Inside health : Conflicted medicine 2/3.

In the next part of this series on conflicted interests, Dr Mark Porter discovers how the smallest interaction between pharmaceutical companies and doctors or charity campaigners have a major impact on the treatment patients receive. First to share her views is Moira Adams director of an advocacy group for breast cancer, she believes that the public should be made aware about the kind of influence drug companies have on the information they receive. She feels strongly about not taking money from pharmaceutical companies. In contrast, Sue Davies is accused of lobbying for the vaccination against meningitis, with the net result of promoting the vaccine manufacturers. However, she believes that receiving investments from these companies is acceptable in moderation as it is often the only way some medicines can be researched and marketed for public consumption. Dr Margaret McCartney talks about the change in the function of charities, before they would provide information for patients and families, now many charities are also campaigning for treatments and get pulled in the path of industry and the politics of lobbying because they are funded by pharmaceutical companies. Moynihan adds that companies are interested in making diseases they are researching look more extreme than they are in reality and use this to promote their drugs. Next Professor Peter Weisberg heading the British Heart Foundation talks about the problem of large organisations like BHF endorsing products produced by food manufacturers who want to sell a new health drink or food on the market. Professor Gerald Hastings discusses the significance of research being invested by companies with vested interests. Dr Fiona Godlee talks about the possibility of publicly funded clinical trials. On the other side of the spectrum Dr Mark Porter looks at the problems on the ground with GPs who have the most first-hand contact with patients and how they might have conflicted interests. Dr McCartney talks about some of these interests. Furthermore, Dr Chaand Nagpaul, talks about the need for a revision in government policies aimed at preventing these types of conflicts. One major thorn in the medical system is the practice of doctors who hold dual positions in the manufacturing of the product or service and the selling of it. Dr Clare Gerada talks about the practice of GPs being performance managed and penalised for referring too many patients to the hospitals even if the reasons are legitimate, therefore the problem often remains undiagnosed or mistreated. Dr McCartney also adds in conclusion the threat of marketisation of the health care system, where cost overrides real medical decisions that need to be made.