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.

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