The Non-surgical Procedures and Functions of Medical Reviewers (Scotland) Bill (“the Bill”) was introduced on 8 October 2025. A new section (section 13A) was added to the Bill at Stage 2 which links to the UK Internal Market Act 2020.
This short blog considers how the Bill and the UK Internal Market Act 2020 (“UKIMA”) interact. This is the first time that the Scottish Parliament has considered primary legislation which interacts with the professional qualifications provisions of UKIMA.
The Parliament is due to consider the Bill at Stage 3 on 17 March 2026.
What is the UK Internal Market Act 2020?
The UK Internal Market Act 2020 (UKIMA) governs the trading relationship between the different parts of the UK. The Act establishes two market access principles – mutual recognition and non-discrimination in relation to goods and services. The Act also establishes an automatic recognition principle in relation to the recognition of professional qualifications across the UK.
The automatic recognition principle for professional qualifications
Some UK professions are regulated, meaning that the law requires an individual to have certain qualifications or experience to practise. Some of these professions, like vets, nurses and airline pilots are regulated on a UK wide basis. Other regulated professions, for example teachers, are regulated separately in different parts of the UK. Where professions are regulated separately, and a person wants to work in a different part of the UK, they need to have their professional qualification(s) and/or experience recognised by the relevant regulator. A list of regulated professions and their regulators is published by the UK Government. Regulated professions are often referred to as ‘registered’.
Many jobs are not regulated. This means that the law doesn’t require a person to hold a professional qualification or certain experience recognised by a regulator. Where no professional qualification is required, a job is referred to as being an ‘unregulated profession’.
Part 3 (sections 24-29) of UKIMA relates to ‘professional qualifications and regulation’, introducing an automatic recognition principle. It allows those in regulated professions, where they are regulated separately across the UK, to qualify in one of the four nations but access the same profession in a different nation without needing to requalify. This is because UKIMA requires all UK regulators to automatically recognise an individual’s professional qualification and/or experience. The automatic recognition principle also applies to professions regulated on a UK wide basis and to unregulated professions.
Why is the automatic recognition principle relevant to the Bill?
UKIMA (section 29) defines what it means to practise a profession. The Explanatory Notes to the Act explain that this provides that “the ability to practise a profession includes being able to undertake the activities that make up a profession, use a professional title or be registered where this is required”.
Section 29 also provides that the automatic recognition principle for professional qualifications is engaged where a legislative provision (something in primary or secondary legislation) limits the ability to undertake professional activities to individuals with certain, qualifications or experience “only if the activities affected by the provision are, in a significant number of cases, essential to the practice of the profession in question.”
Section 4 of the Bill limits procedures to certain permitted premises, overseen by certain registered health professionals, but it does not limit who can undertake such non-surgical procedures (set out in Schedule 1 of the Bill) at present.
If the Bill were to provide that some procedures be restricted to certain registered healthcare providers, it may interact with Part 3 of UKIMA. This is because the Bill could be deemed to regulate the practice of a profession and therefore be caught by the automatic recognition principle (section 24 of UKIMA). Paragraph 26 of the Policy Memorandum for the Bill as introduced highlights this, stating:
The Scottish Government is exploring the extent to which the activities being regulated by the Bill comprise the practice of a profession.
Although the Bill does not limit who can undertake non-surgical procedures, such limiting is the Scottish Government’s stated aim in future.
The Business and Regulatory Impact Assessment on Licensing and Further Regulation of Non-Surgical Procedures (“the BRIA”) states the Scottish Government’s position that it “does propose to put in place restrictions on those providing procedures, set training standards for practitioners, and restrict certain procedures to appropriate healthcare professionals”. Given that these are matters which would engage the automatic recognition principle of UKIMA, the BRIA states that at the point the Bill was introduced, the Scottish Government was continuing to consider its proposals, but that it had:
…engaged with both DHSC and the Department for Business and Trade (DBT) and is reassured that UKIMA is not intended to prevent public safety restrictions being made in line with our proposals. Further exploration the extent to which the activities being regulated by the Bill comprise the practice of a profession under Part 3 is ongoing…Provision to put in place qualifications or experience restrictions has not been made in the Bill, but instead an enabling power is taken, which will allow such restriction to be put in place at a future date.
How does the Bill seek to deal with the UKIMA interaction?
As stated above, the Bill does not regulate who can undertake non-surgical procedures. The Bill does, however, provide Scottish Ministers with a power which would allow them to introduce such restrictions by secondary legislation in the future.
This power is provided for in section 5 of the Bill. The Supplementary Delegated Powers Memorandum for the Bill explains that Scottish Ministers must lay regulations setting training or qualification requirements within 3 years. If Ministers do not feel that it is practical to make such regulations within the time period, then they must lay a report before the Parliament explaining why. The Supplementary Delegated Powers Memorandum states that:
Due to the impact of the UK Internal Market Act 2020 (UKIMA), for this Bill, the Scottish Parliament is not able to set training and supervision standards for Scotland which would operate in the manner in which the Scottish Ministers would like them to. The Scottish Government wants to work with the UK Government in progressing plans to regulate in this sector. This amendment provides an assurance that regulations around training and qualifications will be put in place.
What would happen if the Bill did seek to regulate who could undertake non-surgical procedures?
UKIMA works by ‘disapplying’ legislative provision(s) (something in either primary or secondary legislation) which run contrary to the principles it establishes. Disapplication of a provision is different to where a law is ‘struck down’. In the case of disapplication, the provision is still law, but it doesn’t apply in particular circumstances. Where a law is ‘struck down’ it means that it is null and void and becomes unenforceable.
The way UKIMA operates means that an Act of the Scottish Parliament or a Scottish Statutory Instrument can contain provision which runs contrary to it, but that the provision will be disapplied where relevant. This limits the effectiveness of Scottish Parliament legislation which engages either a market access principle or, as the case may be in relation to the Bill, the automatic recognition principle.
If the Bill sought to restrict who could undertake non-surgical procedures to certain registered medical professionals, those practising in England, for example, who may not be registered medical professionals, could still carry out procedures in Scotland (within permitted premises) without meeting additional requirements in Scotland.
What happened in relation to the UK Internal Market Act at Stage 1 and Stage 2?
There was limited discussion of the interaction with UKIMA at Stage 1. This is likely because the Scottish Government indicated that its work with the UK Government to address the interactions was ongoing.
At Stage 2 the Scottish Government lodged an amendment (amendment 28) which proposed an additional section to the Bill. This became section 13A ‘UK internal market: power to establish individual assessment process’.
The section allows Scottish Ministers to specify in secondary legislation an individual assessment process to which section 26 of UKIMA would apply. Under such a process, an individual may apply to have their qualifications, training, experience or skills assessed for equivalence to any standards which may be set in Scotland.
Importantly, where a regulator offers an individual an individual assessment under section 26 of UKIMA the automatic recognition principle does not apply.
Speaking to the amendment, the Minister for Public Health and Women’s Health, Jenni Minto MSP, said:
Amendments 5, 28, 30 and 34 provide a way to allow Scottish ministers to establish training and qualification standards for practitioners, working within the constraints of the United Kingdom Internal Market Act 2020…
Part 3 of UKIMA establishes an automatic recognition principle whereby a professional who is qualified in one part of the UK is automatically treated as being qualified in another part of the UK. The effects of part 3 of UKIMA mean that the Scottish Government is currently unable to set standards for qualifications or experience for individuals providing non-surgical procedures in the bill in the way that we would like.
Section 26 of UKIMA provides a partial remedy to that. The individual assessment process under that provision would allow someone to have their existing training or qualifications assessed when they were different from those specified, to ensure that they were equivalent to those required in, or met the standards that we establish for, Scotland. We still need to work with the UK Government on a long-term solution, as that is a cumbersome one. Nevertheless, I want to take the available option, which would allow us to progress with setting standards by following that route.
Looking ahead
The issue in the long term is how effective Scottish legislation is where it interacts with UKIMA. Section 13A of the Bill seeks a workaround to the automatic recognition principle of UKIMA, by allowing Ministers to make regulations to specify an individual assessment process for those wishing to undertake non-surgical procedures in Scotland who usually practise elsewhere.
If the Scottish Ministers make regulations under section 5 to prescribe certain training or qualifications for providing non-surgical procedures in Scotland, and regulations under section 13A are not made or are challenged, then there is the potential that an individual who carries out non-surgical procedures in England, for example a beauty therapist, could still legally carry out non-surgical procedures in Scotland.
Sarah McKay, SPICe research