Conflicts of interest within England’s NHSBMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1590 (Published 03 April 2017) Cite this as: BMJ 2017;357:j1590
All rapid responses
Heath and Adlington state that it “seems regrettable” that, in developing guidance on Managing Conflicts of Interest in the NHS, the ‘Task and Finish Group’ included no specific patient representatives (1). At the beginning of the consultation process for this Guidance, which will come into effect next month, I submitted a response to the Task and Finish Group outlining my petition to the Scottish Parliament to introduce a Sunshine Act for Scotland (2). After the gathering of evidence a public consultation was carried out. This showed majority support for mandatory declarations of financial conflicts of interest by all healthcare staff (3).
I fully agree with the four areas identified by Walpole as requiring improvement (4). I also fail to see how multiple, piece-meal, unsearchable databases can be reasonably described as transparent, let alone efficient and cost-effective. Heath, Addlington and Walpole correctly identify that all those involved in commissioning need to be included in guidance on conflicts of interest.
Evidence gathered for my petition indicated that “key opinion leaders” (who often educate large numbers of healthcare staff for mandatory CPD) and who may also contribute to the development of national guidelines may have significant financial conflicts of interest.
The support of the Scottish public for mandatory declarations makes it all the more disappointing to see the limitations of current proposals. Surely as a profession we should be listening to the public and supporting proposals such as “Realistic Medicine” (5) and the BMJs “Too much medicine” campaign.
(1) Heath, I. & Adlington, K. Conflicts of interest within England’s NHS. BMJ 2017;357:j1590 Published 3 April 2017
(2) A Sunshine Act for Scotland. Petition raised with the Scottish Parliament. Dr Peter J Gordon. http://www.parliament.scot/GettingInvolved/Petitions/sunshineact
(3) Scottish health Council. Gathering public views on a register of interests for Scotland. http://www.scottishhealthcouncil.org/publications/gathering_public_views...
(4) Walpole, S. Managing conflicts of interest in today’s NHS. In the BMJ Opinion. Published 10 May 2017. http://blogs.bmj.com/bmj/2017/05/10/sarah-walpole-managing-conflicts-of-...
(5) Calderwood, C. Chief Medical Officer for Scotland https://blogs.gov.scot/cmo/2016/01/20/realistic-medicine-my-first-cmo-an...
Competing interests: I submitted a petition to the Scottish Parliament to consider a Sunshine Act for Scotland: http://www.parliament.scot/GettingInvolved/Petitions/sunshineact