The bill started out as an attempt by the Conservative peer Lord Saatchi to write a new law to encourage innovation in medical research. I have no doubt that the motivation for doing so was based entirely on good intentions, but sadly the attempt was badly misguided. Although many people explained to Lord Saatchi why he was wrong to tackle the problem in the way he did, it turns out that listening to experts is not Saatchi’s strong suit, and he blundered on with his flawed plan anyway.
If you want to know what is wrong with the bill I can do no better than direct you to the Stop the Saatchi Bill website, which explains the problems with the bill very clearly. But briefly, it sets out to solve a problem that does not exist, and causes harm at the same time. It attempts to promote innovation in medical research by removing the fear of litigation from doctors who innovate, despite the fact that fear of litigation is not what stops doctors innovating. But worse, it removes important legal protection for patients. Although the vast majority of doctors put their patients’ best interests firmly at the heart of everything they do, there will always be a small number of unscrupulous quacks who will be only too eager to hoodwink patients into paying for ineffective or dangerous treatments if they think there is money in it.
If the bill is passed, any patients harmed by unscrupulous quacks will find it harder to get redress through the legal system. That does not protect patients.
Although the bill as originally introduced by Saatchi failed to make sufficient progress through Parliament, it has now been resurrected in a new, though essentially similar, form as a private member’s bill in the House of Commons.
I’m afraid to say that the debate in the House of Commons did not show our lawmakers in a good light.
We were treated to several speeches by people who clearly either didn’t understand what the bill was about or were being dishonest. The two notable exceptions were Heidi Alexander, the Shadow Health Secretary, and Sarah Wollaston, chair of the Health Select Committee and a doctor herself in a previous career. Both Alexander and Wollaston clearly showed that they had taken the trouble to read the bill and other relevant information carefully, and based their contributions on facts rather than empty rhetoric.
I won’t go into detail on all the speeches, but if you want to read them you can do so in Hansard.
The one speech I want to focus on is by George Freeman, the Parliamentary Under-Secretary of State for Life Sciences. As he is a government minister, his speech gives us a clue about the government’s official thinking on the bill. Remember that it is a private member’s bill, so government support is crucial if it is to have a chance of becoming law. Sadly, Freeman seems to have swallowed the PR surrounding the bill and was in favour of it.
Although Freeman said many things, many of which showed either a poor understanding of the issues or blatant dishonesty, the one I particularly want to focus on is where he imbued the bill with magic powers.
He repeated the myths about fear of litigation holding back medical research. He was challenged in those claims by both Sarah Wollaston and Heidi Alexander.
When he reeled off a whole bunch of statistics about how much money medical litigation cost the NHS, Wollaston asked him how much of that was specifically related to complaints about innovative treatments. His reply was telling:
“Most of the cases are a result of other contexts— as my hon. Friend will know, obstetrics is a big part of that—rather than innovation. I am happy to write to her with the actual figure as I do not have it to hand.”
Surely that is the one statistic he should have had to hand if he’d wanted to appear even remotely prepared for his speech? What is the point of being able to quote all sorts of irrelevant statistics about the total cost of litigation in the NHS if he didn’t know the one statistic that actually mattered? Could it be that he knew it was so tiny it would completely undermine his case?
He then proceeded to talk about the fear of litigation, at which point Heidi Alexander asked him what evidence he had. He had to admit that he had none, and muttered something about “anecdotally”.
But anyway, despite having failed to make a convincing case that fear of litigation was holding back innovation, he was very clear that he thought the bill would remove that fear.
And now we come to the magic bit.
How exactly was that fear of litigation to be removed? Was it by changing the law on medical negligence to make it harder to sue “innovative” doctors? This is what Freeman said:
“As currently drafted the Bill provides no change to existing protections on medical negligence, and that is important. It sets out the power to create a database, and a mechanism to make clear to clinicians how they can demonstrate compliance with existing legal protection—the Bolam test has been referred to—and allow innovations to be recorded for the benefit of other clinicians and their patients. Importantly for the Government, that does not change existing protections on medical negligence, and it is crucial to understand that.”
So the bill makes no change whatsoever to the law on medical negligence, but removes the fear that doctors will be sued for negligence. If you can think of a way that that could work other than by magic, I’m all ears.
In the end, the bill passed its second reading by 32 votes to 19. Yes, that’s right:
599 well over 500* MPs didn’t think protection of vulnerable patients from unscrupulous quacks was worth turning up to vote about.
I find it very sad that such a misguided bill can make progress through Parliament on the basis of at best misunderstandings and at worst deliberate lies.
Although the bill has passed its second reading, it has not yet become law. It needs to go through its committee stage and then return to the House of Commons for its third reading first. It is to be hoped that common sense will prevail some time during that process, or patients harmed by unscrupulous quacks will find that the law does not protect them as much as it does now.
If you want to write to your MP to urge them to turn up and vote against this dreadful bill when it comes back for its third reading, now would be a good time.
* Many thanks to @_mattl on Twitter for pointing out the flaw in my original figure of 599: I hadn’t taken into account that the Speaker doesn’t vote, the Tellers aren’t counted in the totals, Sinn Fein MPs never turn up at all, and SNP MPs are unlikely to vote as this bill doesn’t apply to Scotland.