A Freedom of Information request submitted as part of an investigation by the British Medical Journal (BMJ) has exposed that the General Medical Council (GMC) has substantial investments in controversial infant formula manufacturer Nestlé, as well as fast food and soft drink companies, including McDonald's, Starbucks, Pepsico, Coca-Cola, and Unilever, owner of ice cream brands Magnum, Wall's, and Ben & Jerry's.
The revelation was greeted with dismay by doctors, who fund the GMC to the tune of £420 each in ongoing annual fees, with one likening the GMC's financial arrangements to investing in tobacco companies.
The BMJ investigation, reported by final year medical student Ronald MacDonald from the Universities of Dundee and St Andrews, noted that the investments were not published on the GMC's website, although "after the BMJ pointed out that they were not displayed transparently", this is something that the GMC is now "considering".
The freedom of information request showed that the regulator held investments of:
- Nearly £870,000 (€985m; $1.05m) in total in Nestlé, fast food, and soft drink firms
- More than £1.2m in pharmaceutical companies, including Abbott Labs, AstraZeneca, clinical research company ICON, Merck, Novo Nordisk, Roche, and veterinary products maker Zoetis
- Over £470,000 in private medical insurers or private healthcare providers, including Humana Health and UnitedHealth Group
- In excess of £1.3m in a number of medical device manufacturers, including Edwards LifeSciences, Thermo Fisher Scientific, and Intuitive Surgical, the makers of the da Vinci robotic surgical system.
Doctors Would 'Despair' if They Knew How Money is Invested
Commenting to the BMJ, Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, said: "Many doctors whose work involves dealing with the harms caused by junk food marketing would, if they knew, despair at how their money is being invested."
The news might also come as a shock to the general public, which, according to a survey also published this week, generally supports the Government's efforts to tackle obesity by shifting eating patterns away from unhealthy diets, particularly junk foods high in fat, salt, and sugar.
The GMC invests through the churches, charities, and local authorities investment management company CCLA, which is the top fund manager for charities and benevolent societies in the UK and has £13.1 billion of assets under management. According to the BMJ, the GMC gave CCLA £50 m to invest in 2019, which as of January 2023 was worth £81.3 m, made up of investments in companies, funds, private equity firms, property, cash, and money market securities.
GMC 'Has a Say' in Fund Investment Decisions
CCLA is owned by its charity and public sector clients, and claims its philosophy is to make "good" investments that aim "to deliver sustainable returns to our clients in a way that aligns with their values and furthers their mission". It further states: "Our clients are united through the determination to maximise their positive impact on society."
The GMC admitted to the BMJ that it "has a say in what CCLA invests in, and access to all decisions through CCLA's reporting". However, it said that as a registered charity it had "a duty to make sure it protects and maintains the value of its financial assets".
Asked to comment by Medscape News UK, a GMC spokesperson said that there were "a number of factual inaccuracies in the BMJ's press release" for the story, and clarified that the value of the GMC's investments with CCLA was £57.6 m as at 10 March, against the BMJ's figure of £81.3 m as of January. The GMC started investing with CCLA from 2016.
"As a registered, not-for-profit charity, we have a duty to make sure that we protect and safeguard the value of our financial assets – which are primarily generated from doctors' registration fees – in a way that aligns with our values," the spokesperson said.
"We invest to make sure our reserves are protected against inflation, and we also hold enough free reserves to manage risk and make sure we have enough funds to cover our operations.
"We chose CCLA to manage our investments because of their strong track record and high standards in ethical investing. We have access to all decisions through CCLA's reporting. and we have a say in what they invest in, as we have specific ethical exclusions in our investment policy.
"We apply a number of ethical restrictions to the types of companies CCLA invest in on our behalf. This includes products and services such as tobacco, alcohol, pornography, gambling, and high-interest rate lending. In addition, we are able to exclude companies where we have concerns about their approach to corporation tax.
"CCLA currently applies a zero-tolerance policy on, and avoids investment entirely, with companies involved with the production of landmines, cluster munitions and chemical and biological weapons or the extraction of thermal coal or tar sands."
The GMC said that its investment policy was reviewed annually by the GMC Council, and that it is now "considering whether the current exclusions remain relevant".
Company Claims 'Positive Public Health Benefit' By Investing
Asked to comment, a spokesperson for CCLA told Medscape News UK: "The investments that we manage on behalf of the GMC are designed to avoid companies that cause the biggest negative public health impacts, as well as earning a return for our clients in the medical profession.
"It is vital to note that this does not mean we support all of the activities of the companies, and we recognize that some of their products can have negative health implications. However, because these companies run popular and influential businesses in the world we live in, we know that we are likely to have a bigger positive health impact by investing in them while working consistently to improve their standards and influence their criteria, rather than avoiding them and pretending that they do not exist.
"In other words, we use our investments as a platform from which we can drive change." The CCLA added: "We actively seek to use our voice as shareholders to drive positive change with companies in the food and drink sector.
"Of late, our focus has been engaging with companies such as Unilever, PepsiCo, Nestlé, and Coca-Cola to urge them to commit to producing healthier products, which are more accessible and more affordable.
"By adopting this approach to investment, we can provide a positive public health benefit in addition to a financial return that assists the medical profession."
'No Different to Investing in Tobacco Companies'
However, Sam Everington, Tower Hamlets GP and chair of Tower Hamlets Clinical Commissioning Group, was not mollified: "The GMC is funded by doctors in the UK. They would be horrified to know that their money is being invested in fast food companies that are the cause of so much disease and reduced quality and quantity of life and significantly more pressure on the NHS and workload of doctors. This is no different to investing in tobacco companies".
The GMC's investment in Nestlé, target of the world's longest running consumer boycott due to 'aggressive marketing' of infant formulas, particularly in underdeveloped countries, is also contentious. The boycott of the world's largest food company started in 1977 and continues today.
A spokesperson for Baby Milk Action, the UK member of International Baby Food Action Network (IBFAN), told Medscape News UK: "The issue of conflicts of interest (COI) has been central to our work for decades and is at the heart of the International Code of Marketing of Breastmilk Substitutes and the 19 World Health Assembly Resolutions that have been passed since 1981.
"The problem of COI is obviously not confined to infant and young child feeding – where it has a huge impact on child health and survival – but as the harm caused by ultra-processed foods and the corporate-led food system is at last being recognised, institutions – especially those that play a role in policy setting as the GMC clearly does – really do need to include ALL health harming industries in their exclusion list.
"Accepting corporate funding of any kind is a huge risk that will at some level influence the work you do – and this is why Baby Milk Action and IBFAN steadfastly refused to go down that path. We need to be totally independent of such pressures in order to do the work we do."
'Unclear' Why the GMC 'Holds So Much Money'
Commenting to the BMJ, Glasgow GP Margaret McCartney said: "Practising UK doctors have no choice but to pay substantial annual fees to the GMC. The organisation must show that it is using its funds wisely and I'm not convinced it is.
"It is unclear to me why the GMC holds so much money and why it has chosen to invest as it has. When the chief executive is paid over a quarter of a million per year, and a further six staff [are] on more than £200,000, doctors should know, with complete transparency, where their fees are being invested and why."
Prof McKee concurred: "I have previously raised concerns about the GMC’s
accountability, but accountability requires transparency."