They can, and of course many do. But many also tell us they fear it.

For cancers and other diseases with large patient groups trials exist.

But this isn’t the case for every disease.

Professor David Walker,  Professor of Paediatric Oncology Faculty of Medicine Health Sciences, University of Nottingham explains:

“There will never be enough trials, they take time and money, there are rarely trials for the less common diseases.

“So when patients are in a situation with “nowhere else to go” and if there is no trial for which they are eligible, they need to be able to try treatments that might work, based upon the best judgment of their medical advisors.

“We need to allow them to try such new drugs that may be applicable and collect that experience to inform the next generation of trials.”

→READ: There will never be enough trials

Innovating can be a high-risk enterprise, which many doctors seek to avoid.

There is a culture in the NHS that drives clinicians to stick to what are known as ‘standard procedures’. These are the prescribed norms of practice for any given illness.

Sticking to these gives the clinician protection in law in the event of a negligence claim – irrespective of whether the standard procedures are effective or not.

A doctor who, knowing his patient has little chance of survival, tries something new, even with the patient’s permission, may risk being taken to court or to a disciplinary tribunal, if the patient or their family later decides to sue or complain.

So, why try something new? Why innovate – when it is safer to stick to the well – worn path, even when that path leads to the death of the patient?

Professor Stephen Kennedy, clinical director of women’s services at Oxford University NHS Trust, told the Independent on 13th October 2013 he supports Lord Saatchi’s Bill because he said doctors are more risk averse in a more litigious culture, where they face being disciplined by the General Medical Council if they do not conform to standard practice.

“Doctors are afraid of being struck off for not following standard practice and they are afraid of how innovation is seen by the general public,

“The problem is particularly acute for rare cancers. What do you do when confronted with a patient with a rare cancer where the evidence base is not strong or when there is no evidence?”

→READ: the full article in the Independent

Professor Andy Hall, Associate Dean of Translational Research at Newcastle University and an expert on bone cancer, said:

“There have been major advances in some areas, but in others it has been agonisingly slow, and we are still left with treatments that are extremely blunt instruments.

“Take, for example, bone cancer. Treatment frequently involves amputation and extremely toxic chemotherapy. Lord Saatchi’s Bill draws attention to the need to innovate when the prognosis of an individual patient is poor.”

The process, as currently laid out in the bill, is as follows.

The doctor wishing to innovate will need to obtain the views of other medical doctors and seek consensus from them about the best course of action for the patient.

→READ: What is the legal meaning of consultation and consensus?

Should those doctors not support the planned innovation, the innovating physician will not be able to rely on the bill.

The option – and it will only be an option – must then be explained carefully to the patient.

This includes explaining the risks. In some cases this may mean explaining that the risks are unknown – especially when the treatment on offer is new.

The patient will always have the option to go through with standard procedures, or consent to the innovative treatment.

Patient consent is a requirement of the Bill.

The bill is still changing, as it proceeds through Parliament and therefore this process may be subject to amendment.

We will keep you updated.

No. The Bill can only be used by qualified and registered doctors. The term ‘doctor’ is a legal one and homeopaths (for example) would not be protected by the Bill, if it became law.

You have to be a legally-recognised doctor. If not, the Bill doesn’t cover you.

Medical doctors, patients and judges will have much greater clarity as to what is negligent and dangerous practice by clinicians and what is careful and reasonable innovation.

This will have two effects.

1/ It will allow good doctors who have the best interests of their patients at heart to innovate safely and responsibly, with the consent of the patient as long as they follow the transparent and accountable procedure that the Bill requires.

Doctors relying on the Medical Innovation Bill will know in advance that as long as they have followed the clear procedures of the Bill they will be protected from negligence claims in regards to the innovative medical intervention they have undertaken.

2/ It will expose mavericks and quacks.

Doctors will be required to follow the accountable and transparent procedure laid out by the Bill – which includes consulting with a multi-disciplinary team of senior medical experts.  It will therefore clearly expose the doctor who acts alone and in a reckless way.

Courts will therefore be able to adjudicate on good and bad clinical behaviour. A doctor who follows the correct process will be protected, allowing and encouraging responsible and measured innovation to take place, with the patient’s consent.

A doctor who does not go through the correct procedure and acts alone, as a ‘maverick’ can be clearly and easily identified.

→READ: Dr Max Pemberton – Why I back the pioneer Lord Saatchi

“It is a tragic indictment of modern medicine that innovation is too often jettisoned in favour of the status quo for fear of legal action. Defensive medicine is at the heart of so much clinical practice today, but the Bill – if accepted into law – would deftly excise this, leading the way for doctors to feel free to strive for medical advancement.

“This doesn’t mean that doctors would have free rein to experiment on a patient – they would still be bound by professional guidance and their duty of care would remain to their patient. Nor would it mean that the Bill would become a substitute for proper clinical trials.

“But what it does mean is that, in cases where the evidence is shaky, wanting or not yet clear, the Bill would set out a code by which doctors could try alternatives. It would provide a legal framework by which doctors, in discussion with their patients, could try off-label drugs or a device, treatment or intervention that might have some clinical data supporting it, but has yet to be fully proven.”

Professor Dean Fennell, Chair of Thoracic Medical Oncology, University of Leicester speaks at the House of Lords about why he feels the Medical Innovation Bill could help advance treatments.

Professor Fennell specialises in mesothelioma, a rare cancer most commonly caused by exposure to asbestos.