by Lois Rogers and Mark Macaskill.THE SUNDAY TIMES 4 April 1999

Senior doctors who advise the government on whether new drugs should be approved for use in Britain have investments worth tens of thousands of pounds in the companies manufacturing them, a Sunday Times investigation has revealed.

Many of the doctors have direct shareholdings in the drug companies. One, who sits on the committee that advises the government on drugs to be used in specific treatments, has shares worth 130,000 pounds in two of Britain's drug companies. Others receive substantial perks such as research and equipment  grants, free air travel to conferences and money to cover salaries of extra research staff.

The extent of the link raises questions about the objectivity of some members of the Standing Medical Advisory Committee (SMAC) and the Committee on Safety of Medicines (CSM). They are drawn from medical royal colleges, universities and hospitals across the country to give independent advice on which treatments should be licensed for use in Britain.

David Hinchliffe, Labour chair of the Commons health committee, said he would investigate the apparent conflict of interest "It is wrong for government advisers to have financial interests in companies whose products they are advising on. It is something that concerns me very much" he said.

Professor Robert Kendall president of the Royal College of Psychiatrists and a member of SMAC,did not believe potential profits from drug sales to the National Health Service would influence the value of his 130,000 pounds holdings in SmithKline Beecham and Glaxo Wellcome. Kendall who has declared his interests, said "Any profit would be utterly trivial, probably only a couple of quid" Committee members are supposed to declare such interests in a register which is, in theory, a public document.

But it was only made available to the Sunday Times by the Department of Health after several requests and is not easily accessible to the public. At least one committee has, however, failed to make any declaration at all. Professor Roderick MacSween, president of the Royal College of Pathologists and a SMAC member, admitted that he might have been "neglectful" in not revealing his drug company shares worth 15,000 pounds. "I have ne ver been conscious of a conflict arising. I don't think I was ever asked about my interest in drug companies" he said.

Others reacted angrily to questions about their financial interests. Brian Evans, a senior pharmacist on the CSM who has declared his shareholdings in Scotia, Glaxo, Boots and SmithKline Beecham, refused to discuss the potential conflict of interest. "I have done everything by the book and I don't see that it is anyone elses's business." he said. Members are not obliged to disclose shares held by their spouses or other close family members. Sheila Williams, a consultant anaesthetist in Bristol and a SMAC member, admitted that her husband had shares in Glaxo but said "I haven't declared them on the register of interests because they are not mine". It is well known among doctors and civil servants at the Department of Health that the committee members are targeted by drug companies.

Some committee members believe that seeking funds from drug companies is ethically acceptable if the money is used to boost their research and so encourage medical advances.(advances like the thousands killed or maimed each year by their approved drugs.ZL)

Members who have drug company links are also adamant that such connections in no way influence their CSM and SMAC decisions. "Any specialist in an area invariably has research collaborations with companies; you just can't avoid it" said Gordon Duff, professor of molecular medicine at Sheffield University. He also sits on the CSM and has declared his interests in eight pharmaceutical companies.

Such links are, however, being increasingly questioned within the medical profession. Richard Nicholson, editor of the Bulletin of Medical Ethics called for the committees to be governed by much stricter regulations ofthe kind that cover MPs. The CMS's 34 members are paid 160 pounds plus expenses to prepare for and attend the fortnightly meetings in London. SMAC's members are not paid. Last week, however, the health department warned members of both committees not to speak to the media about their drug company links. (Wonder if the health dept's relatives have shares?ZL) In an effort to deflect accusations that the committees are exclusive cliques and that the doctors may (may?ZL) be too closely involved with the drug companies, in January it appointed two lay members to the CSM. However, one of them has now declared that she has shareholdings in three drug companies.