Newton Alex, Lloyd-Williams Ffion, Bromley Helen, Capewell Simon
Department of Public Health and Policy, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool, L69 3GB, UK.
BMC Public Health. 2016 Aug 5;16:735. doi: 10.1186/s12889-016-3393-2.
A conflict of interest (CoI) can occur between public duty and private interest, in which a public official's private-capacity interest could improperly influence the performance of their official duties and responsibilities. The most tangible and commonly considered CoI are financial. However, CoI can also arise due to other types of influence including interpersonal relationships, career progression, or ideology. CoI thus exist in academia, business, government and non-governmental organisations. However, public knowledge of CoI is currently limited due to a lack of information. The mechanisms of managing potential conflicts of interest also remain unclear due to a lack of guidelines. We therefore examined the independence of academic experts and how well potential CoI are identified and addressed in four government and non-governmental organisations in the UK responsible for the development of food policy.
Policy analysis. We developed an analytical framework to explore CoI in high-level UK food policy advice, using four case studies. Two government policy-making bodies: Department of Health 'Obesity Review Group' (ORG), 'Scientific Advisory Committee on Nutrition' (SACN) and two charities: 'Action on Sugar' (AoS), & 'Heart of Mersey' (HoM). Information was obtained from publicly available sources and declarations. We developed a five point ordinal scale based upon the ideology of the Nolan Principles of Public Life. Group members were individually categorised on the ordinal ConScale from "0", (complete independence from the food and drink industry) to "4", (employed by the food and drink industry or a representative organisation).
CoI involving various industries have long been evident in policy making, academia and clinical practice. Suggested approaches for managing CoI could be categorised as "deny", "describe", or "diminish". Declared CoI were common in the ORG and SACN. 4 out of 28 ORG members were direct industry employees. In SACN 11 out of 17 members declared industry advisory roles or industry research funding. The two charities appeared to have equally strong academic expertise but fewer conflicts. No HoM members declared CoI. 5 out of 21 AoS members declared links with industry, mainly pharmaceutical companies. We were unable to obtain information on conflicts for some individuals.
Conflicts of interest are unavoidable but potentially manageable. Government organisations responsible for policy development and implementation must institutionalize an approach to identify (disclose) and manage (mitigate or eliminate) perceived and actual CoI to improve public confidence in government decision-making relevant to food policy.
利益冲突可能发生在公共职责与私人利益之间,即公职人员的私人利益可能不当影响其履行公职和职责。最明显且通常被认为的利益冲突是经济利益冲突。然而,利益冲突也可能因其他类型的影响而产生,包括人际关系、职业发展或意识形态。因此,利益冲突存在于学术界、商业界、政府和非政府组织中。然而,由于信息匮乏,公众对利益冲突的了解目前有限。由于缺乏指导方针,管理潜在利益冲突的机制也仍不明确。因此,我们研究了学术专家的独立性,以及在英国负责制定食品政策的四个政府和非政府组织中,潜在利益冲突是如何被识别和处理的。
政策分析。我们使用四个案例研究,开发了一个分析框架,以探讨英国高级食品政策建议中的利益冲突。两个政府决策机构:卫生部“肥胖问题审查小组”(ORG)、“营养科学咨询委员会”(SACN),以及两个慈善机构:“抵制食糖行动”(AoS)和“默西之心”(HoM)。信息从公开可用的来源和声明中获取。我们根据《诺兰公共生活原则》的理念制定了一个五点序数量表。小组成员根据序数冲突量表被分别归类,从“0”(完全独立于食品饮料行业)到“4”(受雇于食品饮料行业或代表组织)。
涉及各行业的利益冲突在政策制定、学术界和临床实践中早已显而易见。建议的管理利益冲突的方法可分为“否认”、“描述”或“减少”。已申报的利益冲突在ORG和SACN中很常见。ORG的28名成员中有4名是行业直接雇员。在SACN的17名成员中,有11名申报了行业咨询角色或行业研究资金。这两个慈善机构似乎拥有同样强大的学术专业知识,但冲突较少。HoM没有成员申报利益冲突。AoS的21名成员中有5名申报了与行业的联系,主要是制药公司。我们无法获取一些个人的冲突信息。
利益冲突不可避免,但有可能得到管理。负责政策制定和实施的政府组织必须将识别(披露)和管理(减轻或消除)感知到的和实际的利益冲突的方法制度化,以提高公众对与食品政策相关的政府决策的信心。