Tuesday, 19 May 2015

“Trust is generally being eroded” by Dr Peter J Gordon on Hole Ousia [reblog]

Dr Peter J Gordon: “Trust is generally being eroded” on Hole Ousia website, 18 May 2015:

"Last week I watched with much interest the 52nd Maudsley debate. The motion debated was: “This house believes that the use of long term psychiatric medications is causing more harm than good”.

52nd Maudsley debate

The Maudsley debate was covered in a head-to-head BMJ article.


Given that I have petitioned the Scottish Government for a Sunshine Act I was interested in what this Maudsley Debate might say about our approach to transparency of financial conflicts of interest:

Transparency: hold the applause (British Psychiatry) from omphalos on Vimeo.
This particular aspect of the 52nd Maudsley Debate reminded me of a series of letters published in the BMJ a decade ago. It is interesting to consider what has and what hasn’t changed in the intervening ten years. The letters were in response to the following 2003 editorial:

No more free lunches (2003)
In a letter of response Dr K S Madhaven argued that “the market has us all in its grip”:

001 Madhaven

Whereas Professor Simon Wessely, in his letter of response, was of a view that “It is time we all grew up”:

001 Simon Wessely
Simon Wessely

Professor Wessely began his letter of 2003: 

002 Simon Wessely
and continued:

005 Simon Wessely
It is interesting to reflect on changes that have occurred in the United Kingdom since 2003:

  1. Continuing Professional Development (CPD) has become a requirement of GMC Revalidation:
  2. the pharmaceutical industry now has to follow the ABPI code and healthcare professionals no longer receive branded products such as pens 
  3. “Sandwich lunches” (sponsored Continuing Medical Education – CME) remain core to continuing education. In NHS Scotland, at least two NHS Boards rely entirely on industry sponsorship to support the education of their staff
  4. It remains the case that, at any educational conference, neither the audience nor the public have any idea of how much speakers may have received from the pharmaceutical industry or commercial enterprises in the past three years. The proposed 2016 ABPI register is unlikely to help as any individual can opt out of disclosing payments received. Going by the experience in America, in some cases considerable sums may be routinely involved.
Professor Wessely, in 2003, was concerned about over-regulation, a concern that many of us, including myself have some sympathy with:

Watching the Maudsley debate, in 2015, I was reminded of Professor Wessely’s 2003 fear that “trust [was] gradually being eroded” . It would seem to me that the audience of 2015 would agree with Professor Wessely that this may indeed have happened. However such erosion of trust would seem to be for exactly the opposite reason given by Professor Wessely. It would appear to be the lack of transparency rather than an “Orwellian world of prohibitions” that has contributed to this.


Following the 52nd Maudsley Debate I have written to Professor Wessely, as President of the Royal College of Psychiatrists, to ask if the College might support a single, central, open, searchable database where all payments to healthcare workers, academics and researchers must be disclosed."

1 comment:

  1. Hello Chrys, I watched the debate on Allied Health Professionals (which is the label all health care workers are under) in the Scottish parliament last night and barely managed to the end (it's so boring listening to one person after another saying mainly the same thing) The person speaking for the Highlands raised the point about NHS delivery being so different because of distance that they rely on AHW to try to make sure services are delivered. Having lived in the Highlands for some years I can say that there was no replacement of the only lonely CPN in Strathspey and Bedenoch when the last post was vacated six years ago. This means if you live in this area and have a mental health issue, you must travel long distances to New Craigs to get the support required (by law, and usually medication) to carry on living in the community. I wonder why this situation has not been changed, when this has been spoken about in parliament as a huge problem, they are still only talking six years later but only using a different label.
    Only last July, Head of Mental Health services Tayside set aside funding for a psychologist to be employed on the male and female adult acute wards at Murray Royal. This was after many meetings and discussions over the use of anti-psychotics that research has now proved are damaging to the brain. Especially in those who have been given them, sometimes forcibly, by law over long periods of time. The research describes a two years maximum, before some brain damage will occur. Some sufferers kept under these conditions have been there the whole of their adult life and there is no other therapy. To date there has been no psychologist employed and I have been informed that this situation will continue until September. My concern is; what happened to that funding? that will be fourteen months of funding for a psychologist disappeared! Not one person has been able to answer despite seeing my local MSP, writing to the FM and further discussions with NHS Tayside. Is there corruption now for the poorest forgotten members of our society to deal with, when they are not afforded the basic human right of treatments that are not brain damaging despite the money being set aside for this purpose?