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In the "Twitter-world" information pings through at the touch of a button

Oven I lay in bed listening to the usual mix of end-of-a-quiet-news-day trivia on late-night BBC Radio 5-Live when my mobile phone sparked to life. It was a text from a friend in the US; Michael Jackson was dead.

Quite why my friend thought it was worth texting me is still a bit of a mystery. Nevertheless, he was dead and I knew it. In fact, I knew it before the BBC did. It was a full 20 minutes before the chit-chat was parked and reports emerged that Jackson had died. News was confirmed; opinions were sought and speculation was piled on conjecture. It was a ragged piece of live broadcasting.

The power of the internet (still only 20 years old) and its newer cousins - Twitter, blogging, YouTube and Facebook, means we no longer have to depend on edited, distilled and filtered news stories from formal sources.

As the police in London learned, to their cost, at the G8 demonstrations this year, a citizen in possession of a £20 mobile phone with a camera in it can wreak havoc with careers, reputations and the 'official truth', and cost millions in enquiries, panels and investigations.

Redefining the establishment
Public opinion can be sought in a moment. Current affairs programmes used to have to wait several days before they knew the opinion of the audience. Listeners and viewers had to 'write in'. It takes an atypical person to sit down, pen an opinion, buy a stamp and post a letter. But these days, the moment something is broadcast, programme editors are inundated with texts and emails.

Political advisors monitor public opinion and policy is shaped. A forest fire of views can torch a policy and panic the herd at Westminster.

Did you see the headline recently stating that new and innovative drugs may be able to bypass NICE?

Here's the story: Science minister, Lord Drayson, from the Office for Life Sciences (who is a former drug company boss), has proposed that drug companies with "innovative" medicines be able to bypass current safeguards and sell to the NHS at a high price under a fast-track procedure.

The so-called 'innovation pass' will be piloted in 2010/2011 with a budget of £25m.

Lord Drayson claims the pass will enable the NHS to become an "innovation champion" and allow "the most innovative new medicines, which target a small patient group, like – for example – late-stage cancer, where that group is not big enough to generate the patient data, to enable a full NICE appraisal to be done".

I don't know about you, but I have my reservations about the 'innovation pass'. The NHS could end up spending a shedload of money for a shedload of stuff that doesn't work. NICE might be clunky, but it does work.

I wondered what doctors thought and so I rang the BMA press office. A very polite person took copious notes of who I was and what I wanted and promised to ring me back by the close of the day. The end of the day came and went and at 11am the following day someone else called me from the BMA and asked me the same questions all over again.

I must say they are very polite!

A day later this arrived by e-mail: "We would welcome more detail about these proposals, in particular the mechanism by which the innovation pass would be used to collect actual usable information for NICE to discuss. There would likely be some practical problems, especially if a decision was made to withdraw a drug that had previously been available, and these issues would need to be addressed."

"However, the prospect of making innovative drugs available more quickly is obviously attractive to doctors, who are frustrated by some of the existing bureaucracy. It could also reduce the need for co-payments for drugs not available on the NHS, which we believe should be kept to an absolute minimum."

It was all very diplomatic and designed not to frighten anyone. Thank you BMA. But it didn't really answer my question. I wondered if, in the Twitter-world, there wasn't a better way of getting doctors' opinions?

Suppose just for a moment, I could ask one hundred doctors what they really thought and demand an instant answer to the question: should new 'innovative medicines' be able to bypass NICE guidance and be made available sooner?

Suppose I could know right away that 13 per cent were definitely in favour of it (provided good evidence was available).

What if I could find out immediately that 28 per cent would say "yes definitely", provided the drug was truly 'life saving'.

Wouldn't it be great if I could rely on the knowledge that 36 per cent would say "maybe" depending on the effectiveness of existing treatments?

How about finding out, on the spot, that 2 per cent thought no more innovative drugs were required, thank you very much!

Or, if I could be sure, immediately, that 21 per cent of doctors would say: "NICE guidance is crucial to end the postcode lottery."

Well, I can and I do, in an instant – well, in a couple of hours actually, not two days!

I got my instant feedback from Doctors.net.uk. I rang their office and asked them what doctors might think about the 'innovation pass'. Within minutes, they had framed the questionnaire, put it on their website and, almost immediately, some of the 30,000 doctors started to give their view.

I am not being critical of the BMA press office; they are not geared up for this. But to be relevant, they will have to be soon.

I am in awe of the electronic world, the Twitter generation and Doctors.net.uk. We no longer have the excuse of not knowing. The landscape of representing opinion has changed forever.

The Author
Roy Lilley is a (sometimes controversial) healthcare author and broadcaster.
To comment on this article, email pm@pmlive.com

19th August 2009

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