Flickr/seanmichaelragan. Some rights reserved.
On 18th June 2015, an extraordinary letter was published in the Independent, opposing Lord Saatchi’s Medical Innovation Bill, which has been resurrected and returned to the House of Lords after being halted in the last Parliament. Written by the various Presidents or Chairs of the British Medical Association, the Royal College of Surgeons, the Academy of Medical Royal Colleges, the Royal College of Physicians, the Royal College of General Practitioners, the Royal College of Psychiatrists, the Royal College of Anaesthetists, the Royal College of Pathologists and the Royal College of Surgeons of Edinburgh, this letter effectively represents the UK’s medical profession, and they were united in their opposition to a bill they described as “unnecessary at best and potentially harmful to patient care at worst.” In opposing this bill, they join the GMC and the vast weight of legal, medical and patient protection organisations, who all understand that, far from helping find new treatments and protecting patients, it would harm research and patients alike. Saatchi claims that all honest opposition to his bill has been met. The Royal Colleges, then, are presumably dishonest opponents, in his opinion.
How will Lord Saatchi respond to this latest demonstration of the opposition to his bill?
He could ignore it and hope nobody notices, as he did with the majority response to the official government consultation on the bill, and the Assembly Government for Wales, who voted unanimously to oppose it as “a solution in search of a problem, and not a very sound solution at that.”
Or he could vilify this opposition, as he did when a group of more than 100 experienced oncologists wrote to the Times to oppose the bill, casting them as Downton Abbey toffs riding past in their carriages, and saying of them “How I pity their patients.” The simile was somewhat ironic for a member of the House of Lords whose own supporters include several other peers and a member of the Royal family.
Alternatively, he could simply claim these organisations support him anyway, as he and his campaign team erroneously claimed the support of Cancer Research UK, the GMC, the unanimous support of the House of Lords and indeed these self-same Royal Colleges who have always opposed his bill. When Lord Saatchi’s campaign website says they aim to win back support, they overlook the fact that to win somebody back, you need to have had their approval at some point in the past.
What he is unlikely to do is change. It is ironic that, while claiming to promote innovation, Lord Saatchi is bringing back to parliament exactly the same bill that failed to pass last time. The medical world has moved on, with major developments in the promotion of innovation and early access to new treatments. The legal world has changed as well. But Lord Saatchi is still stuck in the past, clinging on to a bill that describes an archaic world which we are continually moving further beyond, if it ever existed at all.
The areas where Lord Saatchi has innovated are in the creative use of PR as a substitute for facts, and in the bending of parliament to his will. Indeed, onlookers have been left floundering for their books on parliamentary procedure, all while Saatchi's campaign says one thing and does another, ratcheting the bill forward while everybody is scratching their heads or looking the other way.
It is difficult to express the brazenness with which this is happening. While his website rejoices in how much debating time the bill will now have, Saatchi seeks to bypass normal procedure to push it through the Lords in a single day, using a provision usually reserved for national emergencies.
At the same time, a second bill has quietly appeared in the Commons. Called the “Access to Medical Treatments (Innovation) Bill”, there has been no detailed description of this bill and no draft has been published. But Lord Saatchi himself is clear that this is his bill under an assumed name. Running the same bill under two different names simultaneously in both Houses of Parliament is certainly innovative. It is not, however, conducive to the full and careful scrutiny that those concerned about the bill’s ramifications will have been hoping for.
It must be acknowledged that Chris Heaton-Harris MP, under whose name this new bill appears, says he wants to start afresh. This could represent a positive step. But what he says does not quite match with what Lord Saatchi is saying, and it is questionable how much free will he will be able to exercise under Saatchi’s gaze. Saatchi has demonstrated himself remarkably impervious to expert advice. In the Lords, only seven of more than two thousand words of amendments suggested by his colleagues were actually accepted, and those seven were the removal of a redundant phrase. There isn’t a single word of the Saatchi bill that does not have Lord Saatchi’s imprint upon it.
And we have been here so many times before, cranking the handle on the same tired process of pretending the latest inept tweak to the text of the bill obviates all previous criticism, while somehow not obviating any claimed positives, and making everybody go round the loop again. What this bill needs is to be torn up and a proper attempt made at tackling the real barriers to innovation. Is Heaton-Harris in a position to do this with his Commons bill? Until we’re allowed to see a draft, we cannot tell for certain, although Saatchi says it’s his Bill, and he ought to know. And, all the while, the original version with Saatchi’s name on still works its way through the House of Lords, with the motion to pass it through every stage in a single day currently scheduled for 22nd July.
What can be said with some certainty is that the version of the bill currently being actively steam-rollered through the Lords by Saatchi doesn’t do anything to help patients. All it does is armour-plate doctors who make treatment decisions that no other doctor would support, for any condition, not just terminal illness. It places their treatment decisions beyond question. As Dr Malcolm McKenzie puts it, “If you need a law to protect you before you try an innovation you need to ask yourself if you should be doing that thing.” Believing that this bill could not be terribly misused is tantamount to saying it makes it impossible for a doctor to act negligently. A brief skim of the supposed safeguards in the bill should make clear the folly of that belief.
There were strenuous attempts to introduce safeguards into the bill throughout its original passage through the Lords. The last attempt, by Lord Winston, would have reintroduced a requirement for responsible behaviour, but it was swatted aside by Lord Saatchi’s “one team” partner, the Department of Health, which had been “bad cop” to Saatchi’s “good cop” throughout the Lords discussion, preserving the bill from outside influences in what Saatchi’s campaign describe as a “joint enterprise” between the Department and Lord Saatchi.
Saatchi’s campaign team has claimed they wanted Lord Winston’s amendment, and to be disappointed it didn’t get through. So the fact that it does not appear on this latest incarnation of the bill tells us that Lord Saatchi is more interested in expediency than quality, because amending the bill means having to discuss it, and the bill does not stand up to scrutiny. He is more interested in getting his bill passed than in getting it right.
Parliament needs to stop playing his game.
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