La-la-la-la (not listening)

(Have all those nasty people stopped criticising us yet?)

3rd June 2014

A lot of happenings have happened since I last wrote on this blog (was it really only three weeks ago?) on the subject of the Medical Innovation Bill – the so-called Saatchi Bill. One of those happenings was an invitation for me to write a guest post in the Grauniad on the subject, which has attracted quite a lot of attention. It also appears to have annoyed Dominic Nutt – the bill’s Communications Director – somewhat, to the extent that he asked for a section about the bill’s consultation process to be removed. Now, there’s a lot more to be said on that subject, and on a whole load of other matters that have come to light, but first mention has to go to the headline item of the week.

 

There’s a new draft of the bill.

 

Accompanied by another puff piece in the Telegraph (more on that soon), a piece in the Spectator and a fawning item on BBC Radio 4’s Today Programme with Evan Davis (link will expire, so here’s a blog post about it), the new, shiny, addresses all the concerns, definitely right this time, Medical Innovations Bill, is set for discussion in the Lords.

So it’s all fine now, right? Everybody happy?

Er, no.

The new draft is very short, less than 1½ pages, but the document is padded out to 42 pages by a “briefing note” which sets out the aims for the bill, and attempts to justify the need for it.

There is enough material here for at least a dozen posts, so… er… let’s make a start.

 La la la la la

The first challenge for the promoters of the bill is that the overwhelming response from professional medical bodies, charities and legal organisations, has been that the problem the bill seeks to address – doctors fear to innovate because they may be sued for it – is not actually a problem at all. That’s the view of the Royal College of Radiologists, Cancer Research UK, The Royal College of Physicians, the Academy of Royal Medical Colleges, the Academy of Medical Sciences, Medical Research Council and Wellcome Trust, the British Medical Association, the Medical Defence Union, the General Medical Council and the Motor Neurone Disease Association just for starters. These bodies question, even if there was a problem with innovation, whether legislation would be the way to solve it. In truth, doctors innovate all the time, and fear of the law is no impediment to them. This supposed fear of litigation is the fundamental underpinning of the bill, its justification for existing, and when it turns out not to be real, the bill itself should surely evaporate, shouldn’t it? How can this possibly be taken into account in the new draft?

Simple. They’ve ignored it, and ploughed on as all these organisations with direct experience of the matter at hand had not said anything at all. Effectively, they’ve put their fingers in their ears and gone “la la la la.”

I can’t emphasis this enough: the Saatchi Bill is absolutely rooted in the idea that doctors fear to innovate, and it is not true. This false starting point is then used as the foundation for the tottering edifice of the bill, and the false claims that are made for it.

I’m going to divert for a moment here, as in the past few days I’ve had a chance to see an earlier “guide” to the medical innovation bill that was apparently circulated to interested parties – patient groups, medical charities and the like – before the consultation process. This was a means for the Saatchi Bill team to whip up support for the big push at the consultation. And boy did they whip it up. Sofia’s excellent blog page goes into more detail.

 HOW CAN AN ACT OF PARLIAMENT CURE CANCER?

That’s the massive headline on the first page.

After a draft copy of the bill (not the same version as was in the consultation, mind you) the document then asks “Why do we need this bill?”. It then goes on to claim that current law requires patients receive only standard procedures (which is not true, as we have seen) asserts that any deviation from standard procedure is likely to result in a verdict of guilt for medical negligence (again not true, as we have also seen) before making this statement:

 This is why there is no cure for cancer.

I’ve taken this detour because I think it illuminates the Saatchi Bill mindset, which pervades all the bill team have done and said. Right there, in black and white, page 7 of the guide. Doctors can’t innovate, they claim, and because they can’t innovate we don’t have a cure for cancer.

But none of this is true. Doctors can innovate, perceived failure to innovate is not the reason why we don’t have a cure for cancer, and it’s just the icing on the cake that actually we do now have effective ways of curing some cancers.

But that middle point again. If we had innovated more, would we definitely now have a cure for currently incurable cancers, as Saatchi claims? Well, no, and this should be straightforwardly clear. What the Saatchi campaign is doing here is acting like a gambling addict, who says, “I would have won the lottery if you’d just let me buy a ticket.” They overlook the fact that buying a ticket isn’t the only step between you and the jackpot. You’ve still got to choose the right numbers from millions of possible combinations.

My next two posts will look at key areas of the bill and show where the Saatchi team is indeed gambling, not with money but with lives, and with little prospect of any jackpot.

No protection against quackery

Related:

Other posts on the Saatchi Bill

 

 

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