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

Follow the money

The Money Resolution for Chris Heaton-Harris’s version of Lord Saatchi’s Medical Innovation Bill will be heard and voted on in the Commons this coming Tuesday.

We need a minute of your time again. Today. Now.

The Money Resolution is an essential step in the progress of any Bill that includes a proposal for new or increased public expenditure. The Bill cannot be considered in Committee Stage unless this resolution is passed.

Heaton-Harris’s Access to Medical Treatments (Innovation) Bill (AMTIB) certainly includes a proposal for new or increased public expenditure and the Money Resolution is Tuesday 03 November 2015.

The Bill doesn’t actually set up a database of ‘innovative’ treatments itself, of course; it simply permits the Secretary of State to do it if he wants to, but the costs still have to be considered, as will the costs of the attempts by the Bill to provide ‘legal certainty’ (as the Bill’s supporters would like us to believe) to doctors who treat their patients innovatively.

How much will the database cost?

The Bill allows for the ‘establishment, maintenance and operation’ of a database of (undefined and unknown) ‘innovative’ treatments (that the Bill provides no funding for), the ‘results’ of such treatments (however that can ever be known), recording (undefined) details of patients and treatments, allowing (undefined and unknown) access to that database to persons (or companies) (undefined and unknown), with (undefined and unknown) security and (undefined and unknown) protection for patients’ personal details and medical information, for (undefined and unknown) purposes and uses and not even an assurance that any of this data will not be used for marketing purposes.

That’s a lot of unknowns so it’s going to be interesting to see how a cost can be attached to the database.

In the news last week was Scotland’s new NHS24 IT system — it crashed on its first day of operation. This cost a mere £117 million: chicken feed compared to other Government IT fiascos such as its £10 billion patient record system.

Perhaps the cost of the AMTIB will be somewhere between these two figures. But even if at the lower end of that estimate, that is still a lot of money for a database that will be no more than a database of anecdotes. Much like the other issues Saatchi’s Bill is purported to resolve, the question of how a database of anecdotes of ‘innovative’ treatments could ever help find new treatments has never been answered. All we’re supposed to believe is that a database will magically produce results: that is not and cannot be how medicine progresses. Meanwhile, patients will be harmed.

On top of all that, there’s still the costs of these ‘innovative’ treatments that doctors wouldn’t have prescribed before — will the Money Resolution account for this as well?

Cost of litigation

That the costs of setting up a new database of ‘innovative’ treatments need to be taken into account is obvious. Less obvious are the costs associated with s.3 and s.4 of the Bill: the ones that purport to remove a doctor’s fear of being sued when he/she harms a patient. The writers of the Bill claim this will reduce uncertainty but it will do the opposite and the resulting confusion will mean more litigation, more uncertainty and less money available to spend on patient care.

It has to be noted that the recent interim report on the Government’s Accelerated Access Review makes no mention of fear of litigation as a barrier to doctors innovating. It does, however, highlight a number of barriers, but neither Saatchi’s Bill nor Heaton-Harris’s Bill addresses any one of them.

In his response to one of the questions in Saatchi’s Medical Innovation Bill consultation Sir Robert Francis QC said:

Q 8: Do you have any comments and suggestions for inclusion in the draft impact assessment and equality analysis?

The assessment suggests there will be a reduction in medical negligence claims. On the contrary there is likely to be protracted and complex litigation about the meaning of this Bill. The assessment suggests that the Bill mitigates the risk of inappropriate use of the Bill by the requirements within it. The observations above suggest why this may not be the case.

We’ve yet to see the impact and equality analysis for Heaton-Harris’ Bill, but it would be foolish to disregard Sir Robert’s wise words.

Dr Marika Davies, a medico-legal adviser at the Medical Protection Society has said of Saatchi’s Bill:

The bill may, in fact, increase litigation over the meaning and scope of the bill, decisions not to try innovative treatments or failure to warn of risks.

And Dr Michael Devlin, Head of professional standards and liaison at the Medical Defence Union:

If the Bill were to become law we would expect members to ask for our advice about its correct interpretation. We have been concerned throughout the passage of the Bill that it is likely only to lead to confusion and delay, whereas currently these problems don’t exist.

Nigel Poole QC says it will only cause ‘confusion and muddle’.

Finally, money wasted in setting up a database or is lost in litigation is money that could have been better spent on proper scientific research that would have benefited patients.

Action alert!

We need you to email your MP again, this time asking him/her to turn up for the Money Resolution on Tuesday and ask the Bill’s supporters why they want to waste precious public money on a database that will not and cannot produce any innovation and why they want to increase NHS litigation costs.

We only have 24 hours to do this so please do it now: we need to make sure that the Money Resolution is defeated on Tuesday, ensuring that public money is not available to fund this dangerous and unnecessary Bill.

Write right now

You can write to your MP directly, or use the convenient Write to Them website: all you have to do is enter your postcode below and click on Submit and you will be taken directly to the Write To Them website.

Lots of identical emails may not be delivered and it is a breach of Write to Them’s terms and conditions, so please make the words your own, highlighting the key points you want to make about the Bill. A personally written email will have more impact and is more likely to persuade. Please also keep it polite and to the point and remember to include your name and address so they know it’s one of their constituents who is concerned about the Bill.

Thank you all for your help.

 

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