Letter: Who's influencing who?

From Peter Cardy, Macmillan Cancer Support

In focusing so heavily on funding, your report on industry influence on patients’ groups misses other important aspects of the relationship (28 October, p 18). As in the US, some UK “patients’ groups” are in fact genuinely consumer-led and governed; others are entirely professional associations; while some appear to be voluntary bodies but are in fact extensions of industry.

Influence can be traded in more subtle ways than direct funding. Many all-party parliamentary groups in the UK, for instance, are funded by industry – or by voluntary bodies that channel funding from industry. The ascendancy of the National Institute for Health and Clinical Excellence (NICE) in health technology appraisal in England has resulted in voluntary groups that contribute to appraisals making alliances with manufacturers, and sometimes receiving support from them in cash or kind.

This is not intrinsically wrong. There is sometimes real overlap between voluntary groups’ objectives of ensuring that their beneficiaries receive the best available treatment, and industry’s mission to ensure take-up and a successful return on their huge investments.

But it is proper to ask questions about who is influencing whom. Last year’s debacle in which Patricia Hewitt, the secretary of state for health, appeared to endorse the drug Herceptin, in advance of NICE authorisation, left many questions unanswered.

There is a simple way of ensuring that questions can be asked about the independence of voluntary groups.

Those that receive support from industry can publish full details in their annual reports. Macmillan Cancer Support does it, as do the other health charities which I have led. There is no downside, so why don’t they all do it?

London, UK