Lord Saatchi’s Medical Innovation Bill is bizarre and surreal but it’s no cartoon. It’s dangerous. The only thing light about it is the complete absence of scientific or legal understanding. Throughout the lengthy campaign Lord Saatchi has sought to suggest that his Bill will indeed cure or enable others to cure cancer. He has stated outright that the current law is the reason there is no cure for cancer. He published the startling ‘How Can an Act of Parliament Cure Cancer?’ as a guide to his plan and ensured it was disseminated on cancer treatment forums. More surreal than Jon Snow on skunk.
He has criticised doctors repeatedly for their “complacency” about it all. He has criticised oncologists writing in The Lancet, The Times and any other place they have disagreed with him. Such as the formal consultation. To which an overwhelming number of medical bodies, representative organisations and experts responded with a clear and resounding NO. These include the BMA, RCP, AoMRC, the MDU, MPS, GMC, RCSEd, RCS, RCPath, RCPsych, RCR, RCGP – the list goes on, and accounts for hundreds of thousands of doctors represented. It includes experts such as Sir Robert Francis QC, Chair of the Mid Staffordshire Inquiries – speaking for patient safety.
Lord Saatchi reminded us that “perception is reality“ – if the people perceive a problem there is one. Well, the perception of doctors and their representative organisations is that doctors and patients have no need for his Bill. The perception of Wales – which convened a committee that concluded the Bill was unnecessary and dangerous, and which then voted unanimously in the National Assembly on a cross-party basis against the matter is that doctors, and patients, have no need for his Bill.
But this has not been listened to. Indeed it has been met with complacency. Complacent disregard to the concerns raised and to what actually would help improve patient care or facilitate good innovation. Which seems a terrible shame for patients – particularly a few of ardent supporters who have spent probably 2 years of precious, currently limited, time on this project. They have thrown every ounce of passion and effort into fighting for this, for their child’s life. They have done this because they have been assured the Bill will help them. The evidence for this assurance is and always was entirely absent. The evidence against is overwhelming. This is more than a bit troubling. Saatchi’s view on doctors, the people who devote their lives to treating patients and those researching diseases such as cancer, and how they’re getting on, is also more than a bit troubling.
“The sentence of this Court is that you be taken from hence to the place of execution and that each of you there will be hanged by the neck until you be dead. And may Almighty God have mercy on your souls”
‘It sounds medieval—barbaric even—does it not? Death by hanging, by firing squad, by electric chair—no human being has ever devised a more brutal execution than death by cancer… those condemned…suffer a worse fate than the mass murderer. While they await execution, they are tortured.’
– House of Lords 27 June 2014
As Panorama showcased recently technologies in cancer care are improving all the time, as are results. While quackery and poor practice do exist, the Bill actually only benefits this concerning crew, and by happenstance maybe some other interests. The vast, vast majority of doctors are dedicated, extraordinary professionals who really do devote their lives to their profession, to their patients. To suggest otherwise is deeply insulting. Worse, it’s deeply misleading – arguably hinting to a very real lack of ability to understand what would possibly drive anyone other than self interest.
He has spoken with the same moral viewpoint on lawyers, too, using some pretty nasty tactics against one particular firm (a firm which specialises in human rights, assisting victims of abuse, victims of torture, those harmed in serious accidents and devastated by truly negligent clinical practice and events – as well as helping advocate for those who have been seriously harmed by drugs or other technologies, improving safety for others, helping challenge treatment decisions and gain access to treatment for patients). His remarks about them are disgraceful and revealing of a deep-seated inability to understand why people work for good, not only for self interest. Lord Blencathra, supporting Lord Saatchi’s Medical Innovation Bill on Radio 4 – 21 October 2014- went so far as to state that the country would be a much better place if lawyers were euthanised.
Where does he get these views from? About doctors and lawyers and scientists dedicated to finding new treatments and making them a reality for patients? Where does he draw the view that doctors fail to treat patients with the most appropriate treatments because they like the easy life for themselves? Because they fear for their livelihoods? the livelihood, the drive for most doctors is patient care. His view is that doctors care not one jot about their patients, do not act in their best interests and deliberately cause harm, then ‘torture’ them to death.
Where has he got his perversely wrong interpretation of the law? From where has he drawn the opinion that doctors don’t provide treatment in the best interests of the patient due to their fear of litigation?
It’s outrageous and wrong. He hasn’t got these ideas from any organisation that would know- the Medical Defence Union, Medical Protection Society, NHSLA, British Medical Association, APIL and others have all drawn blanks on even one case and have all been clearly and firmly opposed. He certainly hasn’t had any of his ideas confirmed in the consultation responses either.
He has ignored and insulted the medical profession and continues to do so. He has ignored the responses to his own consultation. He has ignored patient safety experts, patients, charities, academics and more. Lord Saatchi, as a peer in the House of Lords, albeit unelected, has a public responsibility. He holds a position of trust to both the public and to Parliament. He has stood in the House of Lords and erroneously stated the law. He has stood and compared doctors to medieval torturers, driven by unrelenting self-interest. He has stood up in the Lords and gained the trust of some members of the public; who he has used, unrelentingly, as media spokespeople – their tragic circumstance as his emotive hook to further his own interests. It’s just appalling.
But, perhaps I’ve been too hard on Lord Saatchi. Perhaps he was advised badly by someone he trusted. Like the public believing his position of authority and access to accurate law, perhaps he has fallen for a similar fate, dressed as a reliable trustworthy authority.
Lord Harry Woolf is perhaps most famous for his extensive civil reforms that were designed to drive down incidence and costs of litigation. While access to justice is very much down, costs of litigation overall have risen. Woolf, a crossbench life peer, once a member of the Conservatives, Master of the Rolls from 1996 to 2000 and Lord Chief Justice from then until 2005 – although not a medical lawyer, is an impressive fellow with legal experience and such eminence whose views must have been unquestionably reassuring for Lord Saatchi. He trusted him.
So too have other non-legally-qualified individuals trusted him.
Professor Sir Michael Rawlins, writing in the BMJ in support of Lord Saatchi’s Bill, stated, citing Bolam as his anti-innovation example, that
‘Several legal authorities have pointed out that departing from what is regarded as “established practice” or “the standard of care” leaves a doctor open to legal action for negligence’.
In the comments section, he backs up his case, citing what he deems an irrefutable authority.
…Lord Woolf – the former Master of the Rolls and Lord Chief Justice – has an article published in today’s (24th April) Daily Telegraph explaining his reasons for supporting the Saatchi Bill. As my learned friends would say, “I rest my case”.
He then responds to the comments in a Letter – BMJ 2014;348:g3152 – citing his firm belief that he has got it right, as Lord Woolf said so.
‘The current law is clearly confusing even to lawyers. Poole QC and Conway, as well as Bewley, claim that the bill is unnecessary, and that the existing state of affairs allows for “responsible innovation” along the lines of the Saatchi bill. Lord Woolf—a former master of the rolls and a former lord chief justice—disagrees. In an article published on 24 April 2014, he stated: “what I do know about, from sitting as a judge, are the cases where doctors are sued for negligence because they have innovated in the treatment they offer, rather than following generally-accepted medical standards.” The Saatchi bill will bring much needed clarity to an area of law that even the most eminent lawyers disagree about.’
So how can you tell when it’s .. ?
Unfortunately, Lord Woolf has not been able to substantiate his suggestion that doctors have been sued and are sued for innovative treatment and are therefore so afraid of being sued for providing treatment in the patient’s best interests that, to paraphrase Lord Saatchi, they torture their patients to death, and this is why there is no cure for cancer, and this is why the current law requires a radical wrecking ball.
In fact, his authority for this does not exist. It does not exist even in the haziest recesses of recall. It does not exist in his book. It does not exist in case reports. It does not exist in the records of the Medical Defence Union, or the Medical Protection Society, or the Royal Colleges or the BMA or the NHS Litigation Authority.
‘My own reasons for giving my support to his plans – currently the subject of a Department of Health consultation that ends tomorrow – arise from my work as a lawyer. I have not, thankfully, had to face a similar domestic tragedy to his, but what I do know about, from sitting as a judge, are the cases where doctors are sued for negligence because they have innovated in the treatment they offer, rather than following generally-accepted medical standards.
In my experience, professional people are, on the whole, very conservative, and it is cases such as the ones I mention that make doctors frightened to try something different, something not yet fully tested, even when their patients give their consent, and when, as was the case with Josephine Hart and many others, they face certain death if standard procedure is all that is on offer.
Doctors don’t by nature want to step out of line, risk their professional reputation, or being labelled a quack by colleagues. That is, most of the time, a good thing. There should not be a culture in our hospitals of risk-taking with patients’ lives. But what is covered in these plans is a very specific set of exceptional circumstances, where there are potential benefits to allowing doctors to put their heads above the parapet.
…It shouldn’t require too much imagination to envisage those that these proposals might help. If you are a patient suffering with a terrible cancer, where conventional treatment has proved ineffective, your doctor may be aware of something else that could be of benefit, but which has not yet gone through the currently very long process of being fully tried and tested. It can take 15 years and £1 billion to approve just one drug. By the time that has been done, the patient will be dead.
At the moment, the doctor’s hands are tied – by concerns about professional reputation and potential negligence claims. That needs to change.
..Maurice Saatchi’s proposal is about is extending and saving life.’
When asked his authorities in a letter sent to parliament he replied in email correspondence:
‘In the time available, I cannot find references to the cases I had in mind when I wrote the article for “The Telegraph”. I am afraid that it is most unlikely that I will be able to do so even if I had more time but I apologise and have to ask you to accept my recollection, which is of cases I was involved in very many years ago.
My general position remains, however, what is needed is protection available before the event and not a defence, the existence of which can only be determined after a doctor is accused of departing from proper standards of practice.
Upon reading a piece about this very lack of an authority in Solicitors Journal he sent another email.
‘A person I assume who is known to you followed up what I wrote to you with what regarded as an unpleasant threatening request and I am not prepared to be cross examined further I can only say that I am disappointed that your interest in forensic matters does not make you willing to accept that having been appointed a judge in 1979 and having tried many cases depending on medical evidence that I doubt were ever reported it is now impossible for me to give you the information you seek and so if you do not accept my word that is your problem not mine.
Sent from my iPad
Harry Woolf ‘
He has dismissed all calls for evidence so incredulously that you know you wouldn’t want to be sat next to him dictating his response. But while everyone everywhere has drawn a blank, and requests for his authorities have been met with this ‘unrepentant’ wall, his words have been used with flourish by team Saatchi and the patients, families and other supporters drawn in by his authority on the issue. Including medical experts such as Professor Sir Rawlins. It’s concerning indeed if a meeting of Harry Woolf and Saatchi resulted in the unfortunate creation of the Medical Innovation Bill, and in drawing in supporters who had absolutely no way of telling that the premise wasn’t the real thing.