Tag Archives: medicalinnovation

Prof Chas Bountra talks about crowdsourcing science & medical innovation

Chas Bountra is a visionary. A human dynamo who seems to generate his own energy, who doesn’t know the meaning of ‘impossible’.

More formally, he is professor of translational medicine and head of the Structural Genomics Consortium at Oxford University.

Like many scientists working to develop new molecular entities – drugs to you and me – he realises the system is broken littered with barriers and blocks. It takes too long and is too expensive to develop new drugs for killer diseases.

He has said: “The cost of developing new drugs is spiralling. Analysis by Forbes [in 2012] showed that it cost as much as $12 billion to produce one new successful drug. “Most of the cost pays for failed projects that never see the light of day. From 1996 to 2009, research costs have almost tripled, while the number of drugs approved for use has more than halved. “Drug companies do similar research in parallel and in secret, and usually do not share their failures – and 90 per cent of potential therapeutic compounds fail.

It’s madness. “If companies shared their failures they would prevent each other going down blind alleys – and it would mean patients wouldn’t be used as guinea pigs for drugs that another company already knows won’t work.”

And like Lord Saatchi, he knows there is not one single answer to the problem.

His focus is on encouraging big pharma to share the results of their research so that both development time and costs decrease.

Like Lord Saatchi, he is pushing for greater innovation and recognises that the Medical Innovation Bill can play a part in speeding up the drugs discovery pipeline.

No one on the Bill team says innovation doesn’t happen now. It does. But, that is not an argument against more innovation.

As long as there are incurable diseases we must dedicate ourselves to greater, effective, innovation.

Prof Chas Bountra has been in the news this week (16th Feb 2015)  as part of a group scientists pooling their resources to work together on a treatment for dementia.

We visited him at Oxford University last year. In this video he talks about his support for the Medical Innovation Bill, highlights a few of the challenges within the industry and talks about the innovative work of the Structural Genomics Consortium at Oxford University.

 

When relying on the Bill must medical experts who are offering their views to the doctor who is treating the patient actually see the patient?

It is often most efficient and effective for doctors to discuss the principles of treatment without examining each others’ patients.

This is not new and already happens currently.

Doctors will decide for themselves what information they need in order to offer views on treatment, and whether they need to see the patient – as is the case now.

GMC guidance or hospital protocols will also be relevant.

Solicitors Journal: Saatchi Bill will stifle explosion of NHS litigation

Solicitors-Journal

 

Published in the Solicitors Journal 6th January 2015

There has been much heat generated by the debate over the Medical Innovation Bill. Only recently, some described it as a ‘PR war’.

It is – or ought to be – no such thing, and I appeal for calm consideration on all sides.

For two years, Lord Saatchi, parliamentary counsel Daniel Greenberg and I have been talking to doctors, lawyers and patients about how best to encourage medical innovation in order to facilitate better, faster and safe discovery of more effective treatments for currently incurable diseases.

Indeed, we have held meetings with leading medical negligence lawyers and have adapted the Bill accordingly, and it has changed in light of the feedback and challenges given.

This feedback has been gratefully received, by the concerned parties mentioned, as well as former senior judges, politicians and former opponents.

Few would agree that the medical status quo is working well for patients with rare diseases for whom randomised clinical trials (RCTs) are not an option – often because there are few trials open to them, because the cohort numbers are insufficent to populate them.

→READ: Why there will never be enough trials by Professor Walker

But let me be clear. This is not in anyway a derogation of the importance of RCTs. Evidence-based medicine is the gold standard. And it is why we are still committed to logging on a central, open database all innovations under the Bill – so that incidental evidence can be built up and taken forward to full RCTs.

It is, however, a statement of what to many is obvious; RCTs are not the answer for every disease type and every patient. One size does not fit all.

An example – and there are many – how many trials are open in the UK to patients with aneuroendocrine tumour? The answer is one.

Putting aside the fact that the trial is not about researching a potential cure, but comparing two current treatments, neither of which will save lives, there is an exclusion list that rules out many patients.

I am one of them. Two years ago I was diagnosed with a nueroedocrine tumour. I had surgery. If it comes back, I will be excluded from this trial because I am an insulin-dependent diabetic.

In short, there is no trial available. This is the case for so many currently incurable diseases.

Under the Bill, a doctor can be given the necessary confidence, in appropriate cases, to investigate and, if appropriate, offer, an innovative treatment to such a patient outside an RCT.

However, the Medical Innovation Bill is only one of a raft of initiatives that either are – or should – be in play. No one – including Lord Saatchi – claims this Bill is the silver bullet.

As an aside, Lord Saatchi did once pose the question: ‘How can an Act of Parliament cure cancer?’ He answered his own rhetorical question thus: It can’t – but it will enable the men and women who will. It is a question that has unintentionally riled those who have allowed themselves to get angry about the Bill. I say again, this Bill is no cure-all, but is an important step forward.

Bolam test

What does the Bill do? In short it brings forward the Bolam test to a pre-treatment setting. Doctors wishing to avail themselves of protection under the Bill must build a responsible body of medical opinion prior to treatment, rather than hoping they can construct one after the event, if they are sued for negligence or threatened with disciplinary proceedings.

This is designed to give doctors and patients certainty and clarity at the point of treatment, and therefore the necessary confidence to proceed and innovate.

First, this does not mean a doctor must follow this procedure. Some doctors, especially high ranking ones in centres of excellence, may be confident to innovate now.

Others tell us they are not. This Bill is for them. Doctors will have a choice – to rely on Bolam or the Bill.

To defeat a claim of clinical negligence under Bolam, a healthcare professional is required to adduce evidence from respected peers within their speciality who agree with the standard of practice which is the subject of the action..

Under Bolam, a defendant doctor will not be deemed to have been at fault, providing his or her course of action is one that is professionally backed by appropriately experienced colleagues, even if certain other members of the medical profession may take an opposing view. The Bill requires the same, but in advance and with greater clarity.

There has been much made of the requirement in the Bill to ‘obtain the views of’ other doctors, rather than requiring their ‘agreement’ to proceed.

We considered introducing a requirement for agreement, and were persuaded against it by senior doctors. They were worried that being asked formally to approve a colleague’s proposed course of treatment would act as a deterrent, and doctors would feel reluctant to do so without having a complete history. However, they would be happy to feed in their own views, as they already do in many contexts.

As with the Bolam test now, a responsible body of medical opinion supports the treatment – unanimity is not required – so that no one consultee has a veto on a patient’s treatment,

Instead of consultation taking place after the event if the doctor is sued, under the Bill it will take place prior to treatment: views have to be obtained, and there is an express requirement to give effect to them in a reasonable way. The profession, and ultimately the courts, will give guidance on what that means in practice.

Doctors simply ignoring the views of experienced colleagues who were clearly opposed to the treatment could not expect protection under the Bill. And the same goes for doctors who simply surround themselves with ‘yes men’ to approve their proposed treatments.

Culture change

But the Bill is more than a prosaic piece of putative legislation. The Bill also works on another level.

It will allow more doctors to consider innovating as a matter of course, rather than defaulting to procedures that are known not to work. In this respect, the Bill acts as an agent of culture change. It has also stirred welcome debate on how we can drive innovation in healthcare.

Some opponents say the Bill targets the wrong issue. To them I say two things: first, it is an answer to some of these issues. There is a culture of defensive medicine growing in the UK, fuelled in part by the explosion of medical negligence suits against the NHS. This Bill will help to moderate that, safely and sensibly.

Second, it is now for people of goodwill to use the space created in the media by this debate to offer solutions to the problems faced by patients, for whom evidence-based medicine is chimera, and who will die waiting in the queue for the never-to-happen clinical trial.

Dominic Nutt works with Lord Saatchi and Daniel Greenberg on the Medical Innovation Bill

Published in the Solicitors Journal 6th January 2015

Amendments to be moved on report – 12th December 2014

Following the Committee Stage in the House of Lords on 24th October Lord Saatchi has tabled a set of amendments to be considered on Report on 12th December.

The amendments were prepared by the Department of Health  to respond to concerns raised by peers and others at and around the Committee Stage.

We are very grateful for all the input we have received.

The Bill is going through the usual Parliamentary process and amendments are part of that process.

→READ: The Bill has been amended many times. Why?

→READ: Download the amendments on the Parliament website.

The following explanatory notes have been prepared by parliamentary draftsman Daniel Greenberg.

MEDICAL INNOVATION BILL [HL] EXPLANATORY NOTES TO AMENDMENTS FOR REPORT TABLED BY LORD SAATCHI
ON WEDNESDAY 3rd DECEMBER 2014

Introduction

  1. On 3rd December 2014 Lord Saatchi tabled a set of amendments to his Medical Innovation Bill to be considered on Report on 12th December.
  2. The amendments were prepared by the Department for Health to respond to concerns raised by peers and others at and around the Committee Stage.
  3. These Notes explain the manner in which the amendments meet the concerns expressed.

Transparency: patients’ notes; and recording outcome of consultation

  1. Some peers wanted details of decisions to innovate to be recorded in patients’ notes.
  2. Peers and others have also expressed a wish to see greater transparency about the nature of responses received by the doctor when undertaking the consultation with colleagues required by clause 1(3)(a) and (b).
  3. Amendment 1 requires the results of the consultation to be recorded in the patient’s notes, together with details of the doctor’s decision to innovate.
  4. There has also been pressure to turn the requirement to consult colleagues into a requirement to obtain colleagues’ written consent. These amendments do not give effect to that suggestion. Senior doctors consulted by Lord Saatchi expressed concern about giving formal written consent to another doctor’s proposed course of treatment, without knowing the full history and other circumstances, while they would be relaxed about expressing a view of the soundness of the doctor’s proposal as described to them. Lawyers consulted were also concerned about a possible new form of legal liability for consenting doctors. The requirement to record views in the patient’s notes should introduce the necessary formality, transparency and accountability, while avoiding both of these objections.

Preservation of existing law about clinical trials and other forms of research

  1. It has always been the intention of the Bill to make no change of the law relating to research (see clause 1(5)). But concerns were expressed that this needs to be made even clearer.
  2. Amendments 2 and 3 are designed to put the point beyond possible doubt.

Exclusion of cosmetic surgery

  1. At the Committee Stage and elsewhere suggestions have been made that the Bill should be confined expressly to the principal kinds of case at which it is aimed, namely relatively rare terminal cancers and other terminal conditions.
  2. Lord Saatchi has reconsidered attempting to define the intended scope of the Bill, but has found it impossible to do so in a way that answers more questions than it raises.
  3. Much of the concern has centred around the potential use of the Bill in relation to cosmetic surgery, and it was suggested that it could at least be made clear that it is not the purpose of the Bill to apply to that.

13. Amendment 4 accordingly excludes cosmetic surgery from the Bill. (Cosmetic surgery can of course in some cases be crucial to life or quality of life – as in the case of severe burns; doctors wishing to innovate in such cases will be able to rely on the existing common law Bolam test.)

Emergency treatment; and preservation of common law

14. Concern has been expressed whether in emergency situations doctors will realise that they are not expected to follow the procedures set out in the Bill.

15. Amendment 5 accordingly introduces a reference to emergencies, as an example of a situation in which the existing common law Bolam test would apply and a doctor might not engage the procedures in the Bill.

16. Amendment 6 recasts the principle that the Bill does not force doctors to rely on its procedures and that they can simply rely on the existing Bolam test in all cases. The new form is designed to meet concerns expressed as to whether the intention of existing clause 2(2)(a) was sufficiently clear.

17. Amendment 7 is a consequential amendment to reflect the numbering changes effected by Amendment 5.

Daniel Greenberg 3rd December 2014 

 

House of Lords – Committee stage round-up

On Friday 24th October 2014 the House of Lords committee stage for the Medical Innovation Bill took place.

The Bill has now passed through to the report stage.

Lord Saatchi has agreed to a round table discussion prior to the reporting stage.

Watch the full debate here

→READ: The bill as amended in the committee stage on 24th October 2014

→ READ : All the documents relating to the Bill and the committee stage debate

→READ: The debate in Hansard.

The committee stage included debating amendments produced by NHS medical director Sir Bruce Keogh on behalf of the Government that were laid down in Lord Saatchi’s name.

The amendments offered by Sir Bruce have met considerable favour among stakeholders – some of whom were previously concerned about the old version of the Bill.

For example the General Medical Council chair, Professor Sir Peter Rubin, said:  “Medicine is a risky business. There are many people alive today because of the willingness of doctors to innovate, deal with uncertainty and take reasonable risks which are understood, shared with, and consented to, by the patient in accordance with good medical practice. While we welcome the amendments to the Bill in Lord Saatchi’s name, we look forward to seeing the final version.”

→Read: Report in Telegraph featuring General Medical Council latest view.

And Cancer Research UK also made a positive statement about the new Bill.  Sarah Woolnough, the charity’s Director of Policy and Information, said: “We will monitor the Bill’s progress closely and hope we will see a greater focus on innovation thanks to this Bill.”

→Read: Cancer Research UK latest blog post on the Medical Innovation Bill containing the extract above (published 7th October 2014).

Media on the debate:

  READ: Telegraph: 20/10/14 – Saatchi’s Model Bill  

 

   
The above article is written by Dominic Nutt – who is part of the Saatchi Bill team.

We are working with Oxford University on an innovation database

Following feedback we received during the consultation Oxford University have offered to manage an open access database of treatments and outcomes received under the Medical Innovation Bill.

We were asked to ensure that results of innovations and outcomes that arise from the Medical Innovation Bill are publicly shared.

Medical Innovation Bill - Oxford University
We are working with Oxford University to produce an open access database of treatments and outcomes under the Bill.

This database will enable both doctors and patients to access information on treatments and the outcomes.

We are committed to including in the Bill an obligation on doctors that they must register innovative interventions in order to be protected by the Bill.

This obligation will be included as part of the statutory process during the Public Bill Committee Stage in the House of Commons.

Consultation launches in the House of Lords


Last week cancer bloggers, tweeters and patients united to make medical history in the House of Lords – at a Google Hangout in support of Maurice Saatchi’s Medical Innovation Bill.

Together we launched the Saatchi Bill public consultation – backed by the Department of Health and Secretary of State @Jeremy_Hunt.

The Bill will allow patients to ask for – and doctors to deliver – new and innovative medical treatments for rare and hard-to-cure diseases without fear of being sued.

The Government backs our Bill – and promises to pass it into law, if the public consultation is successful.

It all hangs in the balance right now. Nothing is certain.

But if the response we got from those in the room who came to hear Maurice Saatchi, patients, families and professors speak up for the Bill is anything to go by, we have a fighting chance.

You joined us in a Google Hangout and heard the arguments of Debbie Binner who lost her daughter, Chloë to a rare bone cancer, to Chloë’s best friend Mike Thomas and to Mavis Nye who is dying of mesothelioma.

They all want the Bill. They want innovation – not the endless repetition of failed medical treatments.

After the Hangout, #SaatchiBill twitter and blog conversations went ballistic. We want more of that and we want hundreds of people to respond to the government’s public consultation so that no politician can say the Bill is not needed or wanted.

As Mavis Nye told the room: “I’m terminally ill. I shouldn’t have to chase treatment. My oncologist can only give me what’s laid down by the national health system. I back this innovation Bill. I want it and I want it today – because I might not be here tomorrow.”

 

Telegraph: The man who 3D printed a pelvis: supporting the debate on innovation

imageConsultant orthopaedic surgeon Craig Gerrand with a model of a half-pelvis

→Published in the Telegraph 9th February 2014

Craig Gerrand, consultant orthopaedic surgeon at Newcastle upon Tyne Hospitals NHS Foundation Trust, used 3D printing to create a pelvis – the first of its kind – for a patient who had lost his to cancer. The man, a retired professional in his sixties, had been diagnosed with a rare bone tumour called chondrosarcoma.

“The cancer affected virtually the whole right side of the pelvis [the ring of bones that connect the base of the spine to the thigh],” says Mr Gerrand. “Since this cancer does not respond to drugs or radiotherapy, the only option to stop it spreading was to remove half of the pelvis.”

Standard implants, made by hand, do not always fit well – and in this case, so much bone needed removing that nothing would be left to which such an implant could be attached, he says. But without a reconstruction, the patient’s leg would be left “hanging”, unattached to the spine, and shorter than the other.

Which was why the surgeon offered him an extraordinary reconstructive innovation: to 3D-print half a pelvis, designed to fit precisely into the space left by surgery. There were, of course, risks – of such an implant failing to fit, or fracturing. “The patient was fully informed of these and decided to go ahead.”

Meticulous planning was needed if the operation was to have a chance of success. The first step was to fuse CT and MRI scans of the pelvis to calculate precisely how much bone would be removed, and the dimensions of the space that would be left behind. The data were used by a British company Stanmore Implants, to 3D-print a bespoke model of a half-pelvis, with exactly the same shape and dimensions as the bone lost by the patient. The 3D process, also called additive layer manufacturing, involves gradually building a three-dimensional shape by laying down successive, fine layers of titanium powder, fused together by laser.

The 12-hour operation was carried out using surgical navigation technology, in which images of the pelvis are uploaded on to a computer to create a model on the screen. “It’s quite easy with a complex organ such as the pelvis to get lost and take too much or too little bone. Using surgical navigation technology means you can cut the bone exactly where you planned to cut,” says Mr Gerrand.

The next stage was to insert the titanium pelvis, which fitted perfectly. It was covered by a mineral into which the remaining bone cells could grow. This procedure was followed by a standard hip replacement, which fitted seamlessly into the titanium socket. Just over three years later, Mr Gerrand’s patient is able to walk, albeit with a stick – and is still very happy with his 3D-printed half-pelvis.

Mr Gerrand welcomes the debate sparked by Lord Saatchi’s proposed Medical Innovation Bill, which would encourage doctors to innovate by providing them with a legal framework whereby they could try out unproven medical devices or treatments such as this.

Innovation is desperately needed in the development of new treatments for bone cancer, an area where there have been no improvements in survival – currently about 60 per cent – for 30 years.

“It’s fantastic that you can do cool surgery,” Mr Gerrand says, “but the real innovation will be when we don’t have to do this at all, because we have developed new treatments that can stop the cancer in its tracks.”

Read the full article in the Telegraph

What innovation will mean to me as a bowel cancer patient

image

By Charley Kitely

The definition of innovation according to the Collins English dictionary is ‘something newly introduced, such as a new method or device’. But, to a cancer patient, innovation means something much more.  It means opportunity, a chance and hope.

The Saatchi Medical Innovation Bill hopes to support doctors and scientists, providing them with the opportunity to question if there is a new way of managing cancer and the chance to develop treatment, perhaps even a cure. And then there is the hope doctors and scientists will refuse to accept that the standard procedure is good enough and consider a new way to treat cancer, providing people in my situation with the opportunity to test out their theory without the fear of legal recourse.

When I was diagnosed with bowel cancer in February 2012, I was asked my family history.  A quick phone call to my parents revealed that unfortunately my odds weren’t great – my paternal Grandfather had died 35years previously and my maternal Grandmother some 15 years ago, both to bowel cancer.

But surely that was a long time ago and medical research has come a long way?  I was only 33 when diagnosed, a young, fit and healthy mum.  Surely my odds would be significantly better?

Yet 35 years after my grandfather was being treated for the same disease, we are still tackling cancer in the same way – cut, burn and poison.  And whilst there has been moderate improvements on the potential side effects (for example I haven’t lost my hair, it’s just thinned and my stomach convulsions are dramatically improved with an injection prior to chemo), unless detected early, the ‘cure rates’ of bowel cancer remain disappointing. 

I’m not by any means detracting from the ground-breaking work doctors and scientists are doing in the labs. There have been massive advancements in life pro-longing drugs such as Avastin and more recently Aflibercept, which have worked to keep me here, with my young family a year over my ‘expiry date’ and we are detecting cancer much earlier with better screening, though for bowel cancer patients, this is from the age of 65, not much help when you’re 33!

And this is why the Saatchi Medical Innovation Bill is so important.  This bill will give doctors the opportunity to consider new drugs or techniques that could go on to save the lives of people like me.  People who at the moment are written off as incurable, where the best I am offered is a comfortable quality of (shortened) life.

I am, in terms of bowel cancer patient, young and (if you forget the minor cancer detail) healthy.  I lead an active life, from swimming with dolphins to teaching my 3 and 5yr olds to ski (clearly against Drs orders!), I refuse to be defined by or compromise my ambitions just because I’m fitting fortnightly chemo sessions into my life.image

Given I have tried and exhausted the traditional routes, I am now looking at alternative treatment programmes to get me out of this pickle. Trials and innovation could be the answer for me surviving this disease.

We need to encourage innovation, allowing doctors a more exhaustive list of treatments to try out. I need to be able to look my doctor in the eye and ask him if he really has tried everything and if not, what else can we try.

Of course this is not to suggest my doctor will suddenly run into a laboratory, mix some random drugs together, give me an injection and hope all will be better.

R&D and drug development takes years to bring to market and for every successful drug, there are hundreds that don’t make it. And of course there are the research hospitals that already give patients the opportunity to be considered for trials.

But, this bill will make it possible for me to push for a new treatment, accepting the consequences are for me to bear.  It returns some control to the patient (which is something many with cancer feel is lost when they are diagnosed) and encourages better education.  Surely this can only be a good thing?

As patients, we should be open to new, exciting and alternative treatments.

There may not be the vast numbers of patients in new research, but if more of us consider new treatments rather than being scared by it, these figures will increase, prompting further confidence for other patients. We should be taking responsibility as much as the doctors in finding a cure, not only opting in to research programmes, but also taking an honest view of what we put in and around our bodies.

For me, that means avoiding things that could be considered to encourage cancer growth (sugar and dairy) and instead surround myself with things that prevent further tumours (lots of green veg and turmeric).

Doctors need to be encouraged to think beyond what they have always done.  As Einstein once said, ‘insanity is doing the same thing over and over and expecting different results’. If we continue to treat cancer as we have for the last 40 years, we can only expect the same results – more people needlessly dying to a disease that could be curable.

Innovation has to be at the heart of the next stage of cancer research and the Saatchi Medical Innovation Bill could be the bill that makes the difference for doctors to be able to innovate and think outside the box we seem so snugly determined to remain in.

 

 

Mumsnet: Campaign of the week

This week Mumsnet are getting behind the Saatchi Bill. Here is the blog post Lord Saatchi wrote for them. Read it here on Mumsnet.

image

Sign-up here (http://eepurl.com/GcrZ9 ) to be the first to hear when the consultation launches.

And click here to follow us on Twitter @SaatchiBill and Facebook so we are ready to respond.

All cancer deaths are wasted deaths.

For many forms of the disease no new treatments have been developed for decades, and treatments remain brutal, painful and often ineffective.

But doctors are forced, by law, to offer only the standard treatments for cancer – or indeed any disease – even when the doctor knows that the patient is dying, and the standard treatment will not help.

We need innovation; we need to try new treatments where the old ones are known to lead only to death. But doctors are hampered by the courts: if doctors don’t follow the standard procedure they could be sued – a risk most are not willing to take.  The NHS predicts it will face a bill of up to £24 billion for legal cases in the coming years. And the figure is rising.

And of course, when a doctor is sued – even if they win their case –  the stress, isolation and fear they go through can wreck their careers and their lives.  This is why most doctors will not offer you anything other than the standard treatment – even if they know it won’t be efficacious. It’s the only safe course for them, legally, and so they are doomed to repeat an endless cycle of failure.

And by this maddening repetition, nothing is gained, nothing new is learned, no lives can be saved the next time round.

This is why I say cancer deaths are wasted deaths: when a patient dies of cancer, medical science is not advanced one inch. No other cancer patient, now or in the future, will benefit and no lessons will be learned that will improve treatments for others.

But we can change this: we are on the brink of a great medical moment.

I have introduced a Bill into the House of Lords that will, if it becomes law, protect doctors who want to try something new, who do not want to watch their patients dies needlessly.   The Saatchi Bill is about creating a movement of patients, like you, to change the law which stops doctors innovating and trying new treatments.

First, it means doctors will be protected if they innovate reasonably and carefully. To do so they must of course have patient consent and the agreement of other senior medical experts and practitioners. They cannot go it alone.

But if they get this consent, reasonably and carefully and if the patient wants them to, they can then innovate safe in the knowledge their lives and livelihoods will not be in jeopardy if the treatment fails.

Second, it will also stop maverick doctors from experimenting, recklessly, on patients. It will, in fact, tighten the law making it much harder for doctors to carry out untested treatments unreasonably.

This Bill is a patients’ bill – it is for you and me. With it we can go to our doctors and say: “Have you tried everything? I understand there is a treatment out there that might help – can you try it on me? I have nothing to lose.” And the doctor, for the first time ever, will be able to say yes.

But we are not there yet. The Secretary of State for Health, @Jeremy_Hunt says he will support the Bill and ensure it becomes law in the next session of Parliament – but only if the public want it and show that they want it, clearly and loudly. In February the Department of Health is launching a public consultation asking if doctors, lawyers and if you – patients and public – support the bill.

 We have one shot at it, and one shot only. If we fail, there is no second chance. I ask you to support the Bill, to respond to the consultation and to ask your doctor, your MP and your friends and families to support it too.

Sign-up here (http://eepurl.com/GcrZ9 ) to be the first to hear when the consultation launches.

And click here to follow us on Twitter @SaatchiBill and Facebook so we are ready to respond.

And do tell us what you think. Have you wanted different treatment but couldn’t get it? And would you like to see the Bill become law? We’d love to hear from you.