Pallavi Bradshaw: Innovation doesn’t need a new law

pallavi_bradshawAt the end of last week, common sense prevailed. The decision was made that the Medical Innovation Bill would not get a second reading in the House of Commons, and therefore, would not progress any further in this parliament. Rather, there appears to be growing recognition of the need to take a step back and properly understand what innovation in medicine currently looks like. This is something that we at MPS have been calling for since the bill’s inception—and most importantly will ensure there will be a responsible, evidence-based response to this issue. Before introducing legislation it’s important to understand to what extent innovation in medicine is held back, what factors might be a barrier to innovation, and based on this evidence, what the solutions might be. My view remains that ultimately a new law just isn’t necessary.

When Lord Saatchi conceived the Medical Innovation Bill, he confidently claimed that the fear of being sued is ruining modern medicine and hampering innovation. There is no clear evidential basis for this claim. As a result, many in the medical profession were instantly sceptical. We all understand Lord Saatchi’s motivation for introducing this bill. However, too much of the debate around this bill has been driven by the heart, while evidence has been less forthcoming.

There are probably a number of factors which may hold back innovation in medicine and those need to be explored. For example, some clinicians report being fearful of deviating from NICE guidance for fear that it might lead to disciplinary action by employers or the regulator. Funding may also be a barrier. Many innovative techniques and treatments need significant funding—but where would the money come from? At a time when the NHS is making cuts and looking to save money, can a hospital trust justify spending a vast amount of money on an untested treatment? Finally, what might be perceived as a lack of willingness to innovate, might actually be an understandable lack of knowledge of the doctor. Not all doctors will have an in-depth expertise on what is potentially a niche area of practice, or be aware of all recent innovations.

The Medical Innovation Bill was flawed because it appeared to assume that both the money and the knowledge were available to all doctors at all times, but that the fear of litigation was holding them back. These assumptions mean that the bill would have had negative consequences for the doctor-patient relationship. The bill would have increased patient expectations about available treatment options and left the doctor as the bearer of bad news when treatments the patients asks for are unavailable.

There is nothing to suggest that the Medical Innovation Bill would have led to a more pioneering medical field. Innovation is necessary in medicine and doctors find new ways to treat patients all the time. However, innovation without due care and proper safeguards goes against what all doctors hold true—act in the best interest of the patient.

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Pallavi Bradshaw is the medicolegal adviser at the Medical Protection Society. 

Competing interests: I have read and understood BMJ policy on declaration of interests and declare that I have no competing interests.