Something is rotten in the state of Denmark

I have had a number of emails, both from doctors and members of the public, asking about the ethical position of doctors who publicly promote the services they offer. Twenty five years ago any form of advertising would have resulted in a doctor being hauled up in front of the GMC. Nowadays, in the age of information technology it is accepted, and rightly so, that doctors may advertise the services they offer and draw attention to their particular areas of expertise as well as all the mundane information about location and opening times. But are doctors allowed to promote themselves, canvass for business and, indeed, offer inducements to patient to sign on with their practice?

I am not so sure about that.

The Department of Health "Code of practice for promotion of NHS services" is available on the DoH web site here.

Section H: Inducements to the public
No financial inducements or benefits for treatment (including by way of salespromotions) shall be offered to the public, their carers or advocates...

That seems clear to me. So what precisely is the Melbourne Grove Group Practice, part of Concordia Health, up to?

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What, Dr Crippen wonders, do the other family doctor practices in the Dulwich area (and there are several excellent ones) think of this? How will they compete? What inducements do they propose to offer? And who, exactly, are Concordia Health? The plot thickens.

Take a look at this article in the BMJ.

The contracts for the management of the Melbourne Grove practice in Dulwich and Parkside in Camberwell have been awarded to Concordia Health, an organisation led by GPs John Chisholm and Simon Fradd together with NHS specialist lawyer Andrew Lockhart-Mirams.

Just a minute. Chisholm? Fradd? I know those names.

Dr Chisholm, a former chairman of the BMA's General Practitioners Committee, and Dr Fradd both had key roles in negotiating the new General Medical Services contract.

Ha! Ha! Ha!

Last week, in Greedy GPs - the Devil has his say, I drew your attention to the BMA description of the GPC:

"The General Practitioners Committee (GPC) is a committee of the BMA with authority to deal with all matters affecting NHS general practitioners. It is the only body which represents all GPs in Great Britain, whether or not they are members of the BMA. (BMA)"

I then went on to say:

A characteristically arrogant and dishonest statement by the BMA who are so far up the arse of the government that they are close to being an official spokesman. Let us not forget their cynical betrayal of the junior hospital doctors during the MTAS battles. The BMA is not authorised to speak for me. The BMA does not represent me, it does not represent most of my colleagues. The BMA represents the BMA. Pass the port, Charles

A regular correspondent of NHS BLOG DOCTOR who I happen to know is a doctor of the utmost integrity was not best pleased. He said:

Sorry John, but I really, really resent this. Some of us in the BMA are working our arses off to try and help colleagues. We are dealing with the aftermath of MMC, a GOVERNMENT sponsored lunacy that the BMA had tried to warn them about as far back as 2004, the establishment of PMETB when the Colleges rolled over and gave away ALL influence over training and standards (why does no-one ever criticise them? What happens to our college fees now they no,longer pay fro training? Perhaps we should be told?)

A heartfelt response with which I sympathise. Trouble is, though, despite the obvious integrity of this correspondent a lot of us have lost confidence in the BMA. Is it any wonder? Patricia Hewitt is now working as a consultant for a private equity company that buys up hospitals, Peter Hain is paying his 80 year old mother a House of Commons salary of £5400 a year (Daily Telegraph) and Chisholm and Fradd have set up a company to compete against the family doctors they once purported to represent.

Perhaps you will pardon my cynicism but is seems that, in all walks of life, everyone is at it. It must be the new morality.