The Second Reading of the dreadfully misconceived and dangerous Medical Innovation Bill took place in the House of Lord’s last Friday. Condemned as a Quack’s Charter for attempting to remove legal protections from patients against maverick, quack and incompetent practice, the team supporting the Bill have been relying on emotive language and anecdotes about cancer patients to push this through.
Lord Saatchi started the debate with a condemnation of doctors in cancer wards,
“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”.
So wrote Charles Dickens, 150 years ago. It sounds medieval—barbaric even—does it not? Yet much the same can be heard in every cancer ward in every NHS hospital every hour of every day, with only one difference. In Dickens, the condemned were sentenced to death by a court of law. I am not aware that the cancer dead or the victims of any other terrible disease are guilty of any crime. Death by hanging, by firing squad, by electric chair—no human being has ever devised a more brutal execution than death by cancer. Perhaps only the Benches of the right reverend Prelates can advise us on the vexing theological question of why bad things happen to good people.
Either way, those condemned by cancer suffer a worse fate than the worst mass murderer. While they await execution, they are tortured.
This is the sort of rhetoric that we can usually expect from the ‘cut, poison, burn’ cancer quacks. Although Saatchi’s intentions are born from his own loss, there appears to be a very strong anti-medical worldview in how he is pushing forward his Bill. Indeed, one of the major criticisms so far is that the Bill team have failed to take into account the significant and consistent concerns of the medical profession.
I am sure many doctors involved in the care of cancer patients will find these words highly offensive. Cancer can be a brutal disease. And for so many, there are only limited answers as to what can be done and often the treatment can appear to be equally brutal. But to suggest that doctors are personally condemning their patients to death in a ‘medieval’ way is absurd. Care and compassion abounds within our health service.
Saatchi continued,
All cancer deaths are wasted lives. Scientific knowledge does not advance by one centimetre as a result of all these deaths, because the current law requires that the deceased receive only a standard procedure—the endless repetition of a failed experiment. In this way, the current law is a barrier to progress in curing cancer. It defines medical negligence as deviation from standard procedure. In other words, any deviation from standard procedure by a doctor could currently result in a verdict of guilt for medical negligence.
Saatchi has repeated this claim several times that cancer deaths are wasted lives. It is as if our lives are measured by what we can add to medical knowledge at the end. Perhaps, Stephen Sutton MBE might offer an alternative vision. Or even just the countless good lives that have to end in one way and perhaps through cancer.
And in any case, what Saatchi says is just incorrect that doctors have to stick to some rigid formula in treatment. Each patient is different and treatment regimes vary according to the patients needs, make up and wishes. Doctors may not offer unproven treatments precisely because the consequences are not know and may well not be in the best interest of the patient. Suck it and see approaches might quite rightly be seen as negligent.
The rest of the debate was pretty depressing – with a few exceptions. Most Lords accepted what Saatchi was saying at face value. Most worryingly were Law Lords who did not appear to understand the nature of the Bill in front of them and the corresponding law. There were dissenting voices.
Baroness Masham said,
The Bill’s provision may have no positive impact on innovation. It will have no effect on funding, research programmes, clinical governance or professional and medical product regulation. Properly considered, the law already protects a doctor against an allegation of negligence if he innovates responsibly.
She systematically set out the problems with the bill and finished up with,
I have two questions. What evidence is there to suggest that doctors have been discouraged from using innovative treatments for conditions such as Parkinson’s due to concerns about litigation? How many clinical negligence claims in recent years have been linked to innovative medicine?
For taking her time to spell out the problems, Lord Newby (Liberal Democrat) responded,
My Lords, perhaps I may remind the House of what I said at the start of the debate; namely, that it is a firm convention that the House should rise at around three o’clock on sitting Fridays.
Heaven forbid that discussion of such a Bill that might wreck lives drag on and spoil the Lord’s chance to knock off early.
Fortunately, Lord Winston expressed his dismay at such a rebuke,
This is a Bill of colossal importance and to truncate speeches to six minutes, even though it is a Friday, seems to be highly undesirable. It needs to be discussed because there are many implications behind this piece of possible legislation.
Lord Winston was one of the few Lords that appeared to have considered the criticisms of the Bill seriously. He warned his peers,
I conclude with the words of Michael Baum, one of the leading innovative surgeons in cancer in this country, whose contribution to breast cancer is second to none. He has said to me that in his view, “Their Lordships are walking over a precipice if they pass this Bill”.
The government response to the debate came from Earl Howe who made the rather chilling remark,
Noble Lords have highlighted the need to strike a proper balance between innovation and safeguards. That balance is a delicate one. Clearly, patient safety is vital and we would all agree that rogue doctors seeking to take advantage of patients with evidence-free treatments must be stopped. Yet a necessary focus on patient safety must not stifle responsible innovation.
Let’s just repeat that. A focus on patient safety must not stifle innovation.
What was so worrying about this debate is how little attention was actually paid to the views of doctors and medical lawyers. It was as if the Lords knew better and had to legislate in patients’ interests against stubborn professions protecting their interests. The Government did indeed consult on the Bill but that consultation has not been published. The Lords debated in ignorance of the views of the professions. However, on the site that I have set up with Alan Henness (Stop the Saatchi Bill) you can see collated all the responses that have been made public so far. Almost universally, doctors and lawyers, their professional bodies and medical charities have severe misgivings and fears about the Bill. You will not have known about that in the Lords debate.
Most recently, Sir Robert Francis QC, with the support of Professor Sir Ian Kennedy QC, has presented a damning critique of the Bill. It should be enough to stop the Bill in its tracks. It concludes,
This Bill is, like its two or three predecessors, based on the fundamental misapprehension that the law of negligence inhibits genuine and responsible innovative treatment.
Not only that, but for all its good intentions, it is actually dangerous for patients because it proposes “safeguards” which are illusory and which may give free rein to mavericks peddling dangerous remedies to vulnerable and desperate people.
To sum up my fears, let me quote from someone not in the Lords.
Chris Woollams, like Saatchi, is another person who has made his fortune through marketing. And like Saatchi, he lost someone close to him through cancer. Woollams ad agency was bought by Saatchi in 1986, However, after losing his daughter, Woollams set up a charity, CANCERactive that promotes all sorts of ‘complementary therapies’ for cancer. He describes himself as a “Cancer researcher” and “Britain´s leading writer on cancer”.
At this point I am totally in agreement with Maurice Saatchi who I know from my advertising days. Oncologists in the British health system have become myopic. It is very frustrating for two ex-admen to observe the medical profession at work. Love them or hate them, Advertising people at the top are very bright. They believe totally in the power of research. But as a guide. “Wise men use research, fools follow it” was David Ogilvy’s quote. Ad men then think inside and outside the box. They will use whatever it takes to get the job done. To deliver. We are just not the sort of people who would vaguely chuck a drug into someone in the hope it might work. And we would be very concerned about the side-effects and damage that might be caused, in the process. We are the mirror image of the majority of British oncologists. We have both seen their efforts first hand. It is no wonder we both scream that there must be a better way.
We should be very afraid of such words. Join us at http://www.stopthesaatchibill.co.uk/.
Chris Woollams quoting David Ogilvy – as if an insight that might seem witty in the world of advertising should influence government policy on a science? You have to wonder whether they’re actually taking this seriously.
The other day I was in a discussion with a lady who had also lost a partner to cancer, about twenty years ago now. She had been trying to get him in to the Bristol Cancer Centre – the one that was the subject of a scathing 1990 report in the Lancet.* He didn’t make it, because the waiting list was so long, but had he entered he would have been subjected to a “holistic” treatment regime of a strict nearly-raw vegan diet of tofu, pulses etc., coffee enemas, and injections of the surprisingly non-holistic “Vitamin B17”. The last-mentioned was a new one on me, but a bit of Internet research later had me doing multiple facepalms. Study after study has shown that Amygdalin and derivatives such as Laetrile (the one called B17) are ineffective as cancer treatments, and even the heavily-edited Wikipedia page describes it as a “quack” treatment.
She still believes that the Bristol centre would have helped – and maybe “holistic” treatments can make people *feel* better, which can be all that is possible in some cases. But how do I tell this lady – who’s also in to naturopathy & homoeopathy and thinks “chemicals” are evil – that this is only one of the many ways in which she’s fallen prey to quackery? The short answer is: I don’t. Her mother, who is much less gullible, is pushing 90, and yet I really can’t say who will be the first to go.
* http://www.brown.uk.com/teaching/HEST5001/bristol.pdf
Again and again Saatchi repeats the calumny that present laws inhibit innovation.
His persistence with this line displays all the hallmarks of an unhealthy obsessive, and a misinformed one at that.
Bernie (Lord) Ribeiro supports him. I have written to Bernie asking why? Where is the evidence of such inhibition.
Hope springs eternal, but should not be confused with wishful thinking.
Having worked in and around the medical research world for the past 12 years, I have experienced an alarming ‘self interest’ that is holding back the use and development of many new treatments. That self interest also means that treatments that have been through the full trials process and have bee ‘approved’ are not available to the general public. There are many factors that drive that self interest.
I do not see major issues with this Bill. What it may usefully do is to flush out the DH to issue guidance on all procedures around the world.
I write this having been seduced to go overseas some years ago for medical care that was a total waste of time.
The use of such emotive language by Saatchi betrays the lack of evidence for the proposed legislation. Typical of an ad man straying into territory he clearly has little understanding of.
As for the Woolams intervention, the idea that people from the ad World are incredibly bright is not my experience. They may be good with the bs, but that does not qualify them to comment on science. In fact the opposite should be true.
To condemn someone’s views because of their career – and a career where they have been an outstanding success – is not a valid reason. What is important to understand is that these people are clever, bright and, we might presume, are intelligent. If people use emotive language it is because in both their cases, they have ‘been through the system’ and have first hand experience of the issues. I doubt that most people commenting here have not. Until you have this sorry experience, you really don’t have a clue.
I think it is quite valid to criticism marketing people for having arrogant views that sees their skills and approach to life as giving them special insight into other highly specialised professions.
They did not call the TV programme Mad Men for nothing, I fear.
The two people everyone seems to be having a pop at are, first and foremost, people who have experienced the loss of a loved one, and have experience of working with health professionals.
They do not have experience of working with health professionals. In this context, they have experience of loved ones being treated by health professionals.
I am 100% confident that the healthcare professionals that treated their loved ones (or the 100/1000’s of researchers who do the basic science behind the treatments) did not give a flying duck that a couple of ad men think they are the “mirror image of the majority of British oncologists”. Their medical opinions are worthless.
I would like to add a point. Do you know that under the current ‘status quo’ it takes up to 10 years to get a cancer trial through the system? And even after Phase 3, the treatment may not be offered. Take the example of IORT – Intra Operative Radiotherapy. It has been through all the trials system for breast cancer – and so should be available to all patients. Is it? No. Why not? That explains why Bills like this are needed to open up the availability to all of treatments that have been tested. We have also seen the removal (largely) of patients being able to receive treatments (having gone through any level of approvals process) on a ‘named patient’ basis. So, choice is further limited. You must also look at the number of drugs that NHS England has arbitrarily removed from its list that it will pay for. This has still further reduced our choice of other ‘approved’ treatments.
If you were a patient who was deemed ‘terminal’, how would you feel if colleagues posting here could effectively limit your choice of treatments and possibly save your life.
Because I work ‘in the business’, I can point to medical people refusing patients treatments and literally bullying them to have what they want them to have.
Every patient is supposed to have their case reviewed by the MDT that assesses the different options. But in my experience, the options rarely include those offered at other hospitals.
It is worth pointing out the obvious that cancer treatment in themselves can be quite drastic and one needs clear evidence of the benfits and risks before undertaking them. Given that the vast majority of proposed treatments do not actually work, you can unerstand how it takes a long time to find the right treatments and understand their scope, risks, benefits an limitations.
Quite frankly, I do not want our doctors to be able to go back to a time when they can just suck it and see with whatever the latest faddish treatment some company or quack is pushing.
Dear Andy, there is little point having a discussion with someone who plainly knows next to nothing about how cancer (and other trials) are conducted. In Phase 1 – usually dose escalating – the intention is to confirm the drug doses etc required to achieve a given level of tissue destruction. Broadly, in Phase 2 you confirm this with another cohort of patients. So, by the end of Phase 2, you will have confirmed what Phase 1 told you. And in the Phase 3 randomised bit, you are comparing the new treatment with others currently available to see how it compares. I don’t think anyone is suggesting that Doctors and medics are just allowed to pump a patient full of anything without some pretty solid evidence!
Not so. Phase 1 trials assess toxicity and validate pre-clinical animal model trials. Phase 2 trials are first assessment of efficacy. Usually very small cohort of patients, possibly (and quite reasonably) chosen because there are good reasons to think they will benefit. Phase 3 is the first chance to look at efficacy in a cohort large enough to represent a patient population.
I think Edisson said something about innovation being 1 percent inspiration and 99 percent perspiration. There is no shortcut. Only careful systematic painstaking work produces reliable know how. The Saatchi bill seems to have behind it the idea that if only the 99 percent perspiration were legislated away we would be left with pure inspirational innovation. If only wishing made it so. Those working in such a framework would stagger chaotically from botched intervention to botched intervention. Never knowing if they were doing more good than harm, and never accruing the data to tell which, or to improve their understanding enough to make the next intuitive theortical leap to enable the dramatic increases in survival times we want.
Apart from curing my skin cancer on my ear, which my doctor wanted to chop off, with a Rife machine, I have no experience with cancer on my own body. But it made me interested in this terrible disease, particularly that friends and relatives are dying from it. One should have an open mind and be aware of the various treatments and cures, starting with nutrition. Unfortunately, GMOs, processed foods, soft drinks, overpopulation, pollution, the robbed earth from essential minerals, chemical pollution in the soil, plants and animals, atmospheric radiation and many others, needs us to become more aware of our health. Then it is up to us to make our own research and learn the various systems of dealing with health problems. Regarding cancer, we should watch Ty Bollinger’s long serial about cancer. Then it is up to us to decide if his interviews are credible or not.
Dear ‘gecor2014birkozo’ (or may I cally you ‘Birk?),
The entry before yours was in June 2014. Try to keep up.
And it would help you to check out:
http://www.cancerresearchuk.org/about-cancer/cancers-in-general/cancer-questions/rife-machine-and-cancer
“There are several websites claiming that the Rife machine can be used to treat a number of different conditions including cancer. Most of the claims on these websites are personal accounts. They don’t have any scientific research to back them up.”
Also please check out:
http://skepdic.com/naturalcures.html
“Ty Bollinger has a website and a set of videos promoting not only laetrile as a natural cancer cure, but baking soda and the alkaline diet as well many other natural cancer cures that aren’t really cures of anything. He’s an accountant whose research, he says, was driven by seeing several family members die of cancer….William M. London, a professor of public health at California State University, Los Angeles, has evaluated Bollinger’s work in several articles entitled “Untruths About Cancer in the Failed Quest for Cures”. These articles expose the various deceptive ploys used by Bollinger to foster mistrust in science-based medicine and trust in various forms of treatments that have never cured anyone of anything.”
I do hope you have not been taken in by quackery and that you have researched Rife’s bizarre concepts and Bollinger’s claims carefully.
May the Wu be with you.