Medical Innovation (No. 2)
Michael Ellis (Northampton North, Conservative)
I beg to move,
That leave be given to bring in a Bill to make provision about innovation in medical treatment.
It is a great honour to bring this Bill, which was introduced in the other place by my noble Friend Lord Saatchi, to the Commons. I want to take this opportunity to thank the many supporters of the Bill in this House and outside it, who come from across the political spectrum. The fight against cancer and other diseases is one cause that engenders widespread support.
Cancer, as we all know, is a scourge on society and affects the lives of millions of people in this country, so this Bill is about how we can help liberate doctors to innovate and how we can help those deeply dedicated doctors in their drive to find cures and improvements to what are in some cases very stale and even ineffectual treatments.
Cancer will touch almost every person in this country at some time in their life. Many hon. Members will have places of excellence in their constituencies where scientists may research, doctors treat, nurses care and volunteers comfort. In my constituency of Northampton North, for example, the first-class Cynthia Spencer hospice provides devoted and invaluable hospice care for those suffering from this terrible illness. For all these efforts, though, there is always more that can and must be done.
The Bill could make every doctor a researcher and every willing patient a research participant. This country has already produced 34 Nobel prize winners in medicine, but we want more so we must ensure that the UK stays ahead, and to keep pace with what is happening, we must radically change the way we innovate.
The NHS is an amazing asset to innovation because it has a huge wealth of information, all consented to, all anonymised, that is helping it find new answers. The end result could be that every willing patient was a research patient, which would mean that every time a patient used the NHS, they would be playing a part in the fight against disease. Echoing those words, the Government’s life sciences adviser, my hon. Friend George Freeman, is joining me by sponsoring the Bill.
Unfortunately, that vision, which is shared by doctors and charities, might soon hit a roadblock—a seemingly immovable object—of the law, so that is what the Bill is designed to remedy. Let us imagine that a doctor is standing beside a patient and considering a sensible, peer group-approved innovation, to which full consent has been given, after other options have been exhausted and there is little else that can be done. At the moment, that doctor is stopped by the law—or the fear of the law, which is the same thing. The doctor must ask himself, “Do I really want to go along this route of innovation because, if I do, I will depart from the ‘standard procedure’, and then if anything goes wrong, there will be a trial at which I could be found guilty of medical negligence. Should I put my livelihood, family and reputation at risk, or should I stick to the well-worn
path from which no liability can arise?” The law at present obliges the doctor to follow the status quo, even though they know full well that that standard practice leads only to a short period of poor life quality followed by death, and that is how scientific discovery is blocked by the current state of the law.
That is not how it was in the past, when innovation happened much more readily. For example, penicillin did not face such roadblocks. Present law, however, mandates that patients receive only the standard procedure, which is really the endless repetition of a failed experiment. The problem is that the law defines medical negligence as a deviation from that standard procedure, so the law’s insistence on following the standard procedure is really a barrier to progress on curing cancer. Any doctor’s deviation from standard procedure is likely to amount to medical negligence.
Standard procedure is defined simply as a procedure that would have been followed by a competent body of medical persons skilled in the aspect of medicine in question. However, innovation, by its very definition, is something new—a deviation from what went before that did not work. Without deviation from standard procedure, there is no innovation and nothing changes, and the treatment of many cancers has not changed for decades, which is one of the reasons there is no cure for cancer.
In one medical negligence case, it was said in court:
“The practitioner who treads the well-worn path will usually be safer from legal liability than the one who adopts a newly discovered method of treatment.”
The result of all this is that a doctor deciding how to treat a particular case starts with the knowledge that as soon as he or she moves away from existing and established standards within the profession, there is an automatic and serious risk that he or she will be found guilty of negligence, if the treatment is less successful than hoped. When there is only one established practice, even if it is the same course of treatment that has been applied unchanged for 40 years without any particular history of success, it will be impossible for a doctor to depart from it with confidence that he or she will not be exposed to litigation.
Some might ask why a change to the law is suddenly so urgent. It is because while the law may not have changed much, society has. The number of lawsuits filed against the NHS has doubled in four years. Last year’s payout was £1.2 billion. The Treasury provision for claims against the NHS has now reached £19 billion. Doctors are therefore increasingly frightened of being sued and even less likely to feel able to innovate. Furthermore, risk-management processes in the NHS and insurers’ policies only strengthen this roadblock to innovation. A growing fear of litigation has stifled innovation, which is why we need a change in the law to realise the well-expressed vision that every doctor can be a researcher.
We certainly do not want patients to be treated like mice, so the Bill would set out in law for the first time the obvious difference between reckless experimentation and responsible, scientific innovation. The Bill actually strengthens the ability of the medical profession to prevent reckless conduct and to control innovation properly. The good doctor will therefore feel safer in the work that he or she does, and the bad doctor will more easily be revealed as negligent.
How will the Bill do that? It will require the formal approval of any proposed innovation by a hospital’s multi-disciplinary team of doctors, so not only will the innovation need the fully informed consent of the patient, but a hospital’s own multi-disciplinary team of doctors will have to approve it. This is a severe test, more severe than the two doctors’ authorisation that is required by law in order to carry out, for example, an abortion under the Abortion Act 1967, or the two psychiatrists needed to authorise sectioning someone in a mental health institution under the Mental Health Act 1983. Under those provisions, the authorisation of two medical professionals is required. To authorise innovation as I propose, a panel of medical professionals will need to consent. It is a severe test, but however severe, it is better than the current position, in which the road ahead to any innovation in cancer treatment is closed by law.
The Bill will not cure cancer. It will be doctors who cure cancer. This legislation, however, will give those wonderful doctors of ours the certainty they need to innovate and eventually find the cure that will bring such joy to all whose lives have been affected by this dreadful disease. I commend the Bill to the House.
Question put and agreed to.
Michael Ellis accordingly presented the Bill.
Bill read the First time; to be read a Second time on