Monday, 19 May 2014

Sunday, 18 May 2014

'Urgent review as nearly half of health boards ignore pharma disclosure rule' Sunday Herald 18 May 2014

'Urgent review as nearly half of health boards ignore pharma disclosure rule' news piece in Sunday Herald 18 May 2014 by Paul Hutcheon (@paulhutcheon).

Excerpt:
"Government investigation has been launched after nearly 50% of health boards ignored NHS guidance requiring GPs to register their financial interests with the pharmaceutical industry.

Six out of 14 boards, including Greater Glasgow, failed to record if doctors are being paid by drug companies. Civil servants have launched an urgent review of the oversight. Several exposes have revealed the financial links between doctors and Big Pharma.

The industry paid £38.5 million to UK doctors last year, a sum that included consultancy services and fees for attending conferences. But drug companies do not have to name the doctors who benefit until 2016.

Dr Peter Gordon (Herald photo)
Dr Peter Gordon, a consultant psychiatrist at NHS Forth Valley, last year lodged a petition at ­Holyrood calling for legislation to ensure employees declared payments. It then emerged that NHS guidance had been in place for a decade.

The 2003 circular states that, in respect of the pharma industry, boards must establish a register of interest for all NHS employees and primary care contractors. Hospital doctors are classed as NHS staff, while GPs are primary care contractors. The Scottish Government wrote to the 14 regional boards about their compliance with the guidance. The responses reveal big divergences on the section relating to GPs."

Read complete Sunday Herald article

My comment on this article:
"Well done to Dr Peter Gordon for highlighting this important issue, of doctors not declaring their links with drug companies and being transparent about any potential conflicts of interest.

As an unpaid carer of family members who have been forcibly treated with psychiatric drugs and as a survivor myself of mental illness and coercive drug treatment I am keen to know the truth about what is euphemistically called "educational" talks by pharmaceutical companies. I remember being prescribed antipsychotics against my will which then depressed me. Following which I was prescribed venlafaxine, an antidepressant, which further flattened my mood and caused suicidal ideation.

This happened in 2002/4. In March 2005 I broke my fibula in 3 places when only walking down a stair, after a job interview. I got the job and started it after learning to walk again with a 6 inch metal plate in my leg. Recently I found out that maximum doses of venlafaxine, particularly for older people (I was in my 50's) can cause bone loss.

As a mental health activist and campaigner my aim is to help improve choices for people experiencing mental or emotional distress. So that drugs aren't the only tools on offer but a range of talking therapies, intensive if need be, are available at the point of need."


Thursday, 15 May 2014

'Adult ADHD - Amidst the Chaos is a Disorder' conference Dunblane - promoting Strattera - who benefits?

Here is a link to my Pinterest and a poster about a conference that was held yesterday in Dunblane 'Adult ADHD - Amidst the Chaos is a Disorder'.  Sponsored by drug company Lilly, promoting Strattera or atomoxetine, of which "The FDA of the US has issued a black box warning for suicidal behaviour/ideation.".

Speakers included Scottish consultant psychiatrists Dr Prem Shah, NHS Lothian, and Dr David Hayward, NHS Tayside.  [my opinion?  Not sure why these psychiatrists need to be aligning with big pharma and pushing drugs.  Do they not earn enough money in the NHS?]

One of the workshops was called 'It's criminal not to treat ADHD' by a Fran Harland "ADHD coach/trainer", social worker who runs a business Wraparound Services. On the website it mentions "hidden disability".  [My opinion?  It's criminal to be pushing disability so as to make money out of it.]

Then there's a Dr Chris Bushe in the pay of Eli Lilly who says he's "arguably sane".  Whatever, there's no doubt he's making money out of the Big Pharma connection.  It also mentions "schizophrenia" as another of his interests[My opinion?  He who pays the piper calls the tune.]

As a psychiatric survivor and someone who experienced many side effects on antipsychotics and antidepressants I was concerned to read the list of side effects that can occur with atomoxetine, from very common to common.  

Therefore the payoff in accepting an ADHD label (although children don't have this choice) are disabling side effects and thoughts of suicide.  Which is what I experienced when taking antidepressant venlafaxine.  Plus bone loss resulting in a fractured fibula and a 6 inch metal plate in 2005.

Very common (>10% incidence) adverse effects (of atomoxetine) include:
  • Nausea (26%)
  • Xerostomia (dry mouth) (20%)
  • Appetite loss (16%)
  • Insomnia (15%)
  • Fatigue (10%)
  • Headache
  • Cough
Common (1-10% incidence) adverse effects include: 

  • Constipation (8%)
  • Dizziness (8%)
  • Erectile dysfunction (8%)
  • Somnolence (8%)
  • Abdominal pain (7%)
  • Urinary hesitation (6%)
  • Tachycardia (high heart rate) (5-10%)
  • Hypertension (high blood pressure) (5-10%)
  • Irritability (5%)
  • Abnormal Dreams (4%)
  • Dyspepsia (4%)
  • Hyperhidrosis (4%)
  • Vomiting (4%)
  • Hot flashes (3%)
  • Paraesthesia (3%)
  • Menstrual disorder (3%)
  • Weight loss (2%)
  • Depression
  • Sinus headache
  • Dermatitis
  • Mood swings
  • Ejaculation disorder (4%)

 My opinion of this conference?  It's all about the money.

 

Wednesday, 14 May 2014

I've been asking psychiatrists I know if they have links with Big Pharma

For a wee while now I've been writing to psychiatrists I know to ask if they have links with pharmaceutical companies, as a consultant or through "educational meetings" and receive payments.  Email subject "declaration of funding, interests and links with pharmaceutical companies".  And I've received a mixture of responses.  

Some have said no links, another said that he was a consultant with Janssen but now isn't.  Another sent back an Email that seemed to be a cut and paste job, quoting her health board area bumph but not really telling me if she did or did not have pharma links.

One psychiatrist has not responded since I first Emailed him on 6 March 2014, followed up by 2 further Emails, all of these copied in to a senior Scottish government mental health division manager, a GMC (General Medical Council) manager, a senior contact with the ABPI (Association of the British Pharmaceutical Industry) and the Chief Executive of NHS Lothian.

This psychiatrist was one of my colleagues on the Scottish Crisis and Acute Care Network Steering Group which I was a member of for over 2 years until the beginning of this year.  I worked with this psychiatrist on a workshop at the network conference last year in Stirling where I presented on 'Pathways and Perspectives – A Tale of Two Cities'.

I'm not sure why this psychiatrist isn't responding to my request regarding any links he might have with drug companies.  NHS Lothian doesn't have a Register of Interests for their health board staff so I can't check up there.  And of other Scottish health boards that do have Registers they don't all have declarations from doctors and psychiatrists eg in NHS Fife.  

Psychiatrists/doctors are public servants, answerable and accountable to the public, is how I see it.  And I'm the public while also having been a colleague of this doctor in question.  Or I saw myself as a colleague and co-worker.  Maybe he didn't see us as equals.  I don't know.  Or maybe his Email isn't working.  

Hopefully this blog post will help oil the wheels of communication.


comparing NHS Fife to NHS Forth Valley in terms of Registers of Interest (drug company payments)

I've been checking out the Registers of Interest in NHS Forth Valley compared with those in NHS Fife.  The former is very detailed while the latter tells me very little about hospitality or payments from drug companies to health board staff.  

The Forth Valley Register details the pharma company eg Janssen-Cilag and amounts spent, on sandwich lunches or trips to London or "educational" meetings.  (some psychiatrists seem to have weekly lunches, not sure why)  Whereas the Fife Registers have very few doctors listed on them and the pdf documents have no hyperlinks to them, so the public can't see what's in them.

For example, here is the link to the Kirkcaldy and Levenmouth CHP Register of Hospitality and Interests 2013 where I am told there should be psychiatrists listed (a Fife psychiatrist told me this).  It appears to have only 2 doctors listed with Nil beside their names, neither of them psychiatrists.  What about all the other doctors and psychiatrists in Fife?  Does that mean they have something or nothing to declare?  Who knows, I don't.

I do wonder why government isn't holding doctors and psychiatrists accountable in respect of links with drug companies.  What is the point of having registers if they are not adhered to?  It seems to me, a non-medical person and someone who has been forcibly treated with psychiatric drugs, that doctors and psychiatrists are a law unto themselves. 

HDL 2003 62 is a Scottish Government guidance document "on joint working between NHS Scotland and the Pharmaceutical Industry, which is transparent and improves patient care".  It sets out Action by Health Boards and Trusts: "Chief Executives are asked to establish a register of interest for all NHS employees and Primary Care contractors and produce local standing orders specifying who is responsible for keeping and maintaining the register.".


Thursday, 8 May 2014

NHS Lothian still does not maintain a Register of Interests for all employees - why not?

I made an FOI request to NHS Lothian on 30 April 2014, asking if there was now a Register of Interest for all employees, in particular to find out if any psychiatrists in this health board area, where our Scottish Parliament sits, receive payments from drug companies.  

Answer: No Register of Interest for all employees.  Eleven years after Health Boards were all asked to do so.  In the interests of transparency and improved patient care.  Therefore the public, patients and carers have no access to information about doctors who may be receiving payments from pharmaceutical companies, as consultants or other remunerated posts.

HDL 2003 62 is a Scottish Government guidance document "on joint working between NHS Scotland and the Pharmaceutical Industry, which is transparent and improves patient care".  It sets out Action by Health Boards and Trusts: "Chief Executives are asked to establish a register of interest for all NHS employees and Primary Care contractors and produce local standing orders specifying who is responsible for keeping and maintaining the register.". 

Here is my request:

"I am writing to you to ask for information about declarations from doctors in NHS Lothian, regarding their links with and monies received from drug (pharmaceutical) companies.

I know that NHS Circular HDL (2003) 62 makes it clear that all health boards should establish a register of interests for all NHS employees and primary care contractors.  I have read in the Hole Ousia blog post, from a letter dated 6 July 2013 written by Alan Boyter, that there are no centrally held registers in NHS Lothian, apart from board members;
http://holeousia.wordpress.com/2013/11/10/nhs-lothian-register-of-interests/

I would like to know if the position has changed in NHS Lothian in the 9 months since.  Recently there have been a number of media articles and TV programmes highlighting the payment of doctors by pharma and the conflicts of interests that arise.  I want to know if NHS Lothian are now complying with HDL 2003 62 and with the NHS Circular MEL (1994) 48 Standards of Business Conduct For NHS Staff.  This 20 year old standard mentions staff declaring "relevant interests".  A prescribing doctor linked to a drug company by way of payment I contend has to be transparent.  For after all drug companies are about creating customers not cures."

Response received today:

"I must advise that information in relation to NHS Lothian’s Register of Interest for Board Members and the Gift and Hospitality Register is available via the following link:
http://www.nhslothian.scot.nhs.uk/OurOrganisation/BoardCommittees/LothianNHSBoard/BoardMembers/Pages/default.aspx

There are no other centrally held registers available within NHS Lothian and any such register would not necessarily identify payments to staff.  Normal practice would be to declare the interest, not the financial amount.  If someone received payments through secondary employment, we would not have that information.  Ideally any transactions should be on a firm footing directly between the Board and the company.  The appropriateness of the relationship should be considered before it is pursued.

.... we do not maintain a standing register of interests for all employees.  Employees are meant to declare relevant interests as and when required, and then it will be recorded and considered accordingly within the personnel record.  The position has not changed in the last nine months." (bolding is mine)

Here is link to the NHS Lothian FOI Response Letter dated 6 May 2014.


Thursday, 1 May 2014

NEW DOCUMENTS: Serious Adverse Event reports from the University of Minnesota/AstraZeneca CLEARS study

NEW DOCUMENTS: Serious Adverse Event reports from the University of Minnesota/AstraZeneca CLEARS study 

Blog post by Carl Elliott @FearLoathingBTX:

"I am posting these documents before I have looked carefully at them, in case they are helpful to anyone trying to find out what actually happened to their family members in a psychiatric research study at the U. The records officer has finally given me access to the Serious Adverse Event reports filed by Stephen Olson to the IRB for the AstraZeneca CLEARS study (A Study of the Cataractogenic Potential of Seroquel and Risperdal in the Treatment of Participants With Schizophrenia or Schizoaffective Disorder.)  I am spotting a number of things that alarm me, but I would welcome any comments, either here or on Facebook, or on your own blog or website. I would especially welcome comments from psychiatrists, former research subjects and their families."