Nofreelunch was founded by Dr Bob Goodman a general internist practicing in New York City. He is responsible for establishing the original website at www.nofreelunch.org . NFL is now a true international group of health professionals with members around the world. His philosophy is that anyone can join who works in health or a related sector because we all can effect change eg. students, pharmacists, nurses, dentists and doctors.
The UK spokesperson is Dr Des Spence who is a full time GP working in Glasgow. By his own admissions he is a reformed “Pharma Junkie” and as his penance has committed himself to working for NFL. He has written extensively on the subject and was responsible for commissioning the UK website. He is actively seeking to challenge the NHS hospitality culture through the existing regulatory channels. He has given various newspaper, radio and televisions interviews on Pharma related subjects.We in NFL accept that the popular media is our only avenue to the general public. Recently he has given evidence to the Parliamentary Select Committee investigation into the industry's relationship with the medical professions.
The case for the persecution in the UK runs something like this...............
- Most health professionals would accept that we currently are seeing an epidemic of health anxiety with surgeries and clinics full of the “worried well”. This health anxiety is eroding society's sense of well being at a time that paradoxically we have never lived longer.
- We assert that the flame of this health anxiety is being fanned by the corporate vested interests of the major pharmaceutical companies. This is known as “disease mongering” or “disease creep” where the healthy population get drawn into a “disease group”. A good example is cholesterol. The crude mission statement of the industry "is more disease ,more prescriptions and lots more money". The figure stands at £30 million a day 365 a year in the UK alone.
- There are currently 8000 pharmaceuticalpol representatives in the UK targeting about 60 000 NHS doctors. Not a bad teaching ratio! The industry also spend an estimated £10 000 per year on marketing to each doctor. Their staff and money are used for one reason, to influence prescribing. Common sense and research demonstrate how successful this influence is in changing prescribing patterns.
- This is very important as this example demonstrates. Recently an arthritis medication was withdrawn 4 years after its launch and many millions of prescriptions. Research suggested a 1% annual increase in stroke and heart attaks in patients on the medication. This medication had been very heavily promoted and as a result was much more widely used than recommended. Patients were put at risk unnecessarily by over zealous marketing.
- The pharmaceutical companies operate a widespread and highly successful hospitality culture within the NHS. This is not free pens or mugs. This is restaurants, drinks, trips, flights and hotels. All too often it is simple marketing masquerading as education The industry also focus on opinion leaders and many top experts in the UK have received direct payments from the industry. Pharmaceutical money has literally built the reputations and careers of many doctors. Professionals repeatedly say that they are unaffected by the hospitality but this simply isn’t true.
- The medical profession are in deep denial about the hospitality because they like it and frankly feel that they deserve it. If other public servants ( like teachers or police officers )recieved such hospitality a public outcry would ensue.
- We are all well paid respected public servants , enjoying full employment and a generous state pension. We took an oath to “do no harm” and to put patient care above all other considerations. We have a ethical and professional obligation to break the close links with the industry for the sake of our patients. Give us medicine and not marketing.
So endeth the sermon!
What we want in the UK
- We want a public debate – and to make the public aware of what is going on
- We want the medical profession to end its silence and acknowledge that it has a problem.
- We want medical schools to offer teaching about the marketing of medications.
- We want a review of the role of the APBI and a new “watchdog” that actually monitors activity of the industry
- Our main demand is an open, public database of all contact, hospitality and payments between NHS professionals and the industry. This would be the industry's responsibility to maintain as they currently hold all this information anyway. If there isn’t a problem then let the public decide.
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