NHS officials who took £70,000 in bribes to promote prescription drugs visited doctors’ surgeries to ‘change’ patients’ medications, a court heard on Thursday.
Paul Jerram and Dr David Turner have been accused of arriving at surgeries pretending to be on official business and changing a patient’s medication – a practice known as ‘changing’.
James Hines QC prosecuting, told a trial at Southampton Crown Court that the pair had used their positions with the Isle of Wight Clinical Commissioning Group (CCG) medication management team and that if the doctors in the offices had known that it was “not an official visit, they would not have allowed them to [make the changes]”.
“They were effectively using their position in the NHS to contract out the services of the medication management team and they were given money to do so,” the court heard.
‘Switching’ is a function performed only by doctors or NHS professionals which relates to the swapping of drugs that surgery patients are prescribed for a more cost effective drug.
It is ‘fundamental’ that the changes are only made by trusted NHS officials, Mr Hines QC said, but Mr Jerram and Dr Turner breached their positions to promote the drugs they were paid for.
The jury heard how the pair had taken nearly £70,000 in bribes to promote prescription drugs to doctors and were compared to referees in the pocket of a football team.
Mr Jerram and Dr Turner are said to have acted as “paid influencers” for pharmaceutical companies recommending drugs to GPs in return for “secret” payments.
Mr Jerram, of Shanklin, Isle of Wight, is charged with six counts of bribery and one count of bribery while Dr Turner, of Ventnor in the Isle of Wight, is charged with five counts of bribery.
The defendants – along with two others also on trial – deny the charges.
The case came after a secret Telegraph investigation in 2015 revealed how senior NHS officials were paid thousands of pounds and taken on expensive trips by pharmaceutical companies lobbying for their products to be used by the health service.
Mr Jerram, who was responsible for medication management at the Isle of Wight Clinical Commissioning Group at the time of the investigation, told undercover reporters that he had recently attended a meeting in Germany, which took place in “one of the top 10 hotels in the world” and each delegate received £500 a day to attend, he claimed.
Following the disclosure, the NHS Counter Fraud Authority launched an investigation, leading to the ongoing prosecution.
In court, prosecutor Mr Hines QC said the men on trial had “used their expertise, insider knowledge, influence and familiarity with NHS systems to further their own private interests”.
“vehicle of corruption”
“They did it in different ways, but the goal was always the same: to line their pockets. They accepted inappropriate payments time and time again,” he said. “These defendants were each corrupt. They put their own gain ahead of properly performing their important public duties.
The court heard Mr Jerram, 69, was Head of Medicines Management and Senior Pharmacist at the Isle of Wight CCG from 2004 and had ‘great influence’ there.
Dr Turner, 66, was a general practitioner who worked as a consultant to the IoW CCG. He also chaired a care prescription committee which advised the CCG and was made up of specialist nurses and doctors.
Together the men ran a business and used the business as a “vehicle of corruption”, prosecutor Mr Hines QC said.
In total, they are said to have received or agreed to receive £68,760 in “bondes” from January 2008 to July 2015.
Jurors were told NHS officials were being paid by businessman Noel Staunton, whose consultancy represented pharmaceutical companies.
Following their seven-year ‘corrupt’ scheme, the court heard the ‘integrity’ of NHS doctors making honest recommendations on prescription drugs had been breached and drugs had been improperly passed on to surgeries and advisory boards.
Health services pharmacist Cathal Daly – who is also accused of accepting ‘setbacks’ – is also among the group now on trial.
Mr Staunton, 60, was “very well paid” by his pharmaceutical company clients through his company 3i Consultancy and was a long-time friend of Mr Jerram.
Mr Staunton, who has received tens of thousands of pounds from drugmakers, is accused of paying the pair to promote drugs made by his customers, such as cholesterol drugs and ointments.
Mr Staunton has repeatedly approached pharmaceutical companies to promise he could promote their drugs on ScriptSwitch in what was to him an “extremely lucrative” scheme.
In one instance, Mr. Staunton told Genus Pharmaceuticals that he would “secure a flag on ScriptSwitch highlighting (moisturizer) Cetraben as the most cost-effective emollient.”
Other drugs were incorrectly endorsed on the ScriptSwitch newsletter, the court heard.
Elsewhere, the defendants also tricked other NHS healthcare organizations into signing rebate agreements which benefited them financially.
Mr Hines QC said the defendants ‘effectively allowed pharmaceutical companies to buy the services of NHS staff’.
The pharmaceutical companies are not accused of any wrongdoing, Mr Hines QC said.
Jurors heard Mr Jerram ask: ‘Sorry to be cheeky, is there a fee?’ when Mr. Staunton asked him to promote a drug.
The businessman had asked the official to highlight a calcium tablet after successfully promoting another drug.
Mr Hines QC said the response was ‘rather telling’ and that Mr Jerram ‘clearly indicates his particular motivation’.
After Mr Staunton replied “yes of course”, Mr Jerram suggested he would prioritize drug promotion if Mr Staunton increased his bribe, the court heard.
“If you have considered a fee, please advise – this always stimulates a faster response,” Mr Jerram said.
Mr Staunton was paid more than £25,000 for certain dealings with his clients and Mr Jerram and Dr Turner would get smaller ‘setbacks’, the court heard.
He said the effectiveness and cost of the drugs were irrelevant, but the defendants abused the “integrity” of doctors advising each other honestly on drugs.
Mr Hines QC said: ‘The prosecution’s case is that it is totally inappropriate for an NHS professional to covertly promote a particular medicine within the NHS to fellow NHS healthcare professionals when he actually serves as a paid influencer for the pharmaceutical company. who makes this drug.
“This has been happening on the Isle of Wight for some years.
“If it is your job in the NHS to review drugs and medicines and to make recommendations or suggestions for alternative medicine to other NHS healthcare professionals, you are acting inappropriately if you secretly agree money from pharmaceutical companies, directly or indirectly, to promote a particular medicine.
“And it’s not an answer to say ‘but the medicine is cheaper or better’. It doesn’t allow or allow you to accept a bungle, a bribe, a setback – whatever you call it.
“To use the old word, it’s corrupt.”
Mr Staunton, of Seaview on the Isle of Wight, faces a bribery charge linked to a £2,000 payment and a bribery charge linked to the payment of a £4,200 royalty.
Mr Daly, 51, from Norwich, Norfolk, faces a bribery charge linked to the receipt of £1,000. As clinical lead for primary care and prescribing at South Norfolk CCG, Mr Daly is said to have helped secure a dodgy reimbursement deal.
The trial continues.