Re: Financial conflicts - shock horror

22 October 2008
John Stone

London N22

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Re: Re: Financial conflicts - shock horror

I note Malcolm Kendrick's interesting letter. However, I would also point out that Andrew Wakefield presented evidence earlier this year to the GMC that the Lancet and its editor, Richard Horton, were aware of his involvement in the MMR litigation at the time of the publication of the controversial article, whether or not it constituted a competing interest (which is debatable [1] - unlike the cases that Kendrick refers to). Some of this was reported in BMJ [2] although not in the media at large. Richard Horton disputed the detail of the claim to BMJ [2] but the matter is at the very least unresolved, and it would be unwise to jump to any conclusions.

A more troubling conflict might be that of Dr Surendra Kumar, who chairs the present fitness to practice hearing into the three Royal Free doctors [3]. Kumar sits on two committees of the medicine licensing authority (MHRA), the Independent Review Panel for Advertising and the Independent Review Panel for Borderline Products [4] and in the latest declarations of competing interests available ( both unsatisfactorily dating from 2004) Kumar discloses a shareholding in MMR defendents GlaxoSmithKline [5,6].

Given Kendrick's sympathetic view of this issue, I would also finally like to remark on the huge disproportion in the coverage of the 'MMR affair' between the reporting of the allegations against the doctors and the reporting of the defence.

[1] John Stone, '"MMR Science and Fiction" - the Richard Horton story, BMJ Rapid Responses 25 September 2004, http://www.bmj.com/cgi/eletters/328/7438/528#75516  

[2] Owen Dyer, 'Wakefield admits fabricating events when he took children's blood samples' 19 April 2008, http://www.bmj.com/cgi/content/full/336/7649/850  

[3] Andrew Jack, 'MMR doctor denies abuse of trust' Financial Times, 16 July 2007, http://us.ft.com/ftgateway/superpage.ft?news_id=fto071620071825004908&page=2  

[4] Medicine Act 1968, Advisory Body Report 2007, p.84 and 89, http://www.mhra.gov.uk/home/idcplg?IdcService=GET_FILE&dDocName=CON2032766&RevisionSelectionMethod=Latest  

[5] INDEPENDENT REVIEW PANEL FOR ADVERTISING, http://www.mhra.gov.uk/home/groups/es-cb/documents/committeedocument/con003563.pdf  

[6] INDEPENDENT REVIEW PANEL FOR BORDERLINE PRODUCTS, http://www.mhra.gov.uk/home/groups/es-cb/documents/committeedocument/con003564.pdf  

Competing interests: Autistic son