Withdraw Saatchi’s quackery billBMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g2974 (Published 29 April 2014) Cite this as: BMJ 2014;348:g2974
- Margaret McCartney, general practitioner, Glasgow
“Innovation” is a lovely word, with shine and goodness at its heart. Health Secretary Jeremy Hunt has said that Maurice Saatchi’s proposed Medical Innovation Bill1 would encourage “a climate where clinical pioneers have the freedom to make breakthroughs in medicine.” It could “lead to major breakthroughs, such as a cure for cancer,” Hunt said, by removing “barriers that prevent innovation which can save and improve lives.”2
This is misguided. Saatchi’s concern is for people with late stage cancer who “receive only the standard procedure . . . the endless repetition of a failed experiment.” The bill seeks to protect those doctors who make “responsible innovation” when most medical opinion would be unsupportive of their proposals.3 In Saatchi’s view, doctors who currently work outside standard procedure may be leaving themselves vulnerable to accusations of negligence.4
Clinical trials work beyond standard procedure. They help us decide which novel treatments work and which are simply dangerous. The number of patients with cancer taking part in a clinical trial has increased from one in 26 in 2002 to one in six in 2010.5
Bizarrely, the bill makes no note of this success, or the capacity to do better. Worse still, the bill expressly forbids the innovating doctor “to carry out treatment for the purposes of research.” This means that the patient would lack the protection of ethical research—including a systematic review of use of the proposed intervention before treatment, and guarantees that results will be published. A lack of learning would leave patients open to having the same bad treatment repeatedly—multiplying the harm, quite legally.
The only difference between medicine and pseudomedical nonsense is the use of—and ability to learn from—fair tests of treatments. This bill, therefore, is an open door to quackery. There are many expensive clinics already peddling false hope in the form of unproved or disproved interventions for cancer and other serious illnesses. They would legally be allowed to continue or expand, protected by this bill, allowing evidence-free opinion to masquerade as “responsible innovation.”
Much could be done to improve the status quo but it needs to be based on evidence. Evidence shows that people with cancer often lack information about clinical trials, for example.6 And the bureaucracy and delays surrounding research ethics committees are well documented.7
Saatchi’s bill dismisses the slow successes of evidence based medicine, instead offering a public relations quick fix that is heavy on emotion but light on potential harms. The intentions may be honourable—more honourable would be the bill’s withdrawal.
Cite this as: BMJ 2014;348:g2974
Competing interests: I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: I’m an NHS GP partner, with income partly dependant on QOF points. I’m a part time undergraduate tutor at the University of Glasgow. I’ve authored a book and earned from broadcast and written freelance journalism. I’m unpaid patron of Healthwatch. I make a monthly donation to Keep Our NHS Public. I’m a member of MedAct. I’m occasionally paid for time, travel, and accommodation to give talks or have locum fees paid to allow me to give talks but never for any drug or public relations company. I was elected to the national council of the Royal College of General Practitioners in 2013.
See Mike Rawlins’s recent Observations column, “The “Saatchi bill” will allow responsible innovation in treatment” (http://www.bmj.com/content/348/bmj.g2771)
Provenance and peer review: Commissioned; not externally peer reviewed.
Follow Margaret McCartney on Twitter, @mgtmccartney
Find out more about the doctor behind the column: read Margaret McCartney’s recent BMJ Confidential, “Singing the praises of evidence,” http://www.bmj.com/content/348/bmj.g2015