Drinking at the last chance saloon...or - there is no place for integrity in academic medicine

Fiona Godlee, editor, BMJ
fgodlee@bmj.com
Distinguished voices are lining up behind England’s chief medical officer Liam Donaldson in support of a minimum price for alcohol (BMJ 2009;338:b1124, doi:10.1136/bmj.b1124). The BMA and the Royal College of Physicians have made a good case (BMJ 2009;339:b2714, doi:10.1136/bmj.b2714 and BMJ 2010;340:c80, doi:10.1136/bmj.c80), and this week they are joined by the combined weight of the Faculty of Public Health and the Royal Society for Public Health (doi:10.1136/bmj.c342). These two bodies list a minimum price for alcohol among 12 policy changes that will save many lives and relieve pressure on the NHS. As the faculty’s president Alan Maryon-Davies says, in lean times such act ion is all the more essential.
The BMJ supports calls for a minimum price on alcohol, as well as for a ban on alcohol advertising and sponsorship. In her editorial, deputy editor Trish Groves highlights evidence on the damage caused by the fall in price and increase in availability of alcohol over the past 20 years (doi:10.1136/bmj.c372). She concludes that the serious health and societal costs of alcohol misuse are best prevented through legislation on pricing and marketing.
For obvious reasons the drinks industry is against this approach. It would like us to see alcohol misuse as a problem for individuals rather than society, and over the years it has successfully influenced government. In the first of our new Lobby Watch columns (doi:10.1136/bmj.b5659), Claire Harkins dissects the Portman Group, a body funded entirely by drinks manufacturers whose stated aim is to promote social responsibility in the alcohol industry. The group has intervened at key stages in the debate on alcohol and public health: in 1994 it paid academics to write anonymous critiques of a World Health Organization report on alcohol controls, and in 2004 it was the only "alcohol misuse" group cited in the UK government’s alcohol strategy. Who can doubt its continuing influence on UK government and opp osition policy?
New insights into the promotion of alcohol are useful, and here the Health Select Committee has scored some points. At its request Gerald Hastings and colleagues analysed internal industry documents to look at the thinking behind alcohol promotion, especially to the young (doi:10.1136/bmj.b5650). Their results suggest that attempts to control the content of advertisements just make advertisers more creative.
Home secretary Alan Johnson now admits that the voluntary code for alcohol retailers has failed and a mandatory code is needed (doi:10.1136/bmj.c390). But he won’t countenance an advertising and sponsorship ban, such as the one in France, or a minimum price, already successfully in place in Canada. Nor will the Tories (doi:10.1136/bmj.c271). Only the Liberal Democrats are committed to both measures.
In a speech at the Royal Society this week, Liberal Democrat leader Nick Clegg also came out strongly in favour of reform of our libel laws. His grandfather Hugh Clegg was a great former editor of the BMJ and a champion of open debate in science. This week A C Grayling calls libel reform a matter of the first urgency for medicine, science, and the public good (doi:10.1136/bmj.c339). And Jonathan Gornall tells how Peter Wilmshurst came to be sued for libel after questioning a drug company’s research conduct (doi:10.1136/bmj.c110). In a letter (doi:10.1136/bmj.c281), Wilmshurst gives his bleak assessment: "There is no place for integrity in academic medicine and whistleblowers will not be protected."

Cite this as: BMJ 2010;340:c394