Social Audit Ltd
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Mr Roy Alder, Head of Executive Support
Medicines Control Agency
Market Towers, 1 Nine Elms Lane
London SW8 5NQ

17 March 1999

Dear Mr Alder,

This kind of delay isn't really something one can apologise for but, if ever you feel some real need to explain, why not use the telephone? In the meantime, I'll trust my judgement about what's going on. I think the reason the CSM/MCA are so secretive about the long-term risks of antidepressants etc is that they're paralysed by disagreement, and torn by the conflict of interest - between now acknowledging there could be serious risks for patients, and admitting they've made serious mistakes themselves.

I too regret all this delay, but it does at least throw up some vivid examples of government secrecy in action, and the lack of accountability it permits. I see these as significant risk factors in medicine; they are very much part of my professional concerns. I concede that the CSM/MCA has so far largely succeeded in running rings round my rights, as defined in the Code of Practice on Access to Government Information - but this is of professional interest too.

My requests for access to the edited minutes of CSM meetings were originally made one year ago. First, I got no response, then much prevarication, finally a refusal. After appeals and complaints from me - through the MCA's own procedures and via Richard Shepherd MP to the Ombudsman - eventually the MCA had to concede that it was obliged to disclose the information I'd asked for. Still, it's been uphill ever since:

On 11 November, you told me the MCA needed time to conduct a "detailed scrutiny" of the relevant documents to determine whether disclosure could best be effected "by providing an edited version of the document itself or preparing a summary" - adding "our target date for completion is 23 November."

On 9 December, you wrote to say "I have asked staff at the MCA to complete the preparation of the outstanding documentation", that is to "edit minutes to remove any confidential material" - adding that "our aim is to send the material to you this week".

On 20th January, you said you "very much regret that this is taking considerably longer than I had hoped".

On 12th February, you again very much regretted the delay, but said you had "set a deadline for our final reply to be sent to you no later than Monday 15th March". It was a promise.

Today I get a letter, which apparently took five days to arrive, advising me that there would be a further indefinite delay because you had now decided that to release edited minutes "would render the information virtually meaningless".

I nevertheless invite you to disclose them right away, to comply with the request as framed. Please refer to my letter to Mr Whitbread of 20 March 1998, in which I specifically requested edited texts, to "allow me to establish how much of the Committee's business is typically devoted to secret discussion of licensing matters". This was a paradoxical request for disclosure - an attempt to see how little would be revealed. I've made no secret of my working hypothesis, that official secrecy in the medicines field makes effective and meaningful communication almost impossible. I didn't expect to get much and my low expectations were fulfilled.

The point is that I positively wanted people to be able to see how meaningless everything becomes when secrecy is rampant - to stare aghast at nonsensical snippets on blanked-out pages, to visualise what it means. I also wanted to give the MCA/CSM the opportunity to appreciate how meaningless even their best efforts might appear, from the perspective of those on the receiving end.

Then there is the question of what appears to be, if not evidence of pathological and pathogenic secrecy, then of remarkable incompetence. Over four months ago, you told me that some "detailed scrutiny" had led you to conclude that the best option was to disclose edited texts. Now you tell me the opposite. One way or another I feel I have been misled and humiliated by unacceptable delays. I should like to make a formal complaint about this, please - but is this one for Dr Munro or the PCA? You send all your letters to the OPCA, but you can hardly blame me for not wanting inconvenience Richard Shepherd at every turn. Please advise.

You say you are now preparing "summaries of the disclosable information". I shall look forward to reading these when the time comes - and comparing them with the edited texts I hope the MCA` will now provide. It would, of course, be impossible to accept summaries on trust. In any case, I would want to try to follow the metamorphosis of essentially meaningless text into something meaningful. In short, I'm now formally requesting the immediate release of the edited minutes, plus the summaries in due course.

Yours sincerely,
Charles Medawar

cc Richard Shepherd MP


Contents page
List of correspondence with MCA/CSM