Senior medics urge GMC to set up central register of doctors’ declared interests
BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m417 (Published 31 January 2020) Cite this as: BMJ 2020;368:m417
Doctors’ leaders have urged the General Medical Council to establish a central register for UK doctors to declare their interests in order to improve transparency.
In a letter to GMC chair Clare Marx, shared with The BMJ, 11 senior doctors (full list of signatories below) called on the regulator to show leadership on the matter by taking “definitive, positive action” to tackle long standing deficiencies in the current system.
The letter pointed to “substantial evidence” that doctors’ current declarations of interests are incomplete, and lack enough information to enable “informed and fair” judgments.
It argues that voluntary registers set up by the Association of the British Pharmaceutical Industry “are not working well enough to be reliable” and only cover pharma payments, so do not capture declarations relating to journal supplements, nutritional products, medical devices, or patents.
The letter says there are currently too many different places where declarations can be made, creating an administrative burden for doctors who are asked to make declarations in commissioning, academic, and NHS work.
It also highlights that some registers of interest are inaccessible to lay people or behind paywalls, making information difficult to find even when an interest has been declared.
They wrote, “We believe that a central register, updated annually and permanently visible, based on known GMC registrants, would be the easiest, most cost effective, and most transparent way for doctors to declare interests. This could be updated annually and whenever a doctor needs to make a change. It would be visible to all and used by any organisation requiring a declaration. It would mean a reduction in administration for doctors needing to make declarations and be simple to use for doctors with no interests to declare.”
Sarah Wollaston, immediate past chair of the Commons Health Select Committee and a co-signatory of the letter, told The BMJ, “Transparency is a patient safety matter. It doesn’t need to be burdensome or bureaucratic and an open, easily searchable central register would benefit patients, researchers, and clinicians alike.”
Margaret McCartney, a GP in Glasgow and co-signatory of the letter, who has previously called for such a move from the GMC,1 said, “It’s time for doctors to show moral leadership and sort this out—the people with undeclared conflicts may be small in number but are disproportionate in effect.”
The GMC confirmed it had received the letter and said it would be responding to it in full next week.
The letter’s signatories
Susan Bewley, professor Emeritus of obstetrics and gynaecology, Kings College London
Iain Chalmers, co-founder, the Cochrane Collaboration
Sam Everington, chair, Tower Hamlets CCG; GP, Bromley by Bow Partnership
Muir Gray, executive director, Oxford Centre for Triple Value Care
Trish Greenhalgh, professor of primary care health services, senior research fellow, University of Oxford
Ben Goldacre, director, EBM DataLab; fellow Green Templeton College; senior clinical research fellow, department of primary care health sciences, University of Oxford
Sir David Haslam, immediate past chair, NICE
Iona Heath, past president, RCGP
Margaret McCartney, GP, Glasgow
Alyson Pollock, director, Institute of Health and Society, University of Newcastle
Sarah Wollaston, immediate past chair, Health Select Committee