare settings.

The Scottish Government remains committed to helping to reduce the stigma through promoting the positive impact of effective treatment and prevention that is available today, and by championing the changes that are required to ensure that people who live with blood-borne viruses are not treated any differently from others. The amendment to the 2006 order will assist in ensuring that people are not asked unnecessary questions when they seek treatment and will support us in delivering our commitment.

I can advise that, throughout the consultation, no stakeholders objected to amending the 2006 order to remove the provisions, and no evidence was provided to support further amendments to that order. It is not expected that the amendment will have any detrimental effect on businesses in Scotland.

Thank you for considering the amendment. I request the committee’s support to progress the order, and I welcome any questions that you might have to assist in your decision.

11:00

:I have nothing to add to my previous statement.

I move,

That the Health, Social Care and Sport Committee recommends that the Civic Government (Scotland) Act 1982 (Licensing of Skin Piercing and Tattooing) Amendment Order 2026 [draft] be approved.

Motion agreed to.

:I will take the intervention.

:The amendments are necessary to meet the ambition to set training standards in the future.

Amendment 5 agreed to.

:I have previously indicated my intention to commence the bill’s key provisions in September 2027 to align with the Civic Government (Scotland) Act 1982 (Licensing of Non-surgical Procedures) Order 2026. Indeed, I have already made it clear that I do not intend to bring key sections of the bill into force until then.

Amendments 62 and 63, in Mr Balfour’s name, would imply a similar but not identical timeline, delaying commencement by a few months, depending on the date of royal assent. In practice, that would imply that key provisions, including offences, would come into force in early 2028. I am concerned that the current drafting of amendment 63 would not only delay the commencement of offences but prevent us from progressing any regulations under the bill.

:I will continue with my remarks, because I am going to address the point that Mr Balfour has just made.

I am concerned that a delay would mean that it would not be possible to progress work on a scheme under section 26 of the United Kingdom Internal Market Act 2020 and training standards in advance of the main provisions coming into force. I am of the view that bringing in regulations early will be better for businesses and enforcement agencies, even if those amendments can come into force only at the same time as the offences.

I am happy to work with Jeremy Balfour on an alternative approach that might be brought in at stage 3 to give businesses clarity about what they will need to meet the bill’s requirements. In return, I ask the member not to press amendment 62 and not to move amendment 63.

As for amendment 121, in Mr Russell’s name, I cannot support the length of delay that he has suggested, as it would prevent us from taking essential steps to improve safety in the sector. I do not believe that the amendment meets public concern on the matter, and I hope that other members will agree. Therefore, I urge that amendment 121 not be moved.

:This group of amendments goes to the heart of the bill. It contains amendments to section 4, which sets out the most important public safety provisions on where non-surgical procedures can be carried out and the need for healthcare professional involvement in those settings. Those are the issues that have been the subject of most of the correspondence and representations that I have received, and I must make it clear that I have listened carefully to all sides of the discussion.

I will start by discussing my amendments. Amendment 22 is the most substantial. It does not add to or remove any setting from the list of permitted premises, but it provides additional clarity about those premises. Amendment 22 will replace the existing sections 4(1) and 4(2) with a new section 4(1). The new subsections (1)(a) and (1)(b) provide new drafting so that the permitted premises for Healthcare Improvement Scotland-registered independent clinics and independent hospitals are those where the address is entered in the register that is maintained by HIS. Subsection (1)(a)(ii) makes it clear that an independent clinic can include a vehicle. Subsections (1)(c) to (f) are the same as provisions in the bill at introduction, but with minor technical drafting changes.

Amendment 25 will amend section 4(5) to include definitions that relate to new subsection (1). Amendments 9, 23, 24 and 31 make technical drafting changes that are proposed as a consequence of amendment 22. The changes address concerns raised by HIS in evidence to the committee about the clarity of those provisions.

The inclusion of vehicles might surprise some members, but, in the case of dental settings, mobile settings were included in the bill at introduction, and the inclusion is consistent with how those settings can already operate. In the case of a HIS-registered independent clinic, that has been made explicit, recognising that it is possible but not easy for a vehicle to be equipped in the same way as a traditional clinic. For example, such vehicles already provide dental scanning and blood donation services within the NHS. I assure members that independent clinics that are vehicles would be inspected by HIS and would be expected to meet the same standards as fixed premises in relation to the appropriateness of fixtures and fittings.

Amendment 22 also makes it clear that procedures must not be carried out from clients’ homes. It would, however, be possible for a clinic to be established out of rooms in a provider’s home or in a purpose-built outbuilding, because, again, such a setting can still be inspected by HIS and be held to the same standards as any other clinic.

I urge members to support all the amendments in my name.

I will now turn to other members’ amendments in this group and the clear themes that they fall under. Amendments in this group take a variety of approaches. Amendments 22D and 73 would create an additional category of HIS-regulated setting. Amendments 40, 44 and 61, amendments 68 and 71 and amendments 69 and 113 would amend requirements of existing categories of HIS-regulated settings.

Other amendments would provide for new licensing or registration schemes, such as amendments 22A, 41, 42 and 60, on licensed non-healthcare premises, amendments 22B and 43, on community clinics, and amendments 22C and 112.

A number of these amendments seek to allow businesses to operate without healthcare professional involvement. In respect of the proposed licensing schemes, the Civic Government (Scotland) Act 1982 (Licensing of Non-surgical Procedures) Order 2026 has recently been approved by the Scottish Parliament in order to introduce a local authority-run licensing scheme for lower-risk non-surgical procedures. It is intended that the licensing scheme under the order and the regulation of higher-risk procedures under the bill will both commence at the same time. As such, there is no need for any amendment that introduces a new licensing scheme.

I appreciate that all of these amendments seek to address business concerns around the impact of the bill, with the focus being the cost and practicality of having a healthcare professional always present in a setting. I will take this opportunity to explain why I believe that the presence of a healthcare professional is essential.

All the procedures currently described in schedule 1 to the bill carry some risk. Many of them require the use of a prescription-only medicine, and the remainder are all likely, in varying degrees, to require the use of a prescription-only medicine in addressing complications. We heard during the debate that these complications may not emerge immediately. However, I have clinical advice on and examples—some of which were shared in Parliament by Dr Gulhane—of complications emerging or being identified immediately and requiring immediate action to prevent serious adverse outcomes.

In these cases, someone needs to be available to assess the situation and have the ability to prescribe or administer the relevant medication. The setting needs to hold supplies of such emergency medication. Non-regulated settings delivering non-surgical procedures are not able to routinely hold supplies of prescription-only medicines without the involvement of a suitably qualified healthcare professional. I cannot endorse any proposal that could allow procedures to continue to be undertaken without access to emergency medicines.

With specific reference to amendments 44 and 61, which are linked with amendment 40, which seek to create a prescription-only medicine governance process, and amendments 69 and 113, which would require an arrangement for named prescribers to be attached to each permitted premises, there are concerns about the effect of these amendments on the reservation of the subject matter of the Medicines Act 1968 in the Scotland Act 1998.

There are other advantages to the presence of a healthcare professional in settings that provide non-surgical procedures. For example, a healthcare professional’s involvement in consultation can support fully informed consent and consideration of risks, particularly with regard to existing health conditions. A healthcare professional also offers the wider assurance of professional regulation. Complaints can be made against such professionals to professional regulators, with serious consequences if they are upheld. This is not the case for practitioners who are not healthcare professionals.

For all those reasons, I urge members not to move amendments that would in any way undermine the connection between a permitted premises and the presence of a healthcare professional.

Again, I urge members to support the amendments in my name.

I move amendment 9.

:Amendment 29 is a consequential amendment to reflect Healthcare Improvement Scotland’s extended role under part 1 of the bill in relation to non-surgical procedures. It will add reference to part 1 of the bill to sections 76 and 77 of the National Health Service (Scotland) Act 1978, so that inquiries can be held in relation to any matters arising under part 1 of the bill and orders can be made after any such inquiry in relation to any default by Healthcare Improvement Scotland in carrying out its functions in relation to non-surgical procedures. These powers are a last resort, but it is appropriate that any gap that is created where HIS acquires new functions is filled in a manner that is consistent with the approach taken where the powers were first included.

12:00

Section 17 of the bill amends section 18 of the Certification of Death (Scotland) Act 2011 so that medical reviewers will need to authorise cremation where deaths take place “outwith the United Kingdom”. Amendment 32 makes a consequential amendment to section 14(1)(b) of the 2011 act in consequence of the change to section 18 of that act that is to be made by section 17 of the bill.

The Hydrolysis (Scotland) (No 1) Regulations 2026 were approved by Parliament in a vote on 21 January 2026. The regulations ensure that medical reviewers will have the power to authorise hydrolysis in the same way as they authorise cremation; the regulations also change the title of section 18 of the 2011 act. Amendment 33 amends the cross-reference to the title of section 18 in consequence of the hydrolysis regulations.

I move amendment 29.

:I am grateful to members for their contributions to the discussion on this group, which covers some very important issues. The complexity of aspects of the discussion illustrates the importance of the power to amend schedule 1 so that we can ensure that the bill remains up to date, even as the range of procedures on offer changes. I welcome the support for my amendments.

With regard to Dr Gulhane’s point about amendment 6, on clinical trials, such trials are regulated by the 2004 regulations. Those regulations cover only regulated trials.

With regard to the point that Joe FitzPatrick made about Dr Gulhane’s amendments 64 and 65, I am content to continue to discuss those amendments—and any other amendments—with Dr Gulhane as we move to stage 3.

:We have to ensure that we get the right training and standards in place. I believe that amendment 35 does that. I am happy to continue that discussion, but I suggest that members vote for amendment 35 so that we have that as the basis to continue discussions.

The last amendment in this group that I wish to consider also relates to training standards. I am grateful to Fulton MacGregor for working with the Scottish Government on amendment 96, which reflects the strength of concern around training issues. The amendment would ensure that ministers have to address that concern, while acknowledging our limited influence over timing. I hope that members who have lodged amendments on training in general will join me in supporting the amendment.

Bringing my comments on the group to a close, I urge members to support amendment 35 in my name. I apologise, because I said “training” instead of “consultation” when I responded to Dr Gulhane. My comments about Dr Gulhane’s point on consultations still stand.

Amendment 35 would deliver a proportionate consultation requirement in support of amendment 96, in Fulton MacGregor’s name, which recognises the importance of training standards being put in place. I urge members not to move the remaining amendments in the group.