On Thursday 22 March 2018 I will be making a peaceful protest outside the Scottish Parliament, two years to the day that my petition for a Sunshine Act for Scotland was closed. But what is a "Sunshine Act"? And what is the story behind it?
In September 2013 I submitted a petition to the Scottish Parliament urging the Scottish Government to introduce a Sunshine Act for Scotland.
I have worked as a doctor for NHS Scotland for over 25 years and it was his concern that marketing by commercial sector (pharmaceutical industry, device makers, imaging technologies) was routinely part of continuing medical education. Research has conclusively demonstrated that competing financial “conflict of interest” can affect the treatment decisions doctors recommend and that exposure to industry promotional activity can lead to doctors recommending worse treatments for patients.
In the early stages of the petition, when evidence was being gathered, the Cabinet Secretary for Health and Sport wrote to the Scottish Parliament stating: “We can find no record of concerns having been raised with the Scottish Executive or Scottish Government about this issue before contact from Dr Gordon, the petitioner.” [24 Feb 2015] Perhaps inferring that I was being unrealistic in my concerns about a lack of transparency about competing financial interests in NHS Scotland.
A Sunshine Act would make it mandatory for healthcare workers (and hopefully academics and all allied health professionals) to declare fully any payments including payments in kind. The argument that I presented was that a single, searchable, independent register underpinned by statute would ensure transparency, promote scientific integrity, reduce the potential for harm and save money.
Existing Guidance in NHS Scotland (issued by the Scottish Government) has failed for more than 15 years. Other governance bodies, such as the Royal Colleges, have separate systems which also appear to have failed to ensure transparency of financial payments. These overlapping, but ineffective systems of governance duplicate costs and bureaucracy to nobody’s gain
On Thursday 22nd March 2018 I will be standing outside the Scottish Parliament with this banner (see below). This will be a peaceful, one-man protest, two years to the day that his petition for a Sunshine Act was closed. The petition closed on a most positive finding: that the Scottish public, in an official consultation (by the Scottish Health Council) concluded that declarations of competing interests should be mandatory and recorded centrally in an open register.
However it is now two years on and the Scottish Government has provided no update, not a single one, to the Scottish public. This is the reason for my peaceful protest this Thursday
I was hopeful that Scotland’s Chief Medical Officer’s campaign on Realistic Medicine might have encouraged some action before now. You will also be aware that the issue of competing interests has been part of a number of health inquiries such as the Mesh implant scandal, prescribed drug dependence and withdrawal the over-prescribing of antipsychotics to our older generation and the screening for dementia.
Two years on and we have heard nothing about a Sunshine Act from our Government yet other countries introduced this many years ago as they concluded that such transparency was an essential aspect of fully Informed consent. The Scottish public have made it clear that realistic medicine requires a Sunshine Act (or similar legislation).
Let us hope that 2018 will see our Government ensure that realistic medicine brings us sunshine.