Simon says

From 2014 to 2017, Professor Sir Simon Wessely was the elected president of the Royal College of Psychiatrists.

In the week following taking up Presidency, Professor Sir Simon Wessely was interviewed on Radio 4.  James Davies was the presenter and put this to the President:

“We need greater transparency and accountability with respect to the financial ties between the pharmaceutical industry and psychiatry. The research does suggest that doctors who receive these payments from industry are more likely to be biased in their clinical activities and beliefs.”

Professor Sir Simon Wessely responded:

“I’m your worst nightmare here James, because.. I’ve never worked for Pharma”

I have been a campaigner for greater transparency of competing interests in science and media for a long time now and I raised a petition for A Sunshine Act for Scotland with the Scottish parliament in September 2013.

In July 2015 I wrote to my College and the GMC about concerns that competing interests were not being made public and that the current College system of Governance was not being properly followed.

It was most welcome to find that Professor Sir Simon Wessely, as President, was willing to communicate with me personally on this matter. I was assured that the existing Guidance would be updated and governance of it improved. However I was not invited to be part of this process.

The first big test of this new transparency was to be the Royal College of Psychiatry International Congress 2015. Ahead of this the Royal College of Psychiatrists described how new transparency would “avoid some of the criticisms of yesteryear”

However, this reassurance failed to reflect reality.

On the 26 March 2015, Ben Goldacre commented to Professor Sir Simon Wessely “I really wish the College would show some leadership and do conflict of interest declarations properly. Not hard. Surely problem here is the College calling this a problem of the past while still failing to implement basic transparency?”

Professor Sir Simon Wessely replied “Give us a break Ben. We are chasing and everyone speaking will do so with a full COI. Which will largely be empty”

Ben Goldacre replied “I’m very concerned about the reputational consequences for the profession of casual false reassurance on these issues.”

The system that was finally put in place by my College, and is still extant, has not provided necessary transparency.  The system does not record dates or amounts received. It is unsearchable, bureaucratic, and costly to implement. It would help neither a professional nor a member of the public ascertain how much of the £42 million a year may have gone to those providing education on prescribing of psychiatric medications in the UK.

Yet the College has continued to insist this is not a current issue. In December 2016, Vanessa Cameron, as  Chief Executive of the College sated: “These days, the relationship between the College and Pharma is distant. I think that these days we have an appropriately puritanical relationship with Pharma.”

Back to 2015, and in one of my first communications to Professor Sir Simon Wessely as President of my College I said “I would hope that you share my view that those who lead our profession should set the best example in this area that they possibly can. I am pleased that the College is making efforts to address this but my view is that there is a lot of work still to be done. One outstanding issue is the culture within healthcare (psychiatry is certainly not alone in this) that somehow discounts the evidence that involvement with the pharmaceutical industry influences practice.”

As a child I used to love playing a battery-powered toy called “Simon Says” – but Simon always beat me.

It is clear that Professor Sir Simon Wessely has not worked with the pharmaceutical industry in the scale that many other key opinion leaders have done (and may continue to do so). However it is the case that Sir Simon has shown different colours on this matter.

As far back as 2003, in a letter to the BMJ, Sir Simon, most robustly challenged any need for governance of competing interests. His perspective was titled It is time we all grew up” and said “I have dealt with industry at many levels”. Sir Simon went on to express his view that “an Orwellian world of prohibitions and restrictions is the proposed solution to this latest non-problem”

The following clip is of Sir Simon speaking at an IQ Squared debate on 12 November 2014. He was then President of the Royal College of Psychiatrists. The debate was titled “Psychiatrists and the pharma industry are to blame for the current ‘epidemic’ of mental disorders.”

3 Replies to “Simon says”

  1. It’s an interesting letter for sure. Is it a protestation of innocence or a confession of guilt? It brings to mind the idea that “if everyone’s guilty then no one’s guilty”. In any event the letter is a convenient distraction from well-documented conflicts of interest between his pals, disability insurers, and state institutions, as noted in 2006 by the UK Parliament Group on Scientific Research into ME (The Gibson Inquiry): [1] [2]

    “CFS/ME is defined as a psychosocial illness by the Department for Work and Pensions (DWP) and medical insurance companies. Therefore claimants are not entitled to the higher level of benefit payments. We recognise that if CFS/ME remains as one illness and/or both remain defined as psychosocial then it would be in the financial interest of both the DWP and the medical insurance companies.”

    “[There are] numerous cases where advisors to the DWP have also had consultancy roles in medical insurance companies. Particularly the Company UNUMProvident. Given the vested interest private medical insurance companies have in ensuring CFS/ME remain classified as a psychosocial illness there is blatant conflict of interest here.”

    [1] http://erythos.com/gibsonenquiry/Report.html
    [2] http://www.virology.ws/2015/11/17/trial-by-error-continued-pace-teams-work-for-insurance-companies-not-related-to-pace-really/

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