Heart Beat: The pharmaceutical industry is multinational, creative, successful and many new drugs have made real differences to people's lives. It is closely connected to the political system in most countries.
If you google any multinational pharmaceutical company, you will find details of their addressing criticisms from consumer groups, answering regulatory questions and occasionally paying fines for sharp sales practices.
The industry is not beyond bending science to its will with research sponsored by the pharmaceutical industry being four times more likely to favour the company that funded the research.
In Ireland doctors have become tangled up in the industry. There are less than 10,000 doctors working in Ireland and yet we have three free weeklies, the Irish Medical Times, the Irish Medical News and Medicine Weekly. They are almost all funded entirely by the pharmaceutical industry and often contain pages of photographs of doctors.
In our medical schools, our students are often naive about the influence of the pharmaceutical industry.
They see their senior colleagues photographed regularly with the industry giving tacit endorsement to products and consider it normal.
American medical students are now being asked to take a revised Hippocratic Oath that forbids the acceptance of money, gifts or hospitality.
We need to adopt this in our schools in Ireland.
The Medical Council now proposes registering medical students. It would be appropriate that students and student bodies be required to declare gifts from the pharmaceutical and, indeed, alcohol industry.
If medical students are naive about the pharmaceutical industry, then the Irish Government must seem like a babe in arms. The Minister for Health and Children has announced a national steering committee to oversee the health reform programme. It is headed by Mr Kevin Kelly who is a chartered accountant.
The membership of the committee includes some obvious names but also includes Mr Michael Dempsey, managing director of Bristol Myers Squibb. No questions have been asked about Mr Dempsey's appointment.
There is no doubting his professional and business qualifications, not to mention his management acumen, but are there systems in place to handle the obvious conflicts of interests that surround him?
What guidance does his company give him in working so closely with a system that is evolving and can be even unwittingly exploited for outside and commercial benefits?
Will Mr Dempsey take a call from a patient, general practitioner or a hospital consultant about perceived deficiencies about outpatient, inpatient or community care?
Our politicians do even if they don't like it but the new systems don't allow them much leverage. This is where the so-called democratic deficit kicks in.
Politicians seem to have lost confidence in their own ability to modernise and deliver change in healthcare.
This is at a time when politicians are actually making inroads in improving and modernising healthcare and are beginning to lead policy development.
Doctors would give their eye teeth to have saved as many lives as Seamus Brennan through his interest in road safety. Most doctors admire the tenacity of Micheál Martin in facing down the hospitality industry by banning smoking in their establishments.
Both Liz McManus and Gay Mitchell are actually doing what politicians should be doing in producing policies for future healthcare.
Involving the pharmaceutical industry in the running of our health services is like letting the fox into the chicken coop.
Most of us will need a lot of reassurance to believe that involving them in healthcare will do anything for the good of the chickens.
• Dr Tom O'Dowd is a practising GP and professor of general practice at Trinity College Dublin.