Stop the Saatchi Bill

Driven by an extraordinary two-year PR campaign on social media and a supportive newspaper partner, this all started as Lord Saatchi’s Medical Innovation Bill, metamorphosed through several versions, and was resurrected under a new name by Chris Heaton-Harris, before finally clearing its last hurdle in the Lords this week to become the Access to Medical Treatments (Innovation) Act. Pretty much the only thing they share is the word 'Innovation' in the title.

One day, it may be possible for politicians to ask the people who actually work in the medical field: what are the problems you face, and how can we help you overcome them?

One day, politicians may actually listen to the answers they receive, and thus try to tackle genuine problems rather than imagined ones.

One day, politicians, medics, researchers, lawyers, patient groups, charities, and the public, may work together to overcome the barriers to the development and provision of new treatments.

But it is not this day.

Read more: Not this day

FAQ – Dispelling Myths

The Saatchi Bill is being promoted by making claims that are not supported by the text of the Bill or by medical, scientific and legal reality.

1. Doctors do not innovate or depart from standard treatments as they fear litigation or disciplinary proceedings.

During the Government consulation into the Bill, medical professional bodies and charities were consistent in saying that they could find no evidence that this was true.

Cancer Research Uk said “We have been unable to find evidence that fear of medical litigation is currently a barrier to innovation in cancer.” and “We have been unable to find evidence that cases have been brought, or led to compensation, based on a competent doctor attempting to use an innovative treatment with the consent of a patient.”

The Academy of Medical Royal Colleges said, “We have not seen any evidence that suggests litigation or the possibility of litigation is deterring clinicians from innovative practice and, anecdotally, that is not the experience of members.”

The British Medical Association said, “We have no evidence to suggest that the threat of litigation is a barrier to the provision of innovative treatment of this kind and we strongly question the necessity and desirability of introducing statute to clarify or change the law in this area.”

As the Nightingale Collaboration have said, “Without the main assumption of the Bill — that doctors are unwilling to innovate because of fears of litigation — being substantiated, the whole Bill disintegrates.

2. The Bill will help find a cure for cancer.

Medical research requires the efforts of many hundreds of people working collaboratively on programmes of investigation which include large scale trials to establish efficacy. A single treatment on a single patient can never establish if that treatment worked. The patient may have improved anyway or lived longer than average without that treatment. Only carefully conducted randomised controlled trials can establish cause and effect between a treatment and its outcomes. This Bill is no shortcut to that hard work.

By encouraging doctors and patients to try unproven drugs outside of the scope of a randomised controlled trial, it may be harder to recruit patients into trials. This will harm medical research and delay finding new effective treatments.

3. Patients with ‘Nothing to Lose’ will benefit from this Bill.

If a patient has been told there are no known treatment options left then trying an unproven ‘innovative’ treatment cannot guarantee in anyway that the patient will benefit. As the treatment is unknown and unproven it may just as well harm rather than help. There will also be unknown side effects that may seriously harm the quality of life for that patient. Even patients with few proven treatment options can still benefit from care that helps with a quality of life.

Unproven treatments can seriously jeopardise this chance. Patients who enrol in trials do so knowing this is a risk but that knowledge gained may help others. The fact that a Saatchi treatment will take place outside the scope of a trial means that even if something is learned it may not even help others.

4. The Bill could not be used by homeopaths to cover themselves to use quack treatments on cancer patients.

The Saatchi Bill team claim that “The Bill can only be used by qualified and registered doctors. The term ‘doctor’ is a legal one and homeopaths (for example) would not be protected by the Bill, if it became law.”

However, many homeopaths are indeed medically qualified and belong to the Faculty of Homeopathy, the organisation representing medical homeopaths. This Bill should not allow them to try homeopathic treatments where there is no good reason to think that they could do any good.

Indeed, within the many thousands of doctors, there will always be a few who believe in pseudoscientific or superstitious treatments. Sometimes, they form their own private clinics and practices. This Bill will allow them to “consult” with themselves and cover practices that would be considered simple quackery

5. Doctors will only be able to use a treatment if it has the agreement of a Multidisciplinary Team (MDT) and the doctors’ Responsible Officer (RO).

The Bill only demands the doctor consults with a MDT and notifies their RO. There is no requirement for them to heed the views of either.

6 The Bill will not prevent patients suing doctors if they have been harmed through bad practice or negligent treatment.

It is not clear that this is so. The Bill only demands that the doctor takes into “consideration of all matters that appear to the doctor to be reasonably necessary to be considered in order to reach a clinical judgment.”If that doctor is incompetent or delusional then they still might have taken into account all matters that appear to them to be reasonable. The current law demands that such an action would have been supported by a responsible body of medical opinion. This safety net is removed.