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Opening the door on vested interests
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    The Freedom of Information Act may herald a new age of openness in public life, but are medical organisations slow in keeping up with changing attitudes?

    Royal colleges and medical associations—which are currently exempt from the Freedom of Information Act—should not be complacent but should instead openly publish details about the activities of influential members, campaigners have said.

    Currently, only the General Medical Council is covered by the act, which came into force on 1 January. For several years the council has been publishing its register of members' interests on its website (www.gmc-uk.org/about/register_of_interests.pdf). Details include whether a member is a freemason or the member of a political party.

    The Association of British Neurologists has recently put details of senior members' financial interests on its website, but its openness remains unusual.

    The Freedom of Information Act, which applies to about 100 000 public authorities, including the NHS, gives the public new rights to the information previously held back as "for internal use only." It does not, however, apply to professional bodies—yet.

    Maurice Frankel, director of the Campaign for Freedom of Information, warned that professional organisations could end up on a future list of public groups covered by the act. "They could end up listed alongside the GMC. There is also an increasing expectation of openness which indirectly applies to these bodies," he said. "It's a guiding principle that anyone who has a position to influence policy ought to be thinking seriously about declaring their interests. It's much more accepted practice on government advisory committees now, for example.

    "Very often people fear the worst and don't act because of that. It's very unlikely that doctors will wake up one day and find pressure groups camped outside their window," he added.

    Charles Medawar, director of the charity Social Audit, which has campaigned against secrecy in government and public bodies, agreed: "The rather lofty view that `I am above influence and care only for my patients' is no longer realistic," he said. "There have been too many stories in the press to prove the opposite can be the case. There is also the imperative to be seen as being independent. It's good that professional associations are registering this."

    Professor David Chadwick, president elect of the Association of British Neurologists, said that the decision to collect and publish details about members had been uncontroversial. These are openly available on its website (www.theabn.org/theab/registerofinterests.html).

    The association records any research grants or contracts money that council members have received in a financial year. The information includes the name of the drug company, the type of trial, and the exact amount of funding. The requirement to disclose also applied to members on guidelines panels. Members also record connections with any disease pressure groups.

    "By asking our members to do this we were pushing at an open door. I don't think anybody is resentful or sees it as an intrusion. We now have a Freedom of Information Act so people don't see it as a big issue.

    "We feel that as an association that does interact with the pharmaceutical industry we do need to be clear and open of those relationships. Increasingly we are asked for advice from NICE , the Department of Health, the Royal Colleges, for example."

    More and more medical associations have set up registers for members to list interests that concern their employment or practice.

    The Royal College of Anaesthetists, which set up a register a year ago, said it was good practice. "Call it corporate governance or probity, but that is the way the world is going now and you can't make decisions behind closed doors," said the college secretary, Kevin Storey. Although only viewable on its website by college members, the public can write in for the information, he said.

    Several of the associations that already keep a register of interests were considering making them more freely available in the wake of the Freedom of Information Act.

    Alistair Chambers, honorary secretary of the Association of Anaesthetists of Great Britain and Ireland, which has been keeping a register of council and committee members for several years, said, "We like to know if somebody is connected to NICE, or the health technology assessment unit, or a defence organisation. It isn't publicly available, but under the Freedom of Information Act we may need to make it available on our website." He said that his council was due to discuss the act this week.

    The register of interests held by the Pathological Society of Great Britain and Ireland for all its trustees, officers, and committee members includes details of consultancies with commercial organisations, sources of grant funding, and commercial sponsors. Although these details are not available on the internet, the society was considering publishing them as part of its annual report.

    The BMA, the Royal College of Physicians, the Royal College of General Practitioners, and the Royal College of Psychiatrists all keep a register of relevant interests. In common with others, the BMA said its register on the 85 members of its ruling council was not on its website but was not secret either. Interested parties could apply for the information, a spokesperson said.

    Meanwhile the Royal College of Physicians said it had taken legal advice on how the Freedom of Information Act affects its activities. "We have looked into this legislation and think we are not a body that comes under the act, but we are trying to comply with the spirit of the act so if there was a specific inquiry we would do our best to comply," a spokeswoman said.

    Some organisations, such as the British Association of Plastic Surgeons, see no reason for such registers. Chris Caddy, a consultant plastic surgeon in Sheffield and chairman of the association's ethics committee, said the group had plans to relaunch its website detailing the names of members and their specialty. But it had no plan to set up a register of interests. "It is not relevant to what we do. We are about providing clinical and professional information," he said.(Rebecca Coombes)