Lord Saatchi: "To prevent more needless cancer deaths, doctors must be free to innovate"
A new Bill before the House of Lords will allow doctors more freedom in the kinds of treatments they can prescribe to cancer patients.
In this guest post, author of the Bill Lord Maurice Saatchi, whose wife Josephine Hart died of cancer in 2011, explains why he's determined that the bill should become law.
Author, The Medical Innovation Bill
Posted on: Mon 20-Jan-14 14:20:53
(107 comments )
All cancer deaths are wasted deaths.
For many forms of the disease no new treatments have been developed for decades. Treatments remain brutal, painful and often ineffective.
But doctors are forced, by law, to offer only the standard treatments for cancer – or indeed any disease – even when the doctor knows that the patient is dying, and the standard treatment will not help.
We need innovation; we need to try new treatments where the old ones are known to lead only to death. But doctors are hampered by the courts: if doctors don’t follow the standard procedure they could be sued – a risk most are not willing to take. The NHS predicts it will face a bill of up to £24 billion for legal cases in the coming years, and the figure is rising.
And of course, when a doctor is sued - even if they win their case - the stress, isolation and fear they go through can wreck their careers and their lives. This is why most doctors will not offer you anything other than the standard treatment - even if they know it won’t be efficacious. It’s the only safe course for them, legally, and so they are doomed to repeat an endless cycle of failure.
And by this maddening repetition, nothing is gained, nothing new is learned, no lives can be saved the next time round.
This is why I say cancer deaths are wasted deaths: when a patient dies of cancer, medical science is not advanced one inch. No other cancer patient, now or in the future, will benefit, and no lessons will be learned that will improve treatments for others.
When a patient dies of cancer, medical science is not advanced one inch. No other cancer patient, now or in the future, will benefit, and no lessons will be learned that will improve treatments for others. But we can change this: we are on the brink of a great medical moment.
But we can change this: we are on the brink of a great medical moment.
I have introduced a Bill into the House of Lords that will, if it becomes law, protect doctors who want to try something new, who do not want to watch their patients dies needlessly. The Saatchi Bill is about creating a movement of patients, like you, to change the law which stops doctors trying new treatments.
First, it means doctors will be protected if they innovate reasonably and carefully. To do so they must of course have patient consent and the agreement of other senior medical experts and practitioners. They cannot go it alone.
But if they get this consent, reasonably and carefully, they can then innovate - safe in the knowledge their lives and livelihoods will not be in jeopardy if the treatment fails.
Second, it will stop maverick doctors from experimenting recklessly on patients. It will, in fact, tighten the law making it much harder for doctors to carry out untested treatments unreasonably.
This Bill is a patients' bill – it's for you and me. With it we can go to our doctors and say: "Have you tried everything? I understand there is a treatment out there that might help – can you try it on me? I have nothing to lose." And the doctor, for the first time ever, will be able to say yes.
But we're not there yet. The Secretary of State for Health, Jeremy Hunt, says he will support the Bill and ensure it becomes law in the next session of Parliament – but only if the public want it and show that they want it, clearly and loudly. In February the Department of Health is launching a public consultation asking if doctors, lawyers and if you – patients and public – support the bill.
We have one shot at it, and one shot only. If we fail, there is no second chance. I ask you to support the Bill, to respond to the consultation - and to ask your doctor, your MP and your friends and families to support it too.
Sign-up here to be the first to hear when the consultation launches. Follow us on Twitter @SaatchiBill and Facebook - and do tell us what you think. Have you wanted different treatment but couldn’t get it? And would you like to see the Bill become law? We’d love to hear from you.
By Lord Maurice Saatchi
This is dangerous rubbish. Cinical research is highly regulated for a reason and cancer patients are already free to enroll on research studies if they choose to. we are making huge advances in clinical research every day. Trisls exist to see whether new treatments are more effective than standard treatment. if they are then they become the new standard treatment.
I'm concerned that trials may be carried out without being subject to ethics committee approval which is a process designed to weigh up the interests of the subjects of the trial as well as the interests of the advancement of scientific knowledge.
It is the link to cancer that makes this statement absolutely insulting. As if we are not already pouring money into scientific research to understand the causes of cancer, as if any random Gp not already working in a research group is going to say 'Ah well, I think if you rub a bit of lineament into it three times widdershins we may just discover the cure!'
The other thing that seems very strange to me is the reference to the widespread use of off-label drugs in the States which is far more litigious than the UK (my several degrees of magnitude) but where new treatments are often offered to patients with far fewer safeguards than in the UK.
A while ago I used to work for a PCT and was on a group that heard requests to fund extra-ordinary treatment (I have public health training but was really there for process related reasons so not a contributor to the debate). All sorts of requests came through, most outside of standard treatments. Some for treatment abroad, some for treatment generally deemed ineffective or cosmetic. The reason they came to us was because they all involved additional costs. Most were denied on the grounds of lack of evidence of effectiveness or because there were alternative treatments available already, some were agreed on individual grounds. I imagine such a process continues today in the new commissioning groups because it was legally required (blanket bans having been held as illegal in a court case some time before).
I do not personally believe that there would be a cost saving from introducing a resource intensive vetting process (because there would need to be research into what the current literature said about any proposed treatment, and input from a number of specialists) that then provided greater access to new treatment options, many of which would involve additional cost. This might be offset against a small part of the litigation budget , but it would be a small part. I've been out of the NHS for over 5 years but when I was involved I did see claims data, and can confirm that the vast majority of the costs were related to birth injuries, which makes sense as they cover lifetime costs.
If this innovation is limited to end of life cancer patients I really can't see how multiple large payouts would be avoided because they are unlikely in the first place. For example my father recently died from brain cancer. He was terminally ill by the time it was detected and it was agreed that aggressive treatment wasn't an option. If his oncologist had suggested something new and novel, tried it and it failed and we had sued then what damages could have been awarded? He was dying anyway, surely the point is that there was effectively nothing to lose (except his quality of life in the last few months).
If the issue is purely one of risk aversion then I would have thought it was a matter that could be addressed with clinical protocols, guidance etc.
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