Did you know that from 1st October 2010, there will be no restriction on who can operate class 4 lasers and IPL equipment?

At the same time, VAT will be applied to the majority of cosmetic procedures, including laser and light treatments.

Is there a connection?

Since 1984, lasers (and more recently IPL systems) have been regulated by government because it is understood that lasers are hazardous devices requiring strict safety controls and properly trained operators.

In 2005, the government commissioned an Expert Group to report on the safety of cosmetic surgery and expressed concern about poor standards in the laser and light sector. In its response, government accepted the need for more effective regulation for lasers and light.

However, Government have instead decided that from October 1st, ‘cosmetic' treatments, including lasers and light, no longer need to be regulated at all, and, as no longer being registered with CQC will consequently attract VAT.

In detail:

Medical professionals delivering laser and light treatments for the purpose of disease, injury or disorder will be deemed as delivering ‘medical treatments' and will remain regulated by the Care Quality Commission and be VAT exempt.

Medical professionals delivering treatments not deemed to be medical will not be regulated and will attract VAT.

Non healthcare professionals (and physiotherapists) will be deemed not to deliver medical treatments of any kind and will not be registered regardless of what treatments they actually deliver and will be required to charge VAT on all treatments.

In spite of government promises, no regulatory alternatives have been considered for ‘non-medical' treatments and it is unclear where the responsibility for regulating lasers and light will fall following government's abandonment of that responsibility.

Health and Safety legislation covers the risks associated with lasers and light but specifically excludes those undergoing treatment. The only people not protected by law are patients and clients who are directly exposed to the risk.

It is likely that as 1st October approaches, pre-existing bodies and dormant legislation will be brought out of the cold, with Local Authority and Environmental Health interest re-appearing but, this will be on an entirely contingent and variable basis and it remains to be seen how effective any local provision will be.

This decision by government represents the completion of a 5-year plan to raise revenue by applying VAT to cosmetic medical treatments, regardless of the public health risk and without any consideration of the safety implications of allowing untrained and uncontrolled access to class 4 lasers, which can of course burn and blind if used incorrectly .

This is clearly unsatisfactory and is a straight-forward dereliction of responsibility by government. What is worse, this dereliction has been brought about by the corruption of parliamentary process, being the misuse of supposedly open and transparent public consultation. During this consultation, the initial proposal to deregulate was withdrawn following overwhelming objection by the industry, laser safety experts and government's own advisors because no consideration had been made of the actual risks involved or any evidence provided to support the rationale behind the proposal.

In spite of this withdrawal, government simply waited 3 months and then re-submitted the same proposal but without addressing the concerns that had caused it to be withdrawn in the first place. No further consultation was made and the decision to deregulate carried through without any further debate or discussion.

This is a cynical, money raising exercise bought at the cost of public safety and leaves responsibility for ensuring public safety with the public themselves so, if you want to be sure of the safety and competence of those delivering laser and light treatments, you will need to be able to assess that competence yourself because government doesn't want to be involved any more.

However, CQC registration will still be a sign that the provider is monitored by the healthcare regulator and you may wish to seek out CQC registered providers as delivering a regulated service with guaranteed minimum standards.

Paul Stapleton Mapperley Park Clinic April 2010