Stop the Saatchi Bill

Driven by an extraordinary two-year PR campaign on social media and a supportive newspaper partner, this all started as Lord Saatchi’s Medical Innovation Bill, metamorphosed through several versions, and was resurrected under a new name by Chris Heaton-Harris, before finally clearing its last hurdle in the Lords this week to become the Access to Medical Treatments (Innovation) Act.
Pretty much the only thing they share is the word 'Innovation' in the title.

One day, it may be possible for politicians to ask the people who actually work in the medical field: what are the problems you face, and how can we help you overcome them?

One day, politicians may actually listen to the answers they receive, and thus try to tackle genuine problems rather than imagined ones.

One day, politicians, medics, researchers, lawyers, patient groups, charities, and the public, may work together to overcome the barriers to the development and provision of new treatments.

But it is not this day.

Read more: Not this day

Pass the Parcel

Has the Saatchi Bill finally been tamed? Only time (and Lord Saatchi himself) can tell.

The Access to Medical Treatments (Innovation) Bill has passed through the House of Commons and had its First Reading in the House of Lords. A Bill that first appeared more than two years ago as the Medical Innovation Bill (also known as the Saatchi Bill) is back where it began, being steered through the Lords with Lord Saatchi at the tiller.

But this is now a very different Bill to the one Lord Saatchi originally launched with such fanfare back in 2013 (with versions going back even further than that). Back then, his perception was that doctors were prevented by the law of negligence from making use of innovative treatments. Allow a doctor to circumvent the law, as his Bill provided them with the means to do, and a cure for cancer would logically follow, it was claimed.

Unfortunately, this logic was deeply flawed, and the Bill’s basic premise was therefore completely false. Neither the law, nor fear of the law, prevents doctors from innovating. A veritable host of medical, medicolegal, research and patient protection groups lined up to tell Lord Saatchi that not only was this bill unlikely to help promote innovation, it could actually stifle innovation, hinder progress and at the same time was a risk to patient safety. Despite this advice, and the strong and clear response to a Government consultation on the Bill, the numerous drafts and redrafts of the original Medical Innovation Bill never really got to grips with its fundamental flaws.

After running out of time before the May 2015 election, the Bill re-emerged in two forms. The first, Lord Saatchi’s original, is still on the list of Bills before the House of Lords, awaiting a resolution to fire it through all debate in a single day.

The second is Chris Heaton-Harris MP’s Access to Medical Treatments (Innovation) Bill, also known as AMTIB. This explicitly took its inspiration from the Saatchi Bill, importing whole sections almost verbatim, and attracting the same criticism as a result.

Unlike Lord Saatchi, though, Chris Heaton-Harris has finally taken serious note of that criticism, and has realised that it is impossible to tweak sections of a Bill that are based on a false premise and somehow make them work. At the Report Stage of the AMTIB in the Commons on 29th January 2016, he followed through on a promise he had made to drop entirely the negligence provisions of the Bill. At a stroke, the most dangerous parts of the Saatchi Bill, carried over to the AMTIB, were no more. As Anne-Marie Morris pointed out, in disposing of these sections, Heaton-Harris has disposed of any similarity to the Saatchi Bill.

Does this mean that we can all now breathe a collective sigh of relief? Not yet, but perhaps we’re close. There are still a few potential pitfalls between now and when this Bill becomes law.

Firstly, the worst parts of the Saatchi Bill may have been excised, but the AMTIB is back in the Lords and under Saatchi’s control again. It is possible he may attempt to amend it to reintroduce some form of this original intent – to prevent doctors being sued when they harm their patients through negligent action.

Secondly, the original Saatchi Bill, in the form which ran out of time in the last Parliament, is still lurking in the wings. If Lord Saatchi is unhappy with Heaton-Harris’ stewardship of his Bill, he may seek to push forward with the original once more. It all hinges on whether Lord Saatchi is satisfied with what is left in the Bill he bequeathed to Chris Heaton-Harris, beyond the preservation of the words “Medical” and “Innovation” in the title.

The only point of similarity now is in the mention of some sort of register of innovative treatment, though the two Bills are quite different in how they go about tackling this issue. The Saatchi Bill merely points out that a doctor would be required to record their innovative treatments in a register if such a register came into existence and if there were professional requirements that they do so. Since it neither creates the register nor puts into effect the professional requirement to use it, this section of the Saatchi Bill is effectively meaningless.

The AMTIB goes a bit further, as it confers on the Health Secretary the power to create a database of “innovative treatments”, whatever that is taken to mean. However, as Heidi Alexander has pointed out, the Health Secretary already has this power, so it is difficult to see what if anything this provision adds, particularly since it was signalled at Committee stage that the Government intends to create a database regardless of whether or not this Bill passes.

Since the database of “innovative treatments” is now all that remains in the AMTIB, it is right that we should ask whether such a database would actually be of clinical benefit, and whether there are any potential pitfalls. It certainly seems to be unclear to Parliament what purpose it would have, since at Report Stage there was confusion about whether it was intended to be a register of innovation, of guidelines for use of innovative treatment or a register of clinical trials (which already exists), or even who would be expected to (or be able to) access it to search for new treatment possibilities.

The Saatchi Bill’s erstwhile campaign director claims that Lord Saatchi is happy with how things have turned out with his Bill. He says that the innovation database was “fundamental” to Saatchi’s Bill (though not, it should be noted, so fundamental that Saatchi actually included it in his original Bill, or in any of the subsequent drafts, or the 21 amendments he made before Lord Hunt threatened to force a vote on its inclusion).

For the sake of patient safety, we must hope that Lord Saatchi is, indeed, content.