Lord Saatchi: 'Let new cures be tried out on cancer patients'
Doctors are too scared of legal action to try innovative treatments, the peer tells Steve Connor
Steve Connor is the Science Editor of The Independent. He has won many awards for his journalism, including five-times winner of the prestigious British science writers’ award; the David Perlman Award of the American Geophysical Union; twice commended as specialist journalist of the year in the UK Press Awards; UK health journalist of the year and a special merit award of the European School of Oncology for his investigative journalism. He has a degree in zoology from the University of Oxford and has a special interest in genetics and medical science, human evolution and origins, climate change and the environment.
Sunday 13 October 2013
An ambitious attempt by cancer doctors to make it lawful to take measured risks with their patients, when the standard medical treatment is almost certainly doomed to fail, has been blocked by the Department of Health.
The department is opposing a Private Members' Bill on medical innovation, on the grounds that there is no need to introduce legislation to protect doctors who try new and risky treatments that could lead to their being sued for medical negligence.
The Medical Innovation Bill by Lord Saatchi, whose wife, the author Josephine Hart, died of ovarian cancer, attempts to protect doctors from being struck off or sued when they prescribe innovative treatments that do not conform to standard medical procedure.
In an interview with The Independent on Sunday, Lord Saatchi said that he has received widespread support from different levels of government, as well as from the medical and legal professions. "There has been a wide consultation at all levels," he said. "I've yet to hear any objection to the Bill. It strikes people as necessary and logical."
"The view I've received from the medical profession is that there will be no cure for cancer until real doctors with real patients in real hospitals can attempt some kind of innovation, and that is not possible under current law," he said.
"It's not giving freedom to doctors to do what they want. We don't want patients to be treated like mice and we don't want reckless experimentation that puts patients' lives at risk. On the other hand, we do want bold, scientific innovation," he added.
However, sources close to the Department of Health said that officials will try to persuade Lord Saatchi that legislation is not necessary and that the existing law is more than adequate to encourage innovative, but risky, medical treatments.
"We welcome an open debate on how to encourage innovation in the NHS, but the current system does not prevent doctors from doing their best for their patients," said a spokeswoman for the department.
"There is nothing to stop doctors considering novel and innovative treatments to help their patients, but what is crucial is that patients are involved in the decision-making process and are fully informed of the risks and benefits of any treatment," she said.
Lord Saatchi's Bill goes through a crucial phase this week in the House of Commons, where it is about to enter the committee stage. It has received strong support from some sections of the medical profession concerned that doctors are fearful of being sued or struck off if they veer away from standard medical practice, even when the outlook for patients is dismal.
"The problem is that cancer is relentless, remorseless and merciless, and that treatment is medieval, degrading and ineffective. Therefore, we can all agree that more innovation is required to reach a cure for cancer," Lord Saatchi said.
"Under current law, any deviation from standard procedure is likely to result in guilt for medical negligence, that is because current law defines medical negligence as deviation from standard procedure," he added.
"Therefore the doctor is obliged to stick to the well-worn path even though the doctor knows that it leads to poor quality of life, followed by death."
Lord Saatchi's wife of 27 years, Josephine, author of Damage and a number of other best-sellers, died two years ago. She had a rare tumour that can be hard to treat because so little is known about it from large-scale clinical trials – the gold standard for evidence-based medicine.
Professor Stephen Kennedy, clinical director of women's services at Oxford University NHS Trust, supports Lord Saatchi's Bill because he said doctors are more risk averse in a more litigious culture, where they face being disciplined by the General Medical Council if they do not conform to standard practice.
"Doctors are afraid of being struck off for not following standard practice and they are afraid of how innovation is seen by the general public," Professor Kennedy said.
"The problem is particularly acute for rare cancers. What do you do when confronted with a patient with a rare cancer where the evidence base is not strong or when there is no evidence?" he said.
Andy Hall, professor of experimental haematology at Newcastle University and an expert on bone cancer, said: "There have been major advances in some areas, but in others it has been agonisingly slow, and we are still left with treatments that are extremely blunt instruments.
"Take, for example, bone cancer. Treatment frequently involves amputation and extremely toxic chemotherapy. Lord Saatchi's Bill draws attention to the need to innovate when the prognosis of an individual patient is poor."
Lord Saatchi's Bill proposes that doctors and patients agree on a non-standard treatment only with the approval of a multidisciplinary team of experts. This would circumvent the risk of litigation if it went wrong, Lord Saatchi believes.
"Lawsuits against the NHS have doubled in the past four years. The payout last year was £1.2bn," he said. "The Treasury's provision for likely liabilities for medical negligence claims against the NHS is now £23bn. That is up £4bn from last year."
"It is not logical to believe that this climate does not create a risk-averse culture in which the safe path is the status quo. In those circumstances, science cannot advance," he said.
"I am more of the view that the insistence on the status quo in the law on the repetition of standard procedure is a block to scientific advance and, at least in part, an explanation for why there is no cure for cancer.
"The good doctor will be encouraged and the bad doctor will be more easily exposed than under current law."
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