During the recent Department of Health public consultation meeting in Cardiff (18 March 2014) attended by doctors, academics and patients, we got some questions on Twitter we discussed.
Sean Kielthy – @LMKPartnership – in particular asked three questions which sum up what many others are asking.
1. ‘Defining experts [in the Bill]. A homeopath may be an expert in their field. How do we stop them getting in?’
Answer: 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.
Basically, you have to be a legally-recognised doctor. If not, the Bill doesn’t cover you.
2. ‘How do we keep the quacks out? [I want] science-based medicine only’.
Answer: Apart from the answer above – that you must be a doctor to be covered by the Medical Innovation Bill – you must also get the agreement of a panel of medical experts and other doctors before you offer a new treatment to the patient.
It is inconceivable that a quack doctor, treating a terminally ill patient, who comes up with a crazy ‘snake-oil’ treatment would get the support of a panel of other senior doctors.
To get agreement, the doctor will have to produce evidence or coherent reasons and a theory as to why the new treatment is worth considering.
The supporting doctors will be named as part of the sign-off process. At the moment, it is possible for a doctor to act alone without the agreement of senior and qualified peers.
So the Bill makes it harder for a quack to prey on a patient. After the Bill is passed, they will not be able to act alone.
3. ‘People in these situations [patients who are very ill] can be desperate. [I] don’t want to see quackery used and funding taken from science.’
Answer: Quacks will not be able to hide behind the Bill. In fact the Bill will expose quacks.
There is another question here, though – the cost of innovation. Will the Bill cost money? There is no logical reason to say that it will. An innovation may cost, it may cost less or it may cost nothing.
For example, it may conceivably be an innovation to do nothing. There are examples where it is felt that adjuvant chemotherapy for certain cancers may be at best only marginally beneficial, and that the associated potential side-affects of the treatment may outweigh the standard chemo treatment.
In this case, doing nothing would be an innovation. (This is not to advocate in any way that not having chemo is a good thing – it is simply a generic example).
However, if people argue that innovation costs money and that the Bill will inspire innovation and new and better treatments, then that is not an argument against the Bill – it’s an argument against all medical innovation and medical progress.
The Bill won’t divert resources from science. The Bill will help individual doctors help individual patients on a one-off basis.
By trying new ideas and techniques in this way, doctors will learn and the data they collect can be used by other doctors and scientists to inspire full medical trials and scientific discovery.
The Medical Innovation Bill works hand-in-hand with science to deliver new treatments for hard-to-cure diseases.