Hmmm... the html tags appear not to be working despite me having set them to on. I will enclose your words, Ray, in this indicator: [*****]
[*****]Ray Holder said:
"Dear xrn
I wish you good luck with your information campaign!! However, I must tell you that over the last 4 years, I have written to many people in high places, with little or no reaction. From the PM, 2 Health secretaries, NICE, MHRA, various professors and consultants to placing letters on the BMJ web edition, with very little result."[*****]
Hello Ray. I can see that you have tried to inform the correct authorities and attempted to alert those who need to know. The only group who are missing from your list are the public. I don't say that in an effort to pour water on your time or work... I say it just to observe that the public are the group who really matter. The people and groups that you have mentioned, Ray, are not the people being forced to fall into line with the currrent 'best practice'.
[*****]I believe that the medical and research bodies are in a cleft stick, the financial figures bear it out, the great majority of research money spent in UK comes from Big Pharma, who decide which subjects shall receive funding. It follows that the big university hospital research personnel are virtually on the Pharma payroll and any research into unpalatable subjects is frowned upon. That probably carries over to research into other matters, where the outcome might upset the principal benefactor. All the top brass of such departments could put their department and even their personal position at stake by falling out of line.[*****]
I did not want to get sidetracked and have to address the issue of research and how it is funded at this point. I know that research has to be carried out and the issue of how divorced that research has to be from the drug companies is clear to my mind. The drug companies can (and do) employ their own medical staff nad as such, they could carry out their own research but would have to accept that it was tainted by their vested interests.
Research that is nominally independent of such influences would be the only way forward but there is an argument that it would founder and fall into disarray if the NHS were to promote research on its own. Funding research is a nice idea but it is not going to happen when the pot is always empty and the needs of providing the service are always put ahead of the need to carry out useful research. The independent reserach establishments such as the national Cancer research body are probably the model that should be examined and adapted to the needs of public health.
[*****]NICE committees discussing such drugs as statins are made up mainly of such leading persons, with less than unbiassed input to the proceedings, only certain members of the committee being allowed a vote. It really is a scandalous situation, but who is big enough to take it on? I am coming round to the idea that some such organisation as the National Audit office must be brought in, politicians only make political capital out of "Our great success in heart health" and would be defensive. [*****]
The hope for the embryo National Institute for Clinical Excellence (NICE) was that it would be a truly independent scrutineer of best clinical practice. Sadly, the organisation has not proven to be anything more than a puppet of the government. It is comprised of the great and good these days and the name has been subtly changed to become The National Institute for HEALTH and Clinical Excellence. That suggests to me that their original role (determining what was the essence of excellence in healthcare) has now been subsumed into determining what ought to be the national policy on various health issues. It would be a foolhardy practitioner who works in opposition to the printed statements of NICE.
I detest the underlying newspeak that George Orwell predicted in his novel '1984', where we (the unknowing public) are supposed to make the connection in our minds that NICE equates to a body that is helping us. yuk! In my own memory, the much vaunted Commission for Health Improvement was initially abbreviated to CHimp but it has since been changed... although I cannot see why.
[*****]I have been putting some education for doctors in my letters on the BMJ website, whose accent is on evidence based, peer reviewed medicine, but is that evidence always the whole truth and nothing but the truth. There is also the effect of "economy with the truth", and are reviewing peers any less under Big Pharma's influence than report authors? There is a whole can of worms waiting to be opened up.[*****]
I can see some value in keeping the unpopular view in sight of those who would rather not see it published. Young clinicians wishing to make a name for themselves within the highly competitive world of the junior clinician, who is vying with many other clinicians for a career pathway, could see it and try to carry it futher. Is writing to the BMJ website an option that any person can take up? What do I have to do to sign up.
[*****]Keep battling on, you can give me a ring to compare notes if you wish.
Ray[*****]
Surely, I intend to do that. If you PM me with your phone number, I will be delighted to call you and swap notes.
xrn