‘The medical untouchables’

The following is a recent opinion piece by Dr Des Spence published in the British Journal of General Practice.

I had been lined up to do the media interviews on BBC Scotland in relation to petition PE1651. However, on the day, due to changed travel arrangements, I was not available. Dr Des Spence was interviewed instead and did a better job than I could have done.

As an NHS doctor and specialist, I fully support this petition (PE1651) which calls on the Scottish parliament “to urge the Scottish Government to take action to appropriately recognise and effectively support individuals affected and harmed by prescribed drug dependence and withdrawal.”

I have submitted my response.

I feel it would be helpful to hear the views of the Chief Medical Officer for Scotland and in particular, how this matter might be considered as part of Realistic Medicine.

Three recent posts by me demonstrate the scale of competing financial interests in medical education in the UK. If you have a moment, you should have a look. Perhaps you might then share the worry that I have about this matter:

I have previously raised my own petition, PE1493, which the Scottish Public has supported. This was a petition for a Sunshine Act for Scotland, to make it mandatory for all financial conflicts of interest to be declared by healthcare professionals and academics.

My petition, supported by the public, had no support from “Realistic Medicine”. The public has had no update from the Scottish Government on my petition in 18 months. My view is that this is a shocking failure of governance and would seem to demonstrate a lack of respect for democracy.

“Packaging up old myths”

Last week the Association of the British Pharmaceutical Industry (ABPI) held its Annual Conference:Annual Conference 2015The Pharmaceutical Industry are concerned about an “affordability conundrum”:Affordability conundrum1The affordability conundrumThis BBC Report from November 2014: “Pharmaceutical Industry gets high on fat profits” documented that:Pharmaceutical industry gets high on fat profits (2b)There will be many companies around the world who would like to be dealing with this kind of “affordability conundrum”.

Another area of concern to the industry was discussed at the 2015 ABPI Conference:Aileen Thompson 2aileen_thompsonThe closing session of the 2015 ABPI Conference was focused on the reputation of the pharmaceutical industry:  Industry as a credible partner A panel discussion was part of this:      Sponsored by concentraI wonder if the panel considered this:Pharmaceutical industry gets high on fat profits (3)Andrew McConaghie of PharmaPhorum recorded this passage:wrong1 wrong2 wrong3My view is that if the Pharmaceutical industry are concerned about their reputation then they should avoid such obvious scapegoating. Dr Goldacre has been and continues to be a world pioneer for scientific objectivity and it does the “reputation” of the British Pharmaceutical industry no credit to distort his work in this way.

Here is the view of the World Health Organisation:Pharmaceutical industry gets high on fat profits (4)

“In pursuit of marketing approval” [antidepressants for anxiety]

This is a report in the current BMJ:  Publication bias01This was the result of the pursuit of the market:Publication bias02The US Food and Drug Administration failed to ensure scientific objectivity:Publication bias03Robert K Merton would weep at this.

Update, 5th October 2016. The following was published on the 
front page of the Scotsman newspaper: 

"Mental health prescriptions hit ten-year high"

prescriptions-for-mental-health-drugs-10-year-high-nhs-scotland-2016-a prescriptions-for-mental-health-drugs-10-year-high-nhs-scotland-2016-b

The figures are from the Scottish Government and can be accessed here.

Transparency in drug company payments to doctors

In a BMJ “briefing” Rebecca Coombes sums up the new UK system for public disclosure of payments from drug companies to doctors

Published the 2nd January 2015 in The BMJ, here follows the full article:

Transparency-in-drug-compan

I have met Andrew Powrie-Smith of the ABPI several times. He has made it a personal mission to improve transparency for the Pharmaceutical Industry and I applaud his efforts. My concern is that the medical profession may not yet quite agree with Powrie-Smith that transparency is a “societal expectation”. I say this as (1) the voluntary register Who pays this doctor? has not exactly been burdened with declarations, and (2) my research into Registers of interest for all staff employed in NHS Scotland has evidenced very poor compliance with Scottish Government Guidance (HDL 62).

The new database, set up by the ABPI, is a most positive development. We should however be aware that it only applies to the pharmaceutical industry and not other areas of commerce: such as device makers, nutritional supplements, digital technologies etc. It is my understanding that the ABPI Register also only applies to doctors. Do we not also need to consider academics, managers, commissioners, pharmacists, nurses, AHPs, charities all of whom could be paid to “educate” us about a specific condition and a product or test for this. Or to commission a service for it.

Surely however, the main issue with this new ABPI code is that it has no legal underpinning. Doctors can opt out of declaring any financial payments and they so they will not be named.

This is why I have petitioned the Scottish Government for a Sunshine Act (or clause). America has this legislation as do several other countries.

Opt-out