All speaking at today’s Old Age Faculty Annual Meeting will have submitted a DOI

From: Vanessa Cameron
Sent: 26 March 2015 17:22
Subject: RE: Royal College of Psychiatrists and transparency: “Criticisms of yesteryear”?

Dear Dr. Gordon,
Thank you for sending this which I did see this morning – I enclose the College’s response via twitter:
 
@rcpsych is committed to our COI policy. All speaking at today’s Old Age Fac’ Annual Meeting will have submitted a DOI

Yours sincerely
Vanessa Cameron

Vanessa Cameron
Chief Executive
Royal College of Psychiatrists

Dear Ms Cameron,
Thank you for this. I am not on twitter (or any form of social media) and my communications to the Royal College of Psychiatrists have not been through social media.

I look forward to a reply from you by e-mail or letter with complete declarations of financial declarations of speakers, and those involved, with this RCPsych conference. I will share these on Hole Ousia.

Yours sincerely
Dr Peter J Gordon
GMC number 3468861

“A huge number of ‘bipolars’ are missed”

This letter has been published in the current edition of The BMJ:Quetiapine adverse reactions

Reading this letter my thoughts returned to a lecture given by Professor Allan Young at a Royal College of Psychiatrists, CPD-approved conference, in September 2014:Prof-Allan-Young2

Professor Allan Young gave no declarations of interest in his speaker biography:Outline of conference 26 Sept 14

Professor Allan Young’s speaker biography demonstrates that he is a “key opinion leader”:Prof-Allan-Young1

At the start of his talk Professor Allan Young put up this slide of his declarations of interest. Professor Allan Young did not talk through his declarations and the slide was not up long enough for the audience to read it through:

Prof Allan Young declarations 26-9-14

I recorded these quotes made by Professor Allan Young as given by him on 26 Sept 2014:

“For those of you who watch Panorama I do not give my consent for you to film this”

McQueen, 2011 “They missed out my trial” [Embolden trial]

CropperCapture[1]

NICE, for not taking it into account at all [Embolden trial] is rather questionable”

“Quetiapine as a mood stabiliser is the Holy Grail for Bipolar Depression” commenting on work “adapted from Peters”:

“Major Depressive Disorder (“MDD”) will generally end up as Bipolar Disorder”

“A huge number of ‘bipolars’ are missed”

“SParCLE study demonstrated that Lithium is slower than Quetiapine”

Professor Allan Young’s “Key Points slide” for “the pharmacological management of Bipolar Depression”P1030863

The forthcoming 52nd Maudsley debate. The motion is “This house believes that long term use of psychiatric medications is causing more harm than good”. One of those arguing against the motion is Professor Allan Young

52nd Maudsley debate 2015

Royal College of Psychiatrists and transparency: “Criticisms of yesteryear”?

For several years now I have written to the Royal College of Psychiatrists regarding an apparent lack of meaningful transparency regarding financial conflicts of interests in our profession.

A recent communication with the Royal College included discussion of the following Conference being held this week in Scotland:Old Age March 2015 RCPsych

I confirmed to the Treasurer of the Royal College of Psychiatrists my wish to take up the offer to be sent all Declarations of interest of those speaking and involved in this CPD approved Conference:

Nick Craddock on declarations March 2015

The current Chair of the RCPsych Ethics Committee is attending this Old Age Psychiatry Annual Scientific Meeting and stated:Chair of RCPsych Ethics Committee

Operational Guidance issued by the Royal College of Psychiatrists asks that the following three principles should be followed:Principles of RCPsych

The Royal College of Psychiatrists newsletter for this month comments on the Association of the British Pharmaceutical Industry register (or Central Platform as they have termed it) which will not be available till next year. This register, despite what this newsletter says, will have no “force” as healthcare workers can opt-out of revealing any financial payments:

RCPsych March 2015

It would seem very clear to me that what is happening, or perhaps not happening in March 2015, should not be labelled as that of “yesteryear”.

A Sunshine Act for Scotland: the petitioner’s views

A pdf version of the following letter can be accessed here on the Scottish parliament website.

Sunday, 15 March 2015

To: Public Petitions Committee
The Scottish Parliament

Dear Public Petitions Committee
Scottish Parliament Public Petition PE1493 on a Sunshine Act for Scotland
Thank you for informing me that my petition is to be considered by the Public Petitions Committee at its meeting on Tuesday 31st March 2015.

You suggested that I might like to make a written submission for the meeting of the Committee informing me that this would be published online with the other evidence that the Committee have gathered for Petition PE1493. Since my last submission to the committee I have received a letter from the Scottish Government dated 24th February 2015 [included below] which asks my views as petitioner on a number of specific matters.  With the permission of Gordon Clark, Scottish Government, I thought it would be sensible to offer my views in a single letter copied to all.

My preference has always been to keep letters to the committee to one page, but unfortunately on this occasion, given the number of questions asked by the Scottish Government, this letter requires to be longer. I will begin this letter with a current summary of my position as petitioner for a Sunshine Act and then, in the second half of my letter, do my best to answer the questions asked by the Scottish Government.

My summary position as petitioner for a Sunshine Act:
Gathering evidence and necessary research to support this petition has led me to conclude that the pharmaceutical industry has had significant control within Scotland’s health sector and that this has been met with very little opposition or even analysis.

Open and transparent from omphalos on Vimeo.

CropperCapture[3]

The Scottish Government has since confirmed that across Scotland its own guidance, HDL 62, has been widely ignored.

CropperCapture[4]

The Scottish Government position states that we should consider “existing legislation”.

The Scottish Government are of the view that we have two safeguards: (1) professional bodies and (2) “the significant progress towards voluntary registers by the pharmaceutical industry.”

Considering these in turn:

Firstly, regarding professional and regulatory bodies:
Niall Dickson, the Chief Executive Officer for the General Medical Council (GMC), the professional regulatory body for doctors, has recently stated that “Parliament has not given us powers”. This was the official GMC response to Fiona Godlee, Editor in Chief of the BMJ who stated in her recent BMJ editorial that “the profession must take the lead to protect patients and maintain public trust. The GMC should act, and a public register of UK doctors’ financial interests is long overdue.”

I have been in communication with the Royal College of Psychiatrists, the additional “regulatory body” of which I am a member. This recent communication, with the Royal College of Psychiatrists, relevant to this petition, can be read here. In summary the Royal College of Psychiatrists guidance again refers to local registers, as in HDL 62, which we know are not being maintained.

Secondly, the “significant progress towards voluntary registers by the pharmaceutical industry.”  (Scot Gov statement)
It is the case that the Association of British Pharmaceutical Industries (ABPI) have led on setting up what they have termed as a “Central Platform”. From 2016, this platform will gather individual payments and record these in an open, central, searchable database. However, it is the case that any healthcare professional can opt-out of any disclosure of any financial payments made to them on this platform.

The Scottish Government, in a letter to me dated 24th February 2015, [see annexe] asked my views as petitioner on nine separate points.  What follows are my responses as given under each Scottish Government question:

(1) Is your primary concern around ensuring appropriate prescribing?
This is my primary concern.

This is a longstanding concern based on the ethical principle primum non nocere “above all first do no harm”. My view, as petitioner, is that appropriate prescribing must try to achieve maximum benefit and minimum harm: a ratio crucial at both individual and population level.  Evidence has repeatedly revealed that harm and/or risks associated with prescribing may emerge only after the pharmaceutical industry has made its money. My view, as petitioner, is that “appropriate prescribing” in Scotland should follow evidence-based science that is free from financial conflicts of interest. Prescribing should be based upon scientific objectivity alone. Prescribing should not be determined by market forces.

One of my original motivations for raising this petition for a Sunshine Act was an appreciation that pharmaceutical companies use paid speakers, consultants and researchers to promote the off-label use of drugs in Scotland:

222

This is just one example of evidence that this happening. I covered a range of other examples in my original submission to the committee:

 (2) Who should have responsibility for keeping and updating information on payments (including payments in kind) received?
I would like to see an independent body that is set up to maintain a central, single, open, searchable register that is updated on a planned and scheduled basis and which is tied to professional accountability and governance. Such a register should include not just doctors, but pharmacists, academics, nurses, allied health professionals and indeed advisors to charities.

(3) What should happen in the event of non-compliance?
It is my view that any system that is developed to replace HDL 62 must include meaningful sanctions to be used in the event of non-compliance. There is always the potential for litigation following any harms caused.

From a practical point of view, enforcement would be likely to involve a number of different approaches. Failure to follow legislation may involve regulatory bodies. For example, in the case of doctors this would be with the General Medical Council.

CropperCapture[5]

“Non compliance” also has a dimension that may be beyond the employed individual. At least two NHS Boards in Scotland, NHS Lothian and NHS Forth Valley, have confirmed that they have zero budget to support medical education. The financial support of this education is thus solely through commercial arrangements. The details of this are covered here.

(4) Which professions and groups should be covered?
This should include not just doctors (both at primary and secondary care), but also pharmacists, nurses, academics, allied health professionals and indeed advisors to charities. It should also apply to any commissioners of healthcare services in Scotland including all those involved in improvement work.

As petitioner, part of my research confirmed in November 2013 that 44 separate Scottish Intercollegiate Guidelines (SIGN) guidelines had no records of declarations of interest. This concerns me greatly as does the limited governance of the experts involved in the Scottish Medicines Consortium.

1234

(5) Who/what should be covered by the terms ‘industry and commerce’?
The approach taken in France to legislation appears to be a reasonable model. The USA has also introduced Sunshine legislation. As petitioner, I would suggest that there is much to be learned from the approaches taken in France and the USA.

“Industry and commerce” might include: the pharmaceutical industry; device and implement manufacturers; and commercial enterprises involved in diagnostics, nutritional supplements and digital technologies. As petitioner, I would also suggest that academics, patient groups and charities are included.  In France, disclosure of financial support to patient organisations has been a legal obligation since 2009.

(6) Should there be a threshold for providing information on payments (including payments in kind) and if so what should that be?
I think this a matter that should be open to consultation. I would suggest a similar framework to that used by this voluntary database:

who pays this doctor

(7) If registers of payments (including payments in kind) were established what should the status of these registers be?
A national register requires legislation to be put in place to make it meaningful, robust and properly transparent. Timescales for submissions would be clearly defined. This register should be open to all with a link placed obviously on each NHS Board homepage.

All medical educational conferences held in Scotland should have a homepage link to this single, open, searchable database. Thus duplication of recording would no longer be an issue.

001

(8) Do you have experience of concerns raised by patients about these issues that you can share?
My experience of patients is that they trust NHS staff to be acting solely in their best interests. Sadly evidence demonstrates that this is not the case:

CropperCapture[7]

(9) Generally, what is your view on what a robust, transparent and proportionate response would look like fit for 2015 and beyond?
I hope that I have given an indication of my perspective on this. I am most grateful to the Scottish Government for seeking my views as petitioner.  I wondered if it might be helpful to conclude this letter with a range of views of some others who have also considered this area:

004Dr McCartney, General practitioner in Glasgow, BMJ Columnist, Broadcaster and Medical Author

CropperCapture[8]

010

CropperCapture[9]

Closing statement:
When politicians are held to higher standards than doctors, it is my view that it is time for tighter regulation of conflicts of interest in healthcare in Scotland.

Scottish Government guidance, HDL 62, has relied on self regulation and this clearly has not worked.

Moves by the drug industry are welcome but will encounter the same issues as HDL 62.

As a scientist as well as a student of humanities, my view is that Scotland’s wellbeing, reputation and worldwide standing would all benefit from taking a leading approach in this area.

I hope this update is of some assistance to the Committee ahead of the 31st March 2015.

Yours sincerely,

 Peter signature

Full details of all evidence I have collected for this petition, including my writings, publications and films, can be accessed from this one page.

Letter to the Petitioner from Gordon Clark, The Scottish Government, Healthcare Quality and Strategy Directorate, Pharmacy and Medicines Division.

Letter from Gordon Clark, 25 Feb 2015

Royal College of Psychiatrists: relationships with pharmaceutical and other commercial organisations

In response to my letter to the Royal College of Psychiatrists regarding relationships with pharmaceutical and other commercial organisations I received this e-mail from Professor Nick Craddock, Treasurer of the Royal College of Psychiatrists:

From: Nicholas Craddock
Sent: 13 March 2015 15:17

Dr Gordon
Thank you for your letter of 15th February concerning the revision of CR148 “Good Psychiatric Practice: Relationships with pharmaceutical and other commercial relationships”. The current report along with all other College reports is available on the College’s website.

This report has been reviewed initially by the Committee on Professional Practice and Ethics. Their draft has been sent for comment to the Psychopharmacology Committee and to representatives from the Academic Faculty including myself. The document will then be further revised in the light of comments received before being finally approved by the Policy and Public Affairs Committee. If you would like to submit any written comments perhaps you could send these to the Chair of the Policy and Public Affairs Committee as soon as possible.

The declarations of interests for speakers at the forthcoming International Congress will appear on the Congress App which is available to all delegates. If you are not able to come to Birmingham I can arrange for this to be sent to you. Declarations are currently being collected.

The declarations of interests for speakers at the Old Age Conference will be available to all conference delegates. I can also make these available to you if you are not intending to attend this conference.

Yours sincerely
Nick Craddock

Professor Nick Craddock
Treasurer
Royal College of Psychiatrists
21 Prescot Street
London E1 8BB

Here is the reply I have sent to the Royal College of Psychiatrists dated 14th March 2015:

Dear Professor Craddock
Thank you very much for your e-mail of the 13th March 2015 which is most helpful. It is particularly welcome to hear that, in terms of the forthcoming CPD-approved Royal College of Psychiatrists Conference that “the declarations of interests for speakers at the forthcoming International Congress will  appear on the Congress App which is available to all delegates.”  As I am not coming to this conference I would be most grateful to accept your offer to arrange for this to be sent to me.

Forefront 2015

I would also like to accept this further offer: “the declarations of interests for speakers at the Old Age Conference will be available to all conference delegates.  I can also make these available to you if you are not intending to attend this conference.”

Old Age March 2015 RCPsych

I remain of the view, as articulated in my letter of the 14th February 2015, that The College should have no more difficulty in having a tab on the homepage of these Conferences with declarations of all involved than they do in having a tab on the homepage for “Exhibition opportunities.”

exhibition-opportunities

I am also most grateful to be appraised about the process and timescale of the revision of CR148 “Good Psychiatric Practice: Relationships with pharmaceutical and other commercial relationships” which was first approved in January 2008. I note that CR148 contained a “due for review: 2011”.

CR148 cover

You have invited me to make comments on this revision to CR148 and to forward these “as soon as possible” to the Chair of the Policy and Public Affairs Committee. I hope this letter will suffice and I will forward it to the Acting Head of Policy as you suggest. I have not been party to any of the considerations to date and for this reason I would like to comment on the existing guidance, CR148, issued January 2008.

The research that I have undertaken across the UK over the last few years, in preparation for advocating a Sunshine Act to the Scottish Parliament, has led me to conclude that this guidance is not being fully followed.

CR148 principles

The “principles” of CR148 have a basis on “transparency” and “full declaration of relationships with commercial organisations”.  When I was a speaker at the RCPsych Autumn Conference in Durham I was the only speaker to declare my interests in the programme.  At the Conference itself, Professor Clive Ballard, one of the other speakers, did not declare any interests at all. Another speaker, Professor Allan Young, a key Opinion Leader in Affective disorders, appeared to belittle transparency regarding the need to declare financial  interests. There was no declaration of his extensive financial interests in the programme.

debate-as-set-out (2)

This leads me to my FIRST QUESTION in relation to the proposed revisions of CR148: What consequences will there be for an individual who does not follow the guidance?

CR148 guidance

CR148 states “psychiatrists should avoid accepting inducements that might compromise the independence of their professional judgement and practice”. We know from ABPI figures that in a calendar year at least £40 million has been paid to UK health professionals by the pharmaceutical industry.

40 million

The ABPI have recently introduced a “Central Platform” which will form a central register of individual financial payments to healthcare workers. This will not start reporting till 2016. However the main problem with this register is that individual healthcare workers can opt-out of disclosing payments. Given that the Royal College of Psychiatry is not alone in having struggled to govern its own existing guidance, it is reasonable to have concern that this ABPI “Central Platform” will share such difficulties.

Thus, my SECOND QUESTION: What role, if any, will the ABPI “Central Platform” have in the revised CR148?

CR148 Registers of members interests

The research I have undertaken in NHS Scotland has confirmed that local registers are generally not being maintained and are generally not open to the public.

The Scottish Government has confirmed that the guidance issued on this in 2003, HDL 62, has not been followed. HDL 62 asked the following of Chief Executives:

HDL-62

At annual appraisal all doctors are asked to sign a Probity statement similar to the screenshot below. In this, each doctor confirms that he or she has followed paragraphs 56-76 of Good Medical Practice and complied with local mechanisms of declaring interests. In Scotland, I have evidence that in terms of “transparency” that there are widespread discrepancies here and I fear that public trust in our profession may suffer if we do not take action.

Probity statement SOAR Appraisal (Jan 2014)

To conclude, my view is that the simplest, most effective, consistent and evidence-based way to ensure transparency regarding financial conflicts of interest would be to have UK legislation that seeks a central, single, open, searchable register that is updated on a regular basis and which is tied to professional accountability and GMC governance. Ideally this would include not just psychiatrists, but pharmacists, academics, allied health professionals and indeed charities. My final question then is what discussions have taken place between the Royal College of Psychiatrists and the GMC on revisions to CR148

Yours sincerely

Peter signature
Dr Peter J. Gordon

Copied to:

  1. Professor Sir Simon Wessely, President Royal College of Psychiatrists, 21 Prescot Street, London, E1 8BB
  2. Vanessa Cameron, Chief Executive, Royal College of Psychiatrists, 21 Prescot Street, London, E1 8BB
  3. Chris Fitch, Acting Head of Policy, Royal College of Psychiatrists, 21 Prescot Street, London, E1 8BB
  4. Niall Dickson, Chief Executive and Registrar, GMC, Regent’s Place, 350 Euston Road, London NW1 3JN.

NHS Ayrshire and Arran: Register of Interests for staff – “discussions are ongoing”

Sent: 20 February 2015 14:01
Subject: NHS A&A response to – FOI – Compliance with HDL (2003) 62 – our ref 528/2014

Dear Dr Gordon,
Again, please accept my apologies for any inconvenience caused by the delay in responding to your enquiry. Leave commitments of the specialised staff tasked with responding to your request and other events outwith our control have lead to the delay in responding to your request timeously.

Our response in 2013 stated that the organisation was working on compiling a register of interests and register of gifts/hospitality to encompass all staff which would also include payments from pharmaceutical companies.  At the time of your request we already had a ‘declaration of interests’ register for the Area and Drugs Therapeutics Committee to ensure any conflict of interests were registered for decision making around drugs. We had advised at the time of your request that the ‘the Area and Drugs Therapeutics Committee’ were hoping to publish this register in the future. Please see our full 2013 response below:

Discussions are ongoing to create a register to encompass the whole organisation in line with the guidance – A Common Understanding 2012 working together for patients -guidance on joint working between NHSScotland and the Pharmaceutical Industry.

The attached ‘declaration of interests’ register relates to the Area and Drugs Therapeutics Committee, its sub groups and anyone submitting a guideline. We are in the process of updating our Model Publication Scheme to include this register which will be published on our public website.

Since sending our response a decision has been taken not to publish this register.  Please accept my apologies for not fulfilling the assurance to publish the Area and Drugs Therapeutics Committee ‘declaration of interests’ register. However, this was superseded by the register of interest for all staff and the requirement under the Public Services Reform (Scotland) Act 2010.

Section C ‘Standards of Business Conduct’ within the Code of Corporate Governance paragraph. 3.3 states “Where there is an interest, hospitality or relevant outside employment is declared to a manager, they must record that declaration in the employee’s personal file together with any instructions issued to the member of staff in relation to the declaration. This information must also be provided to the Corporate Business Manager to be recorded as part of the Board’s declaration of interests and gifts.”  This register is held by the Corporate Business Manager who is responsible for keeping and maintaining it.  From November 2014 Section C is also included within any contractual paper work for new employees to the organisation. The Chief Executive has also circulated communication to ask employees to ensure they are notifying their line manager and the Corporate Business Manager of any declarations.

We are not at present planning to publish this on our website. As, under part three of the Public Services Reform (Scotland) Act 2010 (the Act), we have a duty to provide information on hospitality and entertainment. This includes any gifts, meals, parties, reception, tickets for or invitations to public, sporting, cultural or other events or other similar benefits accorded by a public body to its own members, employees or third parties for whatever reason. A threshold of £25 for “one off” gifts or benefits has been set as reasonable for this purpose, provided that the gifts or benefits in question are not regular or recurring. If a different threshold is adopted it should be set out in the statement of expenditure.

This information is routinely published as a requirement of the Act as soon as reasonably practical after the year-end. Please follow the link http://www.nhsaaa.net/publications/public-services-reform-(scotland)-act-2010.aspx. Or go to our website, http://www.nhsaaa.net/ click on the ‘publications’ button and select ‘a’ and scroll down to ‘Accounts/financial information.

I trust this response is helpful. However, under the Freedom of Information (Scotland) Act 2002 if you are dissatisfied with our response you are entitled to request a review. A request for a review must be made in writing to Mrs Jillian Neilson, Head of Information Governance, NHS Ayrshire & Arran, 14 Lister Street, University Hospital Crosshouse, Kilmarnock, KA2 0BB or email InformationGovernance@aapct.scot.nhs.uk, no later than 40 working days from 23 February 2015. You must provide your name, an address for correspondence, details of your original request and say why you want a review. If our decision is unchanged following a review and you remain dissatisfied with this, you then have the right to make a formal appeal to the Scottish Information Commissioner.

Please do not hesitate to contact me should you require any further advice or assistance.

Kind regards,

Freedom of Information Officer
Communications dept
28a Lister Street
University Hospital Crosshouse
Kilmarnock
KA2 0BE

Email: foi@aaaht.scot.nhs.uk

www.nhsaaa.net

Previous blog posts on Ayrshire & Arran Register of Interests:

http://wp.me/p3fTIB-p5

http://wp.me/p3fTIB-E8

Sponsored medical education: another Scottish NHS Board

Those who have followed my posts on Hole Ousia will know that I have petitioned the Scottish Parliament for a Sunshine Act. As an NHS doctor working in Scotland I was recently invited to this educational meeting. I thought it might be useful to use this as an example of the current situation for continuing medical education as I have encountered it in Scotland.

Passmore, 26-2-2015, NHS Lothian

Although this flyer does not make clear, this educational meeting is sponsored by the Pharmaceutical industry. Professor Peter Passmore has been described as a “key opinion leader” in medical education both in the UK and internationally.

This list of declarations for Professor Peter Passmore is from 2008 as given to the Journal of the Royal College of Physicians in Edinburgh.

Geriatric-Medical-Symposium2

I do my best to avoid sponsored medical education but I do try to attend meetings organised by the Royal College of Psychiatrists. For the Autumn 2011 Faculty Meeting I had suggested to the organisers that we might debate “early diagnosis of dementia” . I offered to take one side of the argument. However the organisers chose instead to invite Professor Peter Passmore.

Aware of Professor Passmore’s extensive promotion of drugs I chose not to go.Nov-2011-Forth-Valley-Educa

At this time, 2011, Scottish psychiatrists were invited to a number of educational meetings where Professor Passmore was widely promoting Memantine (EBIXA).

Just recently, the Scottish Parliament have recommended that a Register of lobbying of parliamentarians should be established. The following is an example from 2011:

push-for-the-latest-dementi

In 2013, Professor Passmore was promoting SOUVENAID, a nutritional supplement for “early Alzheimer’s disease”:

Dementia-2013

By being paid to give educational meetings for CPD approved conferences and meetings Professor Passmore is by no means departing from accepted practice.

KOLs2

Whilst I was doing my research on NHS “hospitality registers” I wrote to Professor Passmore asking where he recorded his financial interests? I got this reply from NUTRICIA:

Letter-Nutricia-june-2013

The Association of the British Pharmaceutical Industry (ABPI) are currently introducing a register of payments to individual doctors: “The central platform”. Doctors can choose to opt-out from disclosing any payments received from industry.

My interest is in transparency about such financial conflicts of interest and in particular public transparency. This is why I have petitioned the Scottish Government for a Sunshine Act:

Peter's-Sunshine-Act,-Janua

Returning to the start of this post and the invitation to attend this latest sponsored medical education, I wrote to the organisers and had this reply from the Associate Director of Medical Education:

“All of our clinical association meetings are sponsored, if they were not we simply would not be able to provide these educational meetings as we have no budget for either the catering or the travel expenses of our speakers. We have moved away from sponsorship of teaching at foundation level, but for these hospital wide meetings, at which we are keen to attract speakers from out with Lothian, this is not possible at present.”

051

Those who follow my blog posts may recall that since Alexander McCall Smith’s recommendation to me of “A Pattern Landscape” I have been exploring patterns. Here I am reminded of NHS Forth Valley who are another NHS Board in Scotland who have no money to support medical education.

I am one of many scientists who has concerns that continuing medical education in Scotland is being funded by vested interests.

 

 

 

 

Royal College of Psychiatrists and conflicts of interest

The Chief Executive of the General Medical Council (GMC) recently confirmed, in response to a recent BMJ article, that it “takes very seriously the issue of conflicts of interest”:start-with-GMC

We know that in the course of a year, in the United Kingdom:40 million

Currently, it is almost impossible to find out anything other than the overall figure.

NHS registers of interest are not functioning. Yet doctors are asked to sign this at annual Appraisal:Probity-statement-SOAR-ApprAll Appraisals are then scrutinised by senior NHS managers to be “signed off”:

The BMJ make this charge:failure of regulation

However should we be asking if our Royal Colleges are also failing?

For several years I have written to the Royal College of Psychiatrists about conflicts of interest. This post is based on the latest correspondence which was prompted by the recent announcement of this International Conference:

change-my-practice

The Co-chairs give this welcome note:welcome-by-co-chairs

It is almost certain that a significant proportion of the £40 million goes to: KOLs2

The Conference organisers have made it clear of the “exhibition opportunities” provided at this event:exhibition-opportunities

What is less clear is whether the speakers or those involved in workshops or seminars have any conflicts of interest.

This is why I have written to:Board-RCPsych

My most recent letter to the above, copied to the Chief Executive of the GMC, asks for transparency ahead of the Conference in this important area:Craddock-letter

 

 

 

 

 

 

“A probity issue and may lead to a failure to revalidate”

Here is a submission to the BMJ by S. Musheer Hussain, Consultant & Hon Professor of Otolaryngology, Ninewells Hospital & University of Dundee Medical School:
CropperCapture[1]
Here is relevant communication with NHS Tayside on a register of interests

“A public register of UK doctors’ financial interests is long overdue”

Below is my latest submission to the BMJ:

Fiona Godlee, Editor of the BMJ, has concluded that: “The profession must take the lead to protect patients and maintain public trust. The GMC should act, and a public register of UK doctors’ financial interests is long overdue.”(1)75854084_Godlee_62719j

Godlee,-29-Jan-2015

In response, Niall Dickson, Chief Executive of the GMC, has stated that: “Our guidance is comprehensive and clear in respect of the responsibilities of individual doctors and we have taken appropriate action against individual doctors in the past where there has been evidence that our guidance has been breached”. (2)A3DD946F-9966-E522-E48690C05D7C7B5F

I have petitioned the Scottish Government for a Sunshine Act regarding health professionals’ financial conflicts of interest. (3) This was considered most recently at the meeting of the Petitions Committee on 27th January. The evidence accumulated so far demonstrates that existing Scottish Government guidance, in place since 2003, has never been followed in NHS Scotland. FOI response from the GMC confirms that no doctor has been formally investigated in Scotland for breaching guidance on financial interests. (4)

eeee

Niall Dickson has stated on behalf of the GMC that “Parliament has not given us powers”. It would seem that Fiona Godlee has correctly identified what needs to be done, and it is clear that governments will need to act.

References:
(1) Godlee, F. Medical corruption in the UK. 29 Jan 2015 http://www.bmj.com/content/350/bmj.h506

(2) Dickson, N. The GMC responds to the special report in the BMJ on regulating doctors’ financial and commercial interests; 29 Jan 2015 http://www.bmj.com/content/350/bmj.h396/rr

(3) Gordon, P.J. PE01493: A Sunshine Act for Scotland  http://www.scottish.parliament.uk/GettingInvolved/Petitions/sunshineact

(4) General Medical Council response to Dr Peter J Gordon. F13/5915/EH; dated14 Jan 2014