Saturday, 21 February 2015

'Open and transparent' Omphalos film #SunshineAct for Scotland

Open and transparent from omphalos 

Dr Peter J Gordon: "I have petitioned the Scottish parliament to urge the Scottish Government to introduce a Sunshine Act for Scotland, creating a searchable record of all payments (including payments in kind) to NHS Scotland healthcare workers from Industry and Commerce.

All details can be found here from the Scottish Parliament:

Further details from my website, Hole Ousia can be found here:

The Association of the British Pharmaceutical Industry have recently introduced a "Central Platform" to record payments to healthcare workers. Unfortunately there is an OPT-OUT so it may not provide the transparency that I believe we require when it comes to financial conflicts of interest."

(1) Radio Scotland, Wednesday 18th February 2015 "Good Morning Scotland"
(2) "Piggy in the Middle" by Belle & Sebastian for BBC Scotland

Friday, 20 February 2015

Reblog 'Sponsored medical education: another Scottish NHS Board' Dr Peter J Gordon #HoleOusia

Dr Peter J Gordon: 'Sponsored medical education: another Scottish NHS Board' on Hole Ousia blog:

"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.


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.


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 is from 2011:


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


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


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:


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 petition the Scottish Government for a Sunshine Act:


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.”


Those who follow my blog posts may recall that following 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."

Monday, 16 February 2015

Dr Peter J Gordon: 'Royal College of Psychiatrists and conflicts of interest' #HoleOusia

'Royal College of Psychiatrists and conflicts of interest' by Dr Peter J Gordon on Hole Ousia blog:

"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”:


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:


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:


The Co-chairs give this welcome note:


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


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


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:


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:


Friday, 13 February 2015

'Doctors’ financial interests should be declared to avoid any impression of impropriety' BMJ Response 11 February 2015

'Doctors’ financial interests should be declared to avoid any impression of impropriety

BMJ Response 11 February 2015, Gee Yen Shin, Consultant Virologist, Dr Rohini Manuel, Public Health England 

Editorials: The General Medical Council and doctors’ financial interests
BMJ 2015;350:h474


We read with concern the BMJ editorial on the apparently laissez-faire approach taken by the General Medical Council (GMC) to reports of undeclared financial conflicts of interest in the form of financial inducements which may have influenced the referral patterns of UK doctors[1].

We are glad to see that this BMJ editorial appears to have had the desired effect of a GMC response to these serious allegations[2].

We agree that doctors should make conflicts of interest declarations where these may affect prescribing and clinical referral behaviour. This information should be made available to employers and patients. 

Although GMC Good Medical Practice (2013) guidance covers honesty and integrity, including “Honesty in financial dealings”[3], many NHS Trusts will not have any formal or systematic mechanisms to record any financial conflicts of interest.

As Public Health England (PHE) consultants, we know that PHE requires its staff to complete annual declaration of interests returns every year. This may stem from the Nolan principles of public life which require public servants to follow seven principles of public life, the most relevant of which include honesty, integrity and openness[4].

According to the Committee on Standards in Public Life, the seven principles should apply to all civil servants e.g. PHE staff and those appointed to work in “health, education, social and care services” amongst others[5]. 

We suggest the PHE approach of an annual review of employee declarations of interests as a template upon which to build a database of doctors’ conflicts of interest. Such a register could be one way of tackling the opacity of undeclared financial interests as reported by the BMJ. However, we agree that a multi-pronged approach is required and that new conflicts of interests may arise between annual surveys. Nevertheless, our profession has to start somewhere.

If we do not get our house in order, public trust in our profession will suffer; this we can ill afford."


1. Adlington K, Abbasi K, Godlee F. The General Medical Council and doctors’ financial interests. BMJ 2015;350:h474
2. Gornnall J. GMC Considers action against doctors after BMJ “Cash for referrals” investigation. BMJ 2015;350:h620
3. Good Medical Practice (2013). UK General Medical Council.
4. The 7 principles of public life. (document; also known as “the Nolan principles of public life) Committee on standards in public life 1995:
5. The 7 principles of public life guidance page. Committee on standards in public life

Competing interests: GYS & RM work for Public Health England, an executive agency of the Department of Health (England). The views expressed are our own & not those of our employer(s). Neither GYS nor RM have ever engaged in private medical practice. GYS has indirect financial interests in various pharmaceutical/biotechnology companies through collective investment vehicles such as unit trusts like FTSE-100 index trackers etc. He does not own any shares in any such company directly.

Monday, 9 February 2015

Reblog RxISK: 'Dopamine & Addiction: Junkies of the Third Age?'

'Dopamine & Addiction: Junkies of the Third Age?' on

"The last set of posts have brought stimulants and dopamine into the frame.  In the 1960s and 1970s while stimulants were becoming controlled drugs it was nevertheless denied that they caused dependence.

Billian James on
It is now clear that the closely related dopamine agonists, increasingly the first line treatment for Parkinson’s Disease, cause a host of compulsive behaviors in addiction to marked dependence and a debilitating withdrawal problem – Dopamine Agonist Withdrawal Syndrome (DAWS).

There were early RxISK posts on the compulsive behaviors linked to dopamine agonists and on DAWS, with the DAWS post attracting a lot of comment. There are also RxISK papers on both Dopamine & Compulsive Behavior and Dopamine & DAWS.

There was an early RxISK story linking antidepressants like Venlafaxine to compulsive behaviors Gambling on Antidepressants and there will be posts on Abilify covering similar ground in weeks to come ..."

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