The UK General Medical Council has admitted that it does not have the legal power to force doctors to disclose details of payments and benefits they receive from the pharmaceutical industry—either on the new database of the Association of the British Pharmaceutical Industry (ABPI) or the GMC’s own register.
Last week the ABPI published the Disclosure UK database (www.disclosureuk.org.uk) listing details of the fees and benefits in kind paid by the pharmaceutical industry to doctors, pharmacists, nurses, and healthcare organisations.1 However, only healthcare professionals and organisations consenting to being identified were named, and the remainder of the information was published in aggregate form.
The ABPI admitted that health professionals overall were willing to declare just 48% of the money paid to them for consultancy work, travel, and conferences, with some not disclosing everything received and around 30% not consenting to disclose anything. This has prompted renewed calls for publication of such details to be mandatory, as it is in countries such as the United States.2
However, the GMC has told The BMJ that it does not have the power to insist that doctors disclose payments. A spokesman said, “We very much hope that every doctor with a connection to the pharmaceutical industry will take part in the ABPI’s new database, and we will be watching to see how it develops. But we do not have the legal power to make participation in the ABPI’s database, or any similar scheme, mandatory,” he said. “Pharmaceutical companies, on the other hand, do have the option to decide not to work with any doctor who refuses to consent to disclosure.”
GlaxoSmithKline has stated that it will no longer work with healthcare professionals who refuse to consent to publication of details of the payments and benefits in kind they have received,3 and last week NHS England called on other drug companies to follow suit. An NHS England spokesman said, “The ABPI publication is an important step forward in terms of transparency but is not yet the complete solution. Voluntary disclosure does not go far enough, and all companies should follow industry leaders in refusing to fund individuals who decline to be transparent about their payments.”
The GMC is currently consulting on updating its online medical register, including on whether details of doctors’ conflicts of interest should be added, at this stage voluntarily.4 “In order to make it mandatory there would need to be legislative change,” the GMC spokesman said. He said that it was too early to say how the addition of information about competing interests might look and how detailed it might be.
“The future does lie in greater transparency, but whatever information is made available must be proportionate, relevant, and useful. We will be gauging opinions during our consultation and will be in a position to take a firmer view later in the year,” the spokesman said.
During its accountability hearing with the GMC in 2013 the House of Commons Health Committee said that it believed “that there is a compelling case for the GMC to hold a public register of doctors’ interests with the responsibility for maintaining the accuracy of the register sitting with registrants.”5
See more from The BMJ on Disclosure UK at bmj.com/content/disclosure-uk.