The Saatchi Bill

[Alan H]

aka The Medical Innovations Bill

Although this has been mentioned before, I thought it worth giving it its own thread.

You'd have thought a campaign by Maurice Saatchi would have a head start in terms of advertising (given how he made his millions), but advertising only works if you can control the medium; and Saatchi certainly does not control Twitter and the Internet.

The campaign's Director of Communications is Dominic Nutt. He said on Twitter, under his own account, but clearly stating he is their Director of Communications: his Bio says:

Director of Communications for Maurice Saatchi's Cancer Initiative. International media, comms and campaigns strategist. Campaigning for new cancer treatments.

His Tweet:

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The @SaatchiBill account later clarified that "many charities have expressed their support for the Bill consultation process". The Royal Medical Colleges have not said they support the Bill and Cancer Research UK (CRUK) are still considering their position.

I have challenged @SaatchiBill on this several times, asking whether Nutt Tweeted that with the authority of the campaign, but have yet to receive a substantive reply.

However, what matters is what the Bill is, what problem it is trying to solve and what it will allow. You can read what the campaign says on their website.

As I said before, it looks like a quack/charlatans' charter and solves a problem that they have not shown to exist.

here are two excellent article pointing out the issues:

The Saatchi Bill - Why?

Lord Saatchi Innovation Bill

The closing paragraph of the first article sums it up nicely:

The Bill, if enacted, could provide a possible defence to negligence claims where none was intended. One man's "innovation" is another's eccentric experimentation. A doctor whose actions were not supported by any reasonable body of his or her peers, could defeat a claim in negligence by pleading the innovation defence even where the weight he/she gave to the listed considerations was unreasonable and the decision he/she came to was also unreasonable. Provided the doctor can persuasively contend that he or she took into account the considerations set out in the Bill, made a decision through an open process, obtained consent and that the purpose of the treatment was to further the patient's best interests, then he/she has a defence to what would otherwise be considered unacceptable practice by all reasonable bodies of doctors (negligent). I don't believe that changing the law to provide that defence is desirable in the interests of patients or innovation.

[Alan H]

The Medical Defence Union provides indemnity insurance for half of all doctors. They have made their position clear: MDU reassures doctors they are free to push medical boundaries

Commenting on the launch of a consultation today on the draft Medical Innovation Bill, the Medical Defence Union, which helps 50% of UK doctors with complaints and claims, said it sees no need for new legislation.

[Alan H]

The consultation has closed and the Saatchi campaign are declaring it a success because of the numbers allegedly in favour of it. However, this tells a different story: An overwhelming expert consensus against Saatchi Bill

[Dave B]

So, just about all the professional bodies and those organisations representing the people (us) who are most affected are against it.

Er, that makes it a shoe-in with our current government doesn't it?

[Alan H]

Er, that makes it a shoe-in with our current government doesn't it?

My hope is that the Department of Health will drop it like the hot potato it is.

Even Robert Francis QC, the author of the Mid Staffordshire report, is against it.

[Dave B]

I'll share that hope with you . . .

[Nick]

I haven't had (and don't, for the moment, have) the time to read the articles you have cited, so maybe they provide a suitable response, but ISTM that Saatchi's bill has an honorable intention: that in circumstances where there is no realistic alternative, a patient may opt, in consultation with their doctor, to try drugs still going through trials, since, in such circumstances, they literally have nothing to lose, and to wait for full trials would be too late.

I understand your point about a quack's charter, and would, like you, want to stop them peddling false hope, but that leaves several alternatives: The law, as it stands, allows such prescriptions (I don't think so); there is no point to such flexibility in prescriptions (I don't think so), or; the law is too slackly drafted, and does not allow for seemingly more hazardous prescriptions, without also allowing quackery ion by the back door.

You seem to be taking the second alternative (but I may be wrong), and it may be covered in the articles you've cited, but I'm closer to the third option.

(I'll read the other stuff when I can....)

[Alan H]

I haven't had (and don't, for the moment, have) the time to read the articles you have cited, so maybe they provide a suitable response,

They do.

but ISTM that Saatchi's bill has an honorable intention:

I have no doubt of that. However, he clearly does not understand science, ethics or the current legal position: that is no place to start from in framing a new law.

that in circumstances where there is no realistic alternative, a patient may opt, in consultation with their doctor, to try drugs still going through trials, since, in such circumstances, they literally have nothing to lose, and to wait for full trials would be too late.

Wrong. They could have a lot to lose and that is what Saatchi fails to understand. There are many harms that could be done by 'last resort' treatments including slow, painful and even earlier deaths (bear in mind that not all those terminally ill suffer an agonising death). With all treatments that have any effect, there are also harms and they have to be considered. Then there are the additional harms caused by doctors experimenting on people with no good oversight and the damage to public confidence to the medical profession that could bring.

I understand your point about a quack's charter, and would, like you, want to stop them peddling false hope, but that leaves several alternatives: The law, as it stands, allows such prescriptions (I don't think so)

It already does allow such things: an independent prescriber (which is what doctors are) can prescribe any unlicensed medicine or one that is licensed but not for the indication of the patient. There are safeguards in place and ultimately a court would decide whether one given had been reasonable; but the whole point is that doctors are saying that the threat of prosecution and having to justify a treatment in a court is not dissuading them from innovating and trying new treatments. What the Saatchi Bill allows is that court scrutiny to be deprecated and a replaced with something that could be little more than a quiet chat with some (like-minded and possibly junior) colleagues. That does nothing for patient safety.

there is no point to such flexibility in prescriptions (I don't think so)

There is already great flexibility - see above.

the law is too slackly drafted, and does not allow for seemingly more hazardous prescriptions, without also allowing quackery ion by the back door.

That would be difficult to do but in the event, Saatchi has not shown there is a problem that needs to be resolved.

You seem to be taking the second alternative (but I may be wrong), and it may be covered in the articles you've cited, but I'm closer to the third option.

I highly recommend you read some of the responses, but even if you don't read all the responses, a good summary of the main ones are here: An overwhelming expert consensus against Saatchi Bill

And Andy Lewis has published excellent blog posts:

The Saatchi Bill: A Quacks’ Charter

Fooling Nature: How the Saatchi Bill Will Harm Medical Innovation

[Nick]

Thanks, Alan. I'll take a look.

[Alan H]

A further collection of those coming out against the Bill: Responses to the Government Consultation on the Saatchi BillT

Amongst those responding who did not support the draft Bill are:

The General Medical Council which has described the Bill as "unnecessary and undesirable".
Action Against Medical Accidents
The Academy of Royal Medical Colleges
The Royal College of Radiologists
The Association of Personal Injury Lawyers
The Academy of Medical Sciences
The Medical Research Council
The Wellcome Trust
The Medical Defence Union
The Academy for Healthcare Science which represents 50,000 healthcare scientists working in the NHS
The NHS Health Research Authority
Robert Francis QC
The Motor Neurone Disease Association
Cancer Research UK
The Patients Association

[Alan H]

I have put together a list of the responses I know about: http://cloudpage.co/medical-innovation-bill

I've not published the Nightingale Collaboration's yet but will post it here when I do.

[Nick]

I have put together a list of the responses I know about: http://cloudpage.co/medical-innovation-bill

Do these include responses (if there are any) from any groups which one might regard as part of the same peer group? (ie excluding those we would both regard as quacks) . (That may be clear if I read them, but being short of time, I'll have to catch up later.)

I've not published the Nightingale Collaboration's yet but will post it here when I do.

I'll look out for it.

[Alan H]

I have put together a list of the responses I know about: http://cloudpage.co/medical-innovation-bill

Do these include responses (if there are any) from any groups which one might regard as part of the same peer group? (ie excluding those we would both regard as quacks) . (That may be clear if I read them, but being short of time, I'll have to catch up later.)

I believe these are all against if to a greater or lesser extent. Although I've not seen any submissions, I have heard that some quack organisations and their supporters are very much for the Bill. That is, in itself, more than sufficient reason to oppose it!

[Alan H]

An excellent summary of the problems with the Saatchi Bill campaign and their tactics: The Saatchi Bill Campaign – So Untrue it’s Not True

[thundril]

I thought the Saatchi Bill was Maggie Thatcher's election campaign budget?

[Alan H]

I thought the Saatchi Bill was Maggie Thatcher's election campaign budget?

[Alan H]

I've updated my list of responses and articles, including ours.

[Alan H]

It's not everyday I am cited* in the bmj (OK, I think this is a first!), so I'm making sure I tell you about it...

Why there is no legal or medical justification for the Saatchi bill

Unfortunately, you need a login to read it, but it's yet more criticism of the Bill, saying there is no evidence it is needed.




* OK, it's only my list of Saatchi Bill responses, but still...

[Tetenterre]

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[Dave B]

+1

Keep telling you, Alan, you keep getting mentioned like this and you will become a member of the community of experts so far as the media are concerned!

Well, I suppose you are . . . sort of.