Thursday, January 04, 2018

Who pays the piper calls the tune

NHS clinical commissioning groups (CCGs) are supposed to declare all payments from outside sources in a public register, but an investigation by The BMJ found £3.7m in funding that wasn’t recorded. The BMJ found that two-thirds of the 4,600 payments it identified were reported in the public register, but these only account for a quarter of the £5m received in total.

Registers of the 207 NHS CCGs reported £1.28m worth of income, including gifts and hospitality, from private sector or charity organisations between April 2015 and March 2017. Freedom of Information requests, submitted in collaboration with researchers from the University of Bath and Lund University, Sweden, identified a total of £5m received over the period. 

Piotr Ozieranski, a lecturer in social policy and sciences the University of Bath, said that even contributions of small monetary value can have a big influence on doctors’ behaviour, and are part of a pattern dubbed the “pharmaceutical gift cycle”.  Tickets to sporting events and concerts were offered by private sector companies to NHS managers responsible for £73.6bn of NHS funds

CCGs were established as part of former Health Secretary Andrew Lansley’s 2012 reforms of the health service, and aimed to put GPs and other NHS clinicians who understand local health needs in charge of buying NHS services. There are strict rules on conflicts of interest to prevent practising health professionals benefiting from the funding and contracting decisions they make in their CCG role.

The Department of Health launched an investigation in 2015 after CCG and hospital leaders involved in deciding what drugs should be bought were discovered to be also acting as consultants for pharmaceutical companies.

Paul Glasziou, professor in the Centre for Research in Evidence-Based Practice at Bond University, Gold Coast, Australia, told The BMJ that drug company involvement in education does impact doctors’ behaviour.

“Pharmaceutical company dominance of the funding of continuing medical education can result in prescribing that harms,” he said, adding that doctors are often “naïve about the persuasion tactics” used in these events, which meant they urgently needed to be better regulated.




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