Victoria Macdonald of Britain’s Channel 4 News, with the help of the nonprofit Bureau of Investigative Journalism, used FOIA requests to expose the National Health Services’ habit of using “gagging clauses” and financial settlements to silence whistle-blowers.
In a number of requests made under the Freedom of Information Act we discovered that over the past decade 170 doctors signed a settlement, or compromise, agreement with their trust. We were given 64 heavily redacted contracts to review. Of those 55 – that is nearly 90 per cent – contained gagging clauses.
Under another FOI we asked all 225 hospital trusts in England how much they had spent on settlement agreements over the past decade. Of those who responded, only 71 trusts admitted to entering into these agreements, 40 revealed they had spent a total of £3m. In one case, a doctor was paid a quarter of a million pounds. However, a further 31 trusts simply refused to tell us how much they had paid out.
While not every settlement was designed to muzzle a whistle-blower, a significant portion were, Macdonald found. The effort has created what she found was a “culture of fear,” yet there are no plans to revise the relevant laws.
The Bureau of Investigative Journalism, by the way, is a new not-for-profit with a £2 million ($3.2 million) grant to support long-term investigations at British newspapers.
Kris Hundley of the St. Petersburg Times reports that the Ischemia Research and Education Foundation, which maintained a massive patient care database intended to prevent heart attacks and strokes during and after surgery, is teetering on the brink of financial collapse. While his foundation relied on drug company grants for much of its funding, “monumentally stubborn and notoriously prickly” founder and leader Dr. Dennis Mangano insisted on IREF’s right to publish any and all of its findings, a move he said maintained its independence.
Despite its ties to pharmaceutical companies, Mangano’s foundation made some impressive discoveries, Hundley lists a few highlights:
He found that taking low-cost aspirin after bypass surgery reduces the risk of heart attack. He sounded the alarm about the deadly risks of using Bayer’s drug Trasylol to control bleeding during bypass surgery — nearly two years before the FDA suspended marketing of the drug.
And he warned that Pfizer’s painkiller, Bextra, raised the risk of heart attack and stroke in bypass patients. Bextra was pulled from the market in 2005.
The relationship between pharmaceutical companies and IREF seems to have always been an uneasy one. IREF’s recent troubles began when a rogue employee shared data with Pfizer for which the drug giant would otherwise have had to pay $15 million to $20 million. Mangano refused to settle with the company, instead taking it to court and winning damages totaling almost $60 million.
Now, a judge’s ruling has given Pfizer a second chance and Mangano says he can’t afford to match Pfizer’s resources in the courtroom a second time. He says his suit against Pfizer has made him a “persona non grata” in the pharmaceutical industry and thus cut off what used to be the foundation’s primary source of funding. IREF has gone from 80 employees to just three, and is bleeding money at an unsustainable rate.
The Association of Health Care Journalists has sent a letter to the editor of the Journal of the American Medical Association stating its objection to JAMA’s new policy that seeks to keep whistle-blowers from revealing information.
From the letter:
In an editorial (PDF) published March 20, JAMA said it will inform anyone filing a complaint about a potential conflict of interest that they “should not reveal this information to third parties or the media while the investigation is under way.”
JAMA also said it would require whistle-blowers to provide a “written detailed explanation of the unreported conflicts of interest and provide documentation to support the allegation.”
JAMA’s policy is counterproductive. It could discourage potential whistle-blowers from coming forward with crucial information that physicians and the general public urgently need to make informed decisions about medical care.
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