Dear Mr. Medawar,

Yes, it is "cheeky and irksome" to threaten to publish on a website, but if you feel comfortable doing that then I don't see any way I can stop you.

Let me answer some of your criticisms about the Patients Association involvement with the advertising campaign run by Pharmacia and Upjohn on the issue of continence. We entered into this very willingly indeed because we believed, together with the Royal College of Nursing, the Continence Foundation and any number of consultants working in the field of urinary incontinence in women, that there was a huge unmet need in the public, and that it exists largely because people are too embarrassed to come forward and admit they have a problem (please note use the term "need" rather than unmet want).

Pharmacia & Upjohn asked us to look at the campaign as a matter of interest - not because they wanted particularly to get us involved. I offered to provide the voice-over because I thought this might help them with a campaign of which I approved so warmly, and received no payment whatsoever for it.

I have no compunction about standing on the soapboax in the market place provided to me by people who can afford to put up soapboxes in market places. For many years, I provided health education and social guidance to readers of "The Sun". I might not have liked some of the pictures that were plastered on the side of the soapboax, but it made no difference to me; I had a message to transmit, and I wanted to transmit it as loudly and as widely as I could. At that time "The Sun" offered me the highest possible soapbox and the greatest possible amplification of my message.

I now feel the same way about Pharmacia and Upjohn's campaign, using television as well as "print" media. It is necessary to help a large number of very unhappy women in society, whose lives are blighted by urinary incontinence, to encourage them to come forward for treatment.

This now brings up a very important issue. Treatment takes many forms. You seem to assume that the only possible treatment for urinary incontinence is drugs, and only one specific drug, that is the one marketed by Pharmacia & Upjohn. I'm afraid that displays how much you don't know about what you don't know. In-fact, treatment for urinary incontinence can include surgery; physiotherapy; retraining of a musculature; retraining of habit; and in some cases a drug. there are a number that might be prescribed, including imipramine, oxybutinin, flavoxate, propiverine and desmopressin DDAVP, as well as tolterodine, the basis of Pharmacia & Upjohn's Detrusital. I have not the least doubt that the vast majority of people who come forward for help with this problem will be treated by any one of these as well as by the first listed methods. In fact, I think it is exceedingly unlikely that Pharmacia and Upjohn will regain their expenses in running this campaign from any resultant sale of Detrusital, let alone make a profit. For your interest, I enclose a copy of some patient information material on the treatment of urinary incontinence.

I repeat, the Patients Association and I personally got involved in this campaign because we were grateful for the chance to discuss in a fairly large public area, where a great many people could listen, an issue that had been swept under the carpet. I was driven by the same motives that drove me to take part in an advertisement for sanitary towels which, before I did it, had been items which were considered to be too disgusting to publicise at all. And also to publicise such items as condoms to be used in-protecting women from infection which could lead to cancer of the cervix as well as, of course, to HIV.

I hope that explains our motives clearly. Now let me get on to the issue of pharmaceutical companies underpinning the finances of voluntary organisations such as the Patients Association, the Long Term Conditions Medical Alliance, the British Diabetic Association, and many, many more. There is no way these patients' groups can ever count on subscription income to keep themselves going. Occasionally, they can obtain donations from charitable trusts, but certainly rarely get enough from the government to cover their needs. Therefore, every fundraiser from these organisations does the same thing - they go to commercial organisations that might have an interest in the subject, with their cap held out, asking for "no strings" donations. And we do just the same. We do so because we see no reason not to allow these companies to roll back some of their profits into health education; in fact we applaude it.

The number of organisations and companies who have given us "no strings" donations is large, and we're very glad it is. They include companies like Gardner Merchant - whose interest is in providing food for hospital patients; Boots the Chemist, which makes a profit from selling over-the-counter drugs to patients; Denplan, which deals with dental care, and various other groups like that, and also a number of pharmaceutical manufacturers. Glaxo, Eli Lilly, Abbott Laboratories, Merck Sharp & Dohme Ltd, Pasteur Merieux MSD - I can list them all, but it would take too long - are all supporting members of our organisation via our corporate sponsorship scheme. Some of them are "Platinum" members and give us £5,000 a year for three years; others are "Gold" members and give us £2,000 for three years, and others are "Silver members, giving us £1,000 for three years. This is how we are able to we have some revenue income. But none of them expect or get any coverage of their products, any promotion of their products, or anything more than their name listed in our journal "Patients Voices", and a nice thank you once a year, when I invite them to tea. And I don't think anyone will find that reprehensible.

I hope this answers your questions. I must say I have not found this an edifying correspondence. It does seem to me that you start from the baseline of regarding anyone who dares to think pharmaceutical companies as anything but evil, must be at fault, as well as, dare I say it, showing a certain contempt for the ability of patients to make reasonable judgements about their own health.

CLICK HERE TO READ ON

	Contents page
	What's New?