‘The willingness among some . . .’

Hole Ousia

The support of the BMJ Editor in Chief to address meaningfully financial conflicts of interest in medicine and science is most welcome.

As an NHS doctor of 25 years I have willingly given much of my spare time in trying to bring about change in this area. I have to be honest: I have not found it easy and my ‘activism’ has had consequences for my career. In 2013 I raised a petition with the Scottish Parliament seeking the introduction of a Sunshine Act for Scotland. That petition was closed more than three years ago after a public consultation. The majority of those consulted agreed that legislation was necessary. However the Scottish Government, behind closed doors, chose one of four options under consideration. The “option” that was chosen might be reasonably considered as status quo.

It would seem then that the Scottish Government do not find it…

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First FacebookLive

Mental Health Cop

I mentioned a short-time ago that I’d been asked to do some kind of CPD thing via social media where I could explain some stuff and people could ask questions.

I’m planning to start doing this and will be having a bit of a test-drive of the idea at 2pm on Thursday 14th March. I’m genuinely not bothered whether only a few people tune in (hence limited notice of it happening!), as the idea is just to give this a bash and for me to get use to doing it with the IT, etc.. Just seeing if it’s manageable.

Once I’ve got my head around it and if feedback suggests it’s worthwhile, we’ll give it a ‘proper’ go with more notice and a bit more pushing on social media for the fact that it’s happening.

So, Thursday 14th March at 2pm, if you’re free for 20minutes and especially…

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Dr Veronikis Gives Answers

Australian Pelvic Mesh Support Group

Dionysios K. Veronikis, MD, FACOG, FACS

Mesh removal is by far the most complicated and technically demanding procedure(s) a gynecologic surgeon can perform secondary to the scarring/adherence of the mesh on the delicate pelvic organs, the distorted anatomy, previously operated vaginal tissues and the mesh arms that penetrated the pelvic floor muscles.

Therefore, it is imperative that you do your own research and pursue mesh removal surgical treatment with a master vaginal surgeon, with a proven track record of successful and safe mesh removals, who is tenured in the treatment of vaginal prolapse and incontinence; and is able to remove the mesh without tissue destruction utilizing a tissue sparing removal technique by obtaining the needed surgical exposure.

Above all, it is the surgical skill set, experience and judgement of the surgeon that will make the difference for the outcomes of each particular patient and the quality of life.

When did…

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Soft Power [and telling stories]

Hole Ousia

This Feature Article made the cover of the BMJ:

One of the contributors described an approach to influencing healthcare policy as follows:

Telling stories is a well established approach taken by the commercial sector.

[These are the publicly available declarations of interest for this contributor:]

It seems that I am not alone in feeling most uncomfortable that another aspect of “soft power” is that it happens “behind closed doors”, as recognised in the article:

This single reference used in the article expands further on the approach of “soft power”:

“Soft power” is still power. Telling stories is not always the same as telling the truth. The shaping of policy “behind closed doors” excludes wider scrutiny. The power stays with the “narrative controllers”.

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“He delivered piercing insights”

Hole Ousia

The Royal College of Psychiatristsdescribes“7 highlights” from its “sold-out”, and no doubt lucrative, International Congress 2018 which this year was held in Birmingham.

The Royal College of Psychiatrists gives this “keynote” as one of the highlights:

Professor Hamish-McAllister’s declarations of interest can be accessed from the British Association for Psychopharmacology. His declaration of 27th March 2017 confirms that in the previous three years, he had “accepted paid speaking engagements in industry supported symposia”from:

  1. AstraZeneca,
  2. Bristol Myers-Squibb,
  3. Eli Lilly,
  4. GlaxoSmithKline,
  5. Janssen-Cilag,
  6. LivaNova,
  7. Lundbeck,
  8. Merck Sharp & Dohme,
  9. Otsuka,
  10. Pfizer,
  11. Pulse,
  12. Roche,
  13. Servier,
  14. SPIMACO,
  15. Sunovian,
  16. Wyeth

It would be interesting to know how many of the  2,700 delegates from 54 countries, “more countries were represented than in the World Cup”  had  “piercing insight” into Professor Hamish McAllister-Williams extensive financial competing interests?

In June 2017, Professor Hamish-McAllister came to the small District General hospital that I work…

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“Objectivity” does not come in a title

Hole Ousia

On the 17 July 2018 Professor Roy Perlis shared the publication of this paper in which he was lead author:

Professor Perlis who is Director, Center for Experimental Drugs and Diagnostics, Massachusetts General Hospital did so with this introductory statement:

“Papers suggesting that antidepressants are associated with adverse birth outcomes get published in JAMA and hyped on NPR and BBC. Think this one, suggesting the same for psychotherapy, will get noticed? Confounding by indication is the point, of course.”

Two senior Scottish Psychiatrists shared this. One was Professor Keith Mathews and the other was Dr David Christmas, both of whom work for NHS Tayside.

In a post that I wrote in April 2018 I considered another recent paper by Professor Perlis, “Anxiety about Antidepressants” , where he considered “the cognitive and affective biases that may prevent effective treatment“. In this paper Professor Perlis referred to the recent publication…

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Hole Ousia

This post is not about Donald Trump.

I first communicated with Professor Sir Simon Wessely not long after he had been elected as President of the Royal College of Psychiatrists. In his e-mail of introduction to me he asked me to call [him] “just Simon”. I appreciated this to be nothing but an act of extraordinary kindness. I was wowed that the President of my college was on level with me.

At this time my uncle, Dr Guy Scott, was President of Zambia.

My uncle’s Presidency of Zambia was short lived.

Professor Sir Simon Wessely has since moved on from President of the Royal College of Psychiatrists to be elected as President of the Royal Society of Medicine.

I have never met Professor Sir Simon Wessely, however he did walk by me when I protested outside the RCPsych International Congress in Edinburgh, 2017. I noted that he arrived with a carefree…

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Transparency: Revision of NICE guidance on Depression

Hole Ousia

In a recent post I shared a letter that I had sent to the BMJ that was not published. It was based on correspondence with Professor Sir Simon Wessely who is one of the members of a stakeholder group who requested a revision of the Draft NICE Guidelines on Depression in Adults: Recognition and Management

In correspondence with Professor Sir Simon Wessely he suggested that I make a Freedom of Information request to NICE. I followed this advice and have received the following four documents (shared here below as received).

I also share here, to provide open and transparent context, the correspondence that I had with Professor Sir Simon Wessely. I will let the reader decide on whether this is the correct thing for me to do. I have concerns that such a powerful and influential UK medical leader should confuse transparency about a matter of public interest with me as…

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