1. Alleged racism in UK disciplinary hearings investigated
nterim results of an independent overseas than trained in the UK or complex pattern of reasons for these
I study indicate that the UK General
Medical Council (GMC) is not insti-
Ireland. Total complaints about doc-
tors have increased from about 1000
differences”, says the report, which
was presented to the council of the
tutionally racist—despite the fact that in 1993 to about 3000 in 1998 and GMC meeting on May 25–26.
overseas-trained doctors are signifi- are expected to reach 3600 this year. Commenting on the analysis of the
cantly more likely to have their pro- The current study is a prospective results so far, the GMC’s chief exec-
fessional conduct assessed than their follow-up to the 1996 report. For utive Findlay Scott said that the con-
UK-trained peers. both the original and follow-up stud- clusion is “not as simple as saying the
The investigation is being done by ies, the PSI has had unprecedented GMC is racist”. Speaking to the
the Policy Studies Institute (PSI) for unrestricted access to GMC records press before the council meeting,
the GMC, following many years of and files. both Scott and the President of the
complaints that the disciplinary body About 27% of the medical popula- GMC Sir Donald Irvine emphasised
treats overseas doctors more harshly tion of the UK were trained overseas. that the data are incomplete and the
than colleagues from the UK. In the past 2 years, they have statistical analysis of the data yet to
In 1996, a retrospective study by accounted for about half of all cases be done. The full report is expected
the PSI indicated that the GMC appearing before the institution’s to be published early next year.
had investigated complaints about Professional Conduct Committee.
a higher number of doctors trained But preliminary findings “suggest a Sarah Ramsay
Clinton signs away tobacco industry settlement money
O n May 21, President Clinton
waived the federal govern-
ment’s claim to a portion of the
“Congress [has] passed up an
important opportunity to protect
our children from the death and dis-
Medicaid money if they agreed to
spend it on anti-tobacco pro-
grammes. But many states have
US$206 billion settlement between eases caused by tobacco”. earmarked their settlement funds
the states and the tobacco industry. Even before the settlement was for non-health programmes. And
The provision was tucked into a reached last November, the Clinton backers of the provision said the
mid-year supplemental spending administration and the states had government should have no say in
bill to fund the war in Kosovo and been in a war of words over whether the matter. “I believe the states are
provide aid to victims of Hurricane a portion of the funds would have to acting responsibly”, said Senator
Mitch in Central America. be returned to Washington. As Bob Graham, a former governor
The tobacco provision was added Medicaid is a joint federal-state pro- and cosponsor of the provision.
to the Senate version of the bill in gramme, with the federal govern- Anti-tobacco activists are out-
March, and despite Clinton’s threats ment paying about 55% of the costs, raged that the new law not only
to veto the policy, it was kept in the settlement funds attributable to fed- waives the federal government’s
measure by a House–Senate confer- eral Medicaid contributions by law past claims to tobacco-company
ence committee. Backers of the bill must be returned to Washington. refunds for Medicaid, but also bars
bet —correctly —that Clinton would But the states argued that their law- it from seeking compensation for
not dare veto a bill that included the suits were not based on Medicaid, so tobacco-related Medicaid costs that
$15 billion he wanted for Kosovo and the government had no claim. may accrue in the future.
other critical priorities. Clinton had offered a compromise
Nonetheless, said Clinton, where the states could keep even Julie Rovner
Pharmaceutical companies pay criminal fine for global price fixing
oche Holdings AG (Switzerland) cereals and other processed foods. worldwide marketing in the vitamins
R and BASF AG (Germany) have
agreed to pay the US government
Supplement purchasers helped the
Justice Department’s investigation,
division, will serve 4 months in a
USA prison and will pay a $100 000
US$725 million last week to avoid but Assistant Attorney General Joel fine. Roche itself will pay
prosecution on charges that the two Klein said, information provided by $500 million and BASF will pay
companies participated in a global Rhone-Poulenc (France) helped the $225 million.
cartel that raised, fixed, and main- agency solve the case. Because of its Roche executives claimed at a
tained prices of animal and human cooperation, Rhone-Poulenc will not press briefing on May 21 that they
supplements, announced the US be held criminally liable for its partic- were unaware of the cartel’s
Department of Justice on May 20. ipation in the cartel. Klein called the operations, saying that it was the
According to the Justice case the “most pervasive and harmful work of a few employees. The
Department, the two companies, and criminal antitrust conspiracy ever company had been fined once
potentially a dozen others, met to uncovered”. before—paying $14 million in 1997
negotiate over at least 9 years, how Rhone-Poulenc, Roche, and BASF when it was found guilty of setting
they would set prices and how to are the three biggest players in the prices for citric acid. The EU is also
spread sales among the cartel. The US$3 billion nutritional supplement investigating the cartel and may press
supplements included vitamins A, market. At least one Roche executive criminal charges.
B2, B5, C, and E, -carotene, and is being held accountable. Kuno
“premixes” used to enrich Sommer, former director of Alicia Ault
1862 THE LANCET • Vol 353 • May 29, 1999
Copyright © 1999. All rights reserved.