Dear Mr Cox-Brown

Thank you for your letter of 11 May (Ref E1-6XK3V) in response to my enquiries dated 1^st and 28^th February. Thank you too for returning the Panorama DVD that I sent to Anna Neill. I received both on 18 May, several days after I had read the duplicate letter you sent to another complainant, Mr. Derek Brown. He posted your correspondence on the Internet, but you should know that I had no contact with Mr. Brown on this matter: these were independent complaints, albeit prompted by many of the same concerns.

I am now minded to post our correspondence on the Social Audit website (>1m visits/year), to allow others to decide whether my enquiry was handled appropriately. My view is that this response casts doubt on the General Medical Council’s own fitness for purpose. The response to date signals to me lack of competence, capacity, imagination, independence and commitment to health, though in what proportions I can’t be sure.

I was struck by the emptiness of your letter. Everything you wrote emphasised that the GMC believes nothing can or should be done. The available evidence was sufficient to persuade Panorama to complain that Dr Benbow, representing himself as expert, had broadcast false and misleading statements about the safety of Seroxat (paroxetine). Yet the GMC seems unconcerned.

Is this really in the public interest, and in line with public expectations of the GMC? I very much hope not. It seems absurd that the GMC should be satisfied with the conduct of a registered medical practitioner, even when he/she falls short of pharmaceutical industry standards for drug sales representatives:

"Information, claims and comparisons must be accurate, balanced, fair, objective and unambiguous and must be based on an up-to-date evaluation of all evidence and reflect that evidence clearly. They must not mislead either directly or by implication."

I bent over backwards to explain that I don’t have it in for Dr Benbow either as a clinician or personally but - along with many others - I am extremely concerned that any doctor should so uncritically toe the company line, when evidence of drug risk and harm is so strong. The generic issues seem critical: are doctors who speak for drug companies under too much pressure or otherwise professionally compromised? Are they simply to be regarded as company spokespeople, owing correspondingly less to the public by way of duty of care? It seems really feeble that the GMC should conclude so blandly, authoritatively and emphatically that there is nothing to be said, case closed.

The GMC’s position seems all the more unacceptable given that your President recently, if unwittingly, instigated an oppressive investigation of Professor David Healy, on the basis of ropey evidence and dark hints. On that occasion, a bit of deviously orchestrated and nasty gossip was sufficient for the GMC to require Dr. Healy to justify, in some detail, his fitness to practice as a doctor. I suppose it is to the GMC’s credit that they later concluded there was no case to answer; several major pharmaceutical companies would have been well pleased if this monstrous complaint had been pursued.

Here too, the GMC seems to have missed the point. Commercial influence now has profound effects on the ethos of medicine, clinical practice and patients’ health – some undoubtedly welcome, but others unquestionably not. If the GMC wasn’t concerned about the evidence from Dr Benbow, it would strike at the heart of evidence-based clinical medicine. I’d be reassured to think that, as a matter of urgency, the GMC was at least thinking about giving guidance on the subject – strong enough to protect the conscience of honest doctors employed by drug companies.

Both to protect Dr Benbow’s reputation, and to safeguard its own credibility, I suggest that the GMC should now state publicly [a] whether or not Dr Benbow was asked to respond to any allegations? [b] whether and in what manner Dr Benbow explained his position to the GMC? [c] whether or not the GMC accepted evidence from Dr Benbow that he had faithfully described the risks and harms of paroxetine known to him? [d] that the GMC was satisfied that the evidence of risks and harms of paroxetine that were uniquely available to Dr Benbow was satisfactorily communicated and [e] whether he explained to the GMC’s satisfaction that his performance on Panorama was sufficiently guided by the truth, the whole truth and nothing but the truth.

One should expect nothing less from an honourable doctor than from a witness in court, but where does the GMC stand? The question is not rhetorical, but nor am I prepared to fall in with the executive propensity for delay. If you or anyone else from the GMC were to pick up the phone within the next working day or two, I would sympathetically engage in any discussion relating to issues, publicity and engagement – even on off-the-record terms, if that were to serve some greater good. An alternative might be Judicial Review.

Yours sincerely

Charles Medawar
Director

 

Tim Cox-Brown (0161 923 6427) <TCoxbrown@gmc-uk.org>		31-May 2007
Dear Mr Medawar Thank you for your letter of 24 May 2007. We are currently considering your comments and we will contact you again in due course. Yours sincerely Tim Cox-Brown Investigation Officer Fitness to Practise Directorate Direct Line: 0161 923 6427 Fax: 0161 923 6578 E-mail: tcoxbrown@gmc-uk.org This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you have received this email in error please notify gmc@gmc-uk.org General Medical Council St James Building, 79 Oxford Street Manchester. M1 6FQ Tel: 0845 357 8001 Fax: 0845 357 9001

 

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