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Documentation on the Bolkestein-scandal

All forms of cancer spread with the help of the tissue-dissolving mechanism. This illustration shows an example of the development of liver cancer. The liver is the body’s central metabolic organ and is responsible for neutralizing and removing toxins from the body. Of the toxins that enter the body through the diet, such as pesticides, preservatives are the most common cause of liver cancer. Also, all pharmaceutical drugs have to be detoxified by the liver. In this context, in January 1996, the Journal of the American Medical Association (JAMA) issued a warning that all cholesterol-lowering medications (statins) used on the market at that time were carcinogenic (causing cancer).

In this light, it is most remarkable that EU-commissioner Frits Bolkestein, also working for pharmaceutical giant Merck, Sharp & Dome, tried to persuade Dutch minister Els Borst, in a personal letter, to have a cholesterol-lowering MSD-product, called Cozaar, taken into the services covered by the Dutch medical insurance-companies. Normally, these kinds of scandals tend to vanish in a sort of hush-hush policy. But about this scandal there has been published several articles in Dutch newspapers and on Dutch websites. A short impression.

De Telegraaf - 23 September 1996

Bolkestein scandal after medical lobbying

By our parliamentary editor – THE HAGUE, Monday

The VVD party leader is currently embroiled in a scandal after trying to lobby Minister of Health Els Borst on behalf of the pharmaceutical company MSD.

In his capacity as a director of the above company, Bolkestein wrote a personal letter to the lady minister asking her to include the MSD drug Cozaar into the reimbursement scheme operated by the Dutch health service. According to the news program Netwerk, he is also reported to have been urging Minister Borst to reduce the reimbursement limit for Zocor, another MSD drug.

The Lower Chamber has severely criticized Bolkestein’s conflict of interests. The Dutch Labour Party (PvdA) and the Green Party (GroenLinks) will be seeking an explanation from the Minister this week. “Because this cannot really be”, says the Green Party leader Rosenmöller. The Minister herself reacted by saying: “I am no friend of politicians who use their positions as company directors to try and influence government policies.”

The coalition partners, PvdA and D66, together with the CDA opposition party, believe that Bolkestein has gone too far. “It was a very stupid and clumsy thing to do”, comments the D66 Deputy leader Van Boxtel. "Bolkestein owes us all a full explanation without delay. The VVD has a problem here.”

CDA spokesman Smits believes in any case that Minister Borst has nothing to reproach herself for. “She has chosen her own approach. We in the CDA must not do what Bolkestein did.” The VVD will be studying the matter carefully at its party meeting tomorrow. However, Bolkestein will not be there as he is away on holiday for the whole week in Cyprus. “We need to know firstly what actually happened”, says Bolkestein’s spokesman. “We shall be talking to him on the telephone.” Former Secretary of State Simons (Public Health) is reported by Netwerk as being ‘horrified’ at Bolkestein’s actions. He believes that a political debate is called for in the matter.

NRC – 30 September 1997:

Bolkestein resigns from the MSD

THE HAGUE, 30 OCTOBER. VVD Party leader Bolkestein has resigned his post as director of the pharmaceutical company MSD. Last year, Bolkestein was involved in a scandal when he lobbied Minister Borst (Department of Health) on behalf of MSD.

NRC – 28 September 1996:

Broker - Politician

Travel plans permitting, this week is likely to end in much the same way as it started: with Bolkestein. Surrounded on his flight by crowds of journalists who were unable to speak to him on Cyprus, and awaited by more journalists, who are convinced that he will be speaking on his return, the leader of the Lower Chamber party of the VVD is due to land at Schiphol on Friday. It promises to be the grand finale of a week, in which Bolkestein has not only dominated the political headlines but has also been the main topic of news himself.

The affair began last Sunday with the revelation in the Netwerk television news program that last year Bolkestein, in his capacity as a director of the pharmaceutical group Merck, Sharp and Dohme (MSD) had written to the Minister of Health Els Borst asking for her support for a certain drug to be included in the national health insurance reimbursement scheme. The important question was whether Bolkestein was getting himself caught up in a conflict of interests. But the national debate that has arisen in the meantime has now moved on and covered a lot more ground, ranging from the ‘pernicious role’ played in the matter by the media right up to the notion of a political conspiracy. It is to be hoped that Bolkestein’s return will restore the debate to its proper proportions. Because the only question that needs to be answered is whether Bolkestein has acted honorably.

The defense that has been heard a lot this week in the VVD - that Bolkestein wrote the letter in his capacity of director – is not relevant. Although a clear difference can be made between the politician and the company director, the way in which this dual function actually works out in practice is very different. That applies both to Bolkestein as a politician and Bolkestein as a company director. With regard to the latter, the primary function of a company director is to be responsible for the administration of a company. Lobbying for the company, as Bolkestein has done on several occasions, is certainly not a part of the principal duties of a company director. In this case, it seems that the need for a sense of proportion has been overlooked.

From the answers given by Minister Borst to questions from the Lower Chamber it seems that last year, at her request, Bolkestein the politician had had a conversation with the Director General of Public Health on the draft law governing drug prices, during which the VVD as the only coalition partner present had displayed hesitation. According to Borst, the party leader had introduced the subject of the MSD drug Zocor as a “fringe topic” to the discussion. This was the product that he had previously brought to the Minister’s attention. The fact that in her answers the Minister expressly refers to ‘the party leader’ is typical. In the Department of Health, discussions involving “fringe topics” are clearly not intended to include interventions by Bolkestein the company director. The dividing lines were therefore not clear. The result was that anybody who was approached by the politician/company director would inevitably be in an awkward position. Once again, a sense of proportion seems to have been lost.

The almost natural reaction to this type of question is to demand the introduction of a code of conduct. This is a maneuver that looks fair but is otherwise superfluous. This is because the politician with a sense of proportion does not need a code of conduct. The same applies to the declaration of a ban on politicians dressing themselves up as company directors. Here too, it is the politician himself – or his party – that has to weigh up the advantages and disadvantages.

This does not detract from the fact that a critical consideration of the politician-company director combination is urgently needed. Every time there seems to be a lack of compatibility. Commercial interests and general interests do not always go together. It is too easy to say that members of the Lower Chamber can broaden their horizons (which often stretch no further than different departments of the Parliament) with the help of directors from the commercial sector. The result is that the problem is approached from the wrong direction. A Lower Chamber that sets out to act as the representatives of the people is not will not benefit people that have links with a board of directors or have a lot to do with the commercial world. The Chamber is of greater benefit to those people whose backgrounds are in this commercial world.

Reformatorisch Dagblad – December 1998:

Lobbying: expertise in the corridors

By P. Chr. van Olst

Anyone who thinks of the Dutch parliament can visualize ministers fighting their way through lines of journalists or members of parliament in deep discussion with secretaries of state. Even government officials or party research assistants are keen to be seen on the television. But the large battalion of lobbying representatives prefers to remain off-screen, protected by a screen of informality.

As a politician, Frits Bolkestein may be justly famous, but as a lobbyist he is just an amateur. The former VVD party leader, as a director of the pharmaceutical company Merck, Sharpe and Dohme (MSD), approached Minister of Health Els Borst to ask for her help in getting the MSD drug Cozaar accepted for use under the medicines reimbursement scheme. In the view of people in the know, his action was not just politically suspect as a result of his conflict of interests, but also ill-considered and clumsy.

The first point is that, exactly because of his name and fame, Bolkestein was not the right person to conduct a lobby on behalf of MSD. A person of his stature should not stoop to this level. He is too widely respected. Modern lobbyists prefer to keep “a low profile”, discreetly and without too much show. In addition, they prefer informal and unrecorded contacts, for example during a boat trip, over a meal or over the telephone. This was a principle that Bolkestein trampled over when he addressed the Minister of Health as “Dear Els” in a (formal) letter.

As a politician who was vital to his party’s image, Bolkestein clearly had the necessary power. But every lobbyist knows that you cannot say a word if there is a hint of conflict of interests or honor at stake. The chance of any lobby for MSD succeeding would have been much greater if it had been carried out by a professional representative from the company instead of a well-known director of the company. Provided that he had acted promptly and not, like Bolkestein, just reacted at the time when the issue had reached the decision-forming stage.

Lessons to be learned

Power-hungry people like Bolkestein should be careful. Lobbying has become a professional occupation, an area in which you need to know the ropes if you are to succeed. The modern lobbyist never goes to work until he has decided on his strategy. He has a range of tactics that he employs to manipulate people and he knows exactly how far he can go. Although the lobbyist relies on informality to carry out his trade, his profession is nowadays an honorable and respectable profession.

A good lobbyist is always friendly and honest and he always does his homework thoroughly, according to G. Alferink, a representative of the KNJV (the Royal Netherlands Hunting Association), and his opposite number P. Eichholtz at the Animal Protection League, both of whom know all the tricks of this particular trade. He must be friendly in order to be able to maintain good relations with politicians and officials. Courtesy is also essential. Knowing the names and the hobbies of his political contacts gives the lobbyist the opportunity to engage in friendly conversations thus breaking the ice. Furthermore, conversations must be above all brief and factual, because politicians are always under pressure and for them time is money.

The lobbyist is always honest. “Always be truthful” is the advice given by both Alferink and Eichholtz. “Otherwise tomorrow you’re finished”. Once you start spreading unreliable information you can forget about the parliament.

Providing reliable information is so important for a lobbyist because it is information and knowledge that represent his currency. A politician who is under pressure will not know all the details of every file. Often, he will need the services of a lobbyist from a certain community, province or organization. This lobbyist will find the right moment to pass him the information that he needs - in exchange for his goodwill, obviously.

Every lobbyist knows that he is never going to squeeze the last drop out of the bottle . In many cases, the results of a lobby cannot be measured. But you do know that if you were not there, only the voice of your opposite number would be heard. Alferink representing the hunters can stay at home, but if he does he cannot do anything to challenge the statements made by Eichholtz, the protector of animals.

The ideal ambition of the lobbyist is therefore to become as involved as possible on a specific level in those issues for which the lobbying is being carried out, and on a general level, in which the politician has to make a decision. That is what makes the special relationship possible between the politician (representing the general interest) and the lobbyist (representing the specific interest).

“Informal communication”

The original definition of what lobbying really is indicates the strange alliance between politician and lobbyist. Lobbying is “informal communication with selected politicians”. In this sense, it is naturally as old as electing public officers. Broader and more up to date definitions therefore refer to contact with “formal officials” or “officials”. The so-called “ideal definition” of lobbying is: “an informal attempt to influence formal persons in authority”.

The term “lobbying” itself was first used in early British and American politics. Representatives of election constituencies and official organizations would prowl around the corridors and hover in the recesses of the parliament buildings in order to accost passing members of parliament. As a result, the corridors have become inseparably bound up with the concept of lobbying. The origin of the word “lobbying” can be traced back to the fact that the recesses in which the representatives used to hover were known as “lobbies”.

The word “lobbying” was first used in the Netherlands in the eighteenth century. At a time when the “high and mighty” members of the States General in The Hague were becoming increasingly autocratic in the way in which they passed laws and decrees, a number of local authority administrations decided to appoint their own representatives at The Hague. In this way, Willem van Thiel was appointed by the town of Hulst to “engineer, solicit and promote all matters that might come to his attention that could affect in any way the interests of the government and the people of the town of Hulst”. Obviously the Anglo-American term “lobbying” had not yet arrived.

Mystery

The modern lobbyist has grown into a professional, although not everyone sees it in this way. Because the lobbyist operates along the corridors and behind screens, he always gives off an aura of mystery. He is always trying to shake off his image as a Mr. Fixit or a sinister go-between. The lobbyist himself finds this image very unfair. “We are not sniveling children tugging at people’s sleeves and eying candies in a shop window”. Not at all. The lobbyist at The Hague is “every inch a gentleman”. A specialist.

Sometimes the lobbyist himself is the cause of such suspicion. He may find himself on a very slippery slope as a result of his choice of certain influencing maneuvers. Plying politicians with gifts is one such dubious activity. What can be made of politicians, who, during a working day, are presented with a new camera or treated to a slap-up dinner and to top it all get a nice Christmas box as well? If that doesn’t generate goodwill...

At such times, lobbying can come dangerously close to being bribery. The dividing line between an appropriate present gift and a valuable gift is not always very clear. “One bottle of Beerenburg is alright, but two are one too many”, was roughly the outcome of a conference held not so long ago on the ethical aspects of lobbying.

“A sinister club”

But even without bottles of Beerenburg, lobbyists can acquire an unethical amount of influence. One notorious lobby is the ‘Nederland Distributieland’, the ‘sinister club’, in which a large number of organizations and important personalities from the transport sector are all collaborating to provide the country with a really efficient transport system. This is the lobby that was behind the high speed rail system, the Betuwe line, the enlargement of Schiphol airport and all of the major infrastructural projects.

By pooling their resources, the organizations behind the ‘Nederland Distributieland’ lobby represent such a powerful, omnipresent and forcefully persuasive network that it is difficult to counter by political means. Not so long ago, it drove the former Secretary of State for Transport and Public Works, M. van Hulten from the Den-Uyl cabinet, to the depths of despair: “It may be legal, but as far as I can see it works in the same way as the Mafia”.

Even by using quite innocent techniques, lobbyists can play on the feelings of politicians or their assistants. For example, a passing remark on the support of voters can have a telling effect: “Do you know how many members of your party I can count on for support? And what can I say to them if they ask me what their party is doing about it?”

Political primacy

Under the process of the removal of traditional barriers, the strength of the different lobbying groups had increased so greatly that, about ten years ago, it was decided to set up a large number of consultative bodies (under the so-called “Desert Law”). Political primacy needed to be restored was the call of a number of leading figures, including VVD Chairman Bolkestein himself (sic!).

Experts, such as the Rotterdam academic Van Schendelen (an expert par excellence in matters of lobbies) have concluded that the influence of the professional lobby has only increased with the advent of the polder model of debate and collectiveness. Attempts to restore political primacy have at most resulted in the emergence of a more open form of competition between the different interests.

Website of the Socialist Party:

In the absence of any readiness to arrive at any form of a national code of conduct, it is important to ensure that at all times national politicians do not portray the wrong image and give rise to any blurring of standards. Unfortunately, recent experiences have shown the contrary. Bolkestein’s assumed air of innocence with regard to his disputed intervention with Minister Borst in his capacity as director of MSD and Jorritsma’s naive question “so what’s wrong with that?” on the subject of her free flights paid for by the Groningen businessman Koop cannot, with the best will in the world, be seen as major impulses for political and administrative integrity.

De Telegraaf – 24 September 1996:

Drug company happy about Bolkestein’s action

From our own reporter – THE HAGUE, Tuesday

According to spokesman Wim Böhne, the drug company Merck Sharpe & Dome (MSD) is “very happy” about the actions of its director and VVD party leader Frits Bolkestein in spite of the uproar that this has caused. “Bolkestein’s actions were successful. He did it all in his own way and on his own responsibility. He is the person who is best able to tell you what happened.”

Böhne was referring to the fact that the anti-hypertension drug Cozaar had been included in the category of reimbursable medicines with effect from June this year. “Just in time. If it had taken longer, the distribution of this drug would have been switched from the Netherlands to France. When this sort of action is taken by our top management, others are certain to follow. We were only too well aware of this in Haarlem.”

The MSD company, which has been active in the Netherlands for 40 years, has invested ƒ372 million in recent years in the Haarlem company. “Bolkestein must be given the chance to explain the reasons behind his action,” added Böhne.

VVD party leader Bolkestein himself denies that he went too far when he tried to influence Minister of Health Borst in the interests of MSD.

Through his spokesman, he declared yesterday from Cyprus that the accusation of an alleged conflict of interests was unjust. Furthermore, Bolkestein wanted it to be known that he had only acted in accordance with the rules by which politicians are bound.

The liberal party leader was in no mood to cut short his holiday in Cyprus because of this outcry. He will wait until Saturday, when he lands at Schiphol, to give his version of the events.

The VVD party in the Lower Chamber lined up officially behind their leader. Members felt that the incident had been “blown up out of proportion”. However, there were some liberal members of parliament – who preferred to remain anonymous – who did believe that Bolkestein “had acted in an underhand manner”.

Deputy VVD Korthals is of the opinion that his leader acted correctly, when, in his capacity as a representative of the MSD company, he wrote a personal letter to the Minister asking her to recommend that the MSD drug Cozaar be included in the medicine reimbursement package.

Minister Borst declared earlier in response that she was not in favor of politicians trying to influence government policy when there was a commercial interest at stake.

Korthals admits however that there is a grey area with regard to members of parliament carrying out other duties. “It is possible that a code of conduct governing unjustified conflicts of interest will be introduced. On the other hand, it is up to the politician himself what he can and cannot do.”

The VVD party leader is at his beck and call. The SP party leader Marijnissen is due to press the Presidium of the Lower Chamber today for the introduction of such a code of conduct, under which all other activities carried out by members of parliament can be scrutinized. PvdA spokesman Oudkerk supports this initiative.

The D66 party leader Wolffensperger also believes that the Chamber should hold a fundamental debate as quickly as possible on the subject of what members of parliament are allowed to do in terms of promoting outside interests.

Green Party leader Rosenmöller (GroenLinks) has in the meantime asked Minister Borst if Bolkestein, as a director of MSD, had often approached her or her staff “with a view to influencing matters of public health”.

VVD party leader Hoekzema will only give his verdict once the party has received chapter and verse from Bolkestein. Similarly, Prime Minister Kok and the former VVD leader Wiegel are waiting for Bolkestein’s formal statement before they give their reaction.

Column written by the satirist Youp van ’t Hek in NRC – 5 October 1996

Your Majesty,

You asked me to keep a bit of an eye on this country of ours while you were away and I can tell you it’s all been a bit nasty! The Hague was Bolkestein and very embarrassing the whole thing turned out to be. Wim wrote three letters (Dear Gerrit, Dear Frits and Dear Jacques) and as a result the three musketeers together with Dijkstal went up into their tower where they cooked up some scheme to prevent the coalition from falling apart. And then, on Wednesday afternoon we had this shameful debacle. Just before the debate started, Frits uttered the word “democracy” several times, but rather too grandly in his well-oiled voice and you can guess the rest. He came across like a real simpleton, maintaining that he had not done anything dishonorable although he must have known deep down inside that it wasn’t really true. Legally, he seems to be sitting in the clear, but that’s how the VVD have been sitting for years. And what sort of spineless politicians Wallage and Wolffensperger have turned out to be!

Can you still take Bolkie seriously? A man who, together with his party colleague, Dick Dees, receives a high-ranking official in the VVD party offices and thinks that the latter sees him at that moment as a director of those Haarlem pill peddlers. You may well think that he is a little confused. In psychiatry it is known as dysfunctional behavior and MSD have a pill that you can take for it known as TRYPTIZOL. Of course, it is part of the sickness scheme package, but I’ll wager that Frits has his own private insurance.

The entire Bolkestein affair doesn’t seem to have damaged the VVD in the opinion polls at all, but then you know what ghastly people you have under you. On Monday and Tuesday , I am doing a show round the corner from you and if I’ll pop round afterwards if I can. All the best from your humble and equally astonished servant

YOUP VAN 'T HEK