Friday, 9 May 2014

NHS Lothian still does not maintain a Register of Interests for all employees - why not?

I made an FOI request to NHS Lothian on 30 April 2014, asking if there was now a Register of Interest for all employees, in particular to find out if any psychiatrists in this health board area, where our Scottish Parliament sits, receive payments from drug companies.  

Answer: No Register of Interest for all employees.  Eleven years after Health Boards were all asked to do so.  In the interests of transparency and improved patient care.  Therefore the public, patients and carers have no access to information about doctors who may be receiving payments from pharmaceutical companies, as consultants or other remunerated posts.

HDL 2003 62 is a Scottish Government guidance document "on joint working between NHS Scotland and the Pharmaceutical Industry, which is transparent and improves patient care".  It sets out Action by Health Boards and Trusts: "Chief Executives are asked to establish a register of interest for all NHS employees and Primary Care contractors and produce local standing orders specifying who is responsible for keeping and maintaining the register.". 

Here is my request:

"I am writing to you to ask for information about declarations from doctors in NHS Lothian, regarding their links with and monies received from drug (pharmaceutical) companies.

I know that NHS Circular HDL (2003) 62 makes it clear that all health boards should establish a register of interests for all NHS employees and primary care contractors.  I have read in the Hole Ousia blog post, from a letter dated 6 July 2013 written by Alan Boyter, that there are no centrally held registers in NHS Lothian, apart from board members;

I would like to know if the position has changed in NHS Lothian in the 9 months since.  Recently there have been a number of media articles and TV programmes highlighting the payment of doctors by pharma and the conflicts of interests that arise.  I want to know if NHS Lothian are now complying with HDL 2003 62 and with the NHS Circular MEL (1994) 48 Standards of Business Conduct For NHS Staff.  This 20 year old standard mentions staff declaring "relevant interests".  A prescribing doctor linked to a drug company by way of payment I contend has to be transparent.  For after all drug companies are about creating customers not cures."

Response received today:

"I must advise that information in relation to NHS Lothian’s Register of Interest for Board Members and the Gift and Hospitality Register is available via the following link:

There are no other centrally held registers available within NHS Lothian and any such register would not necessarily identify payments to staff.  Normal practice would be to declare the interest, not the financial amount.  If someone received payments through secondary employment, we would not have that information.  Ideally any transactions should be on a firm footing directly between the Board and the company.  The appropriateness of the relationship should be considered before it is pursued.

.... we do not maintain a standing register of interests for all employees.  Employees are meant to declare relevant interests as and when required, and then it will be recorded and considered accordingly within the personnel record.  The position has not changed in the last nine months." (bolding is mine)

Here is link to the NHS Lothian FOI Response Letter dated 6 May 2014.

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