24 February 2011

News From Nowhere - How the Papers got Their Stories - BBC Radio 4, Thurs. 24th Feb

This saga, long running, some believe, because of poor investigative rigour and lack of will, for whatever reason, on the part of the Met. police force to pursue many strong leads and a welter of evidence, rumbles on.

Recently, thanks to dogged work to keep the story alive by the Guardian, Independent, Channel 4 Dispatches, concerned Bloggers and 'victims' from all walks of life, it appears that the feeble flame is at last showing signs of bursting into the roaring fire it should have been at least six years ago.

On our Blog, #PRESSREFORM, here, are links to many articles and comments made about the whole affair over the past years. An example of these would be this :

Secret Phone-hacking Documents - Guardian

We seem now to be moving ever deeper into the murky world of (questionable at best and corrupt at the very worst) news story information gathering.

Today's Radio 4 programme, News from Nowhere - How the Papers got Their Stories, with presenter Jon Manel, sought to show that the methods of collecting details and information on personalities in the public eye were not merely confined to phone-hacking. Listen here.

It illuminated the way newspaper journalists used private detectives to gain access to medical records, addresses from phone numbers, details about and information from friends and relatives of targets, vehicle registration numbers, ex-directory numbers and so on. The PIs were skilled in the art of 'Blagging' and could elicit very personal details of a target's life from receptionists, office clerks etc. 

The programme suggested that the illegal practices employed by journalists and sanctioned by their editors were not confined to the News of the World, nor did they cease when the Private Investigator Glen Mulcaire was sentenced to prison. There is evidence that the practices still go on today....which goes some way to explain why most of the media have failed to publicise this whole affair properly.

Have editors, journalists and newspaper proprietors bitten their tongues, squeezed their eyes tight shut and held their breath in the hope that they could delay the inevitable, put off the reckoning which edges ever closer? 

Rosie Robertson

A glimpse into the future - where the Stafford story is leading us.

Yesterday 23rd Feb 2011 I had a glimpse of the future.

We are in a time of rapid change in the NHS. Few people yet understand the details and fewer can predict the outcomes.

As a result of the public perception of what happened at Stafford, and the way in which it resonated with the press and media,  Andrew Lansley has justified his decision to cut two whole tiers of the management of the NHS. The Primary Care trust, and the Strategic health authority are both going.

It is interesting that the health bill was initially supposed to take on board the recommendations of the Stafford Public inquiry, but the time scales may make this impossible. The Inquiry in its slow and painstaking examination of the evidence of many individuals is painting a much more complex and balanced picture of what happened at Stafford, than we have so far seen through the press. It is by no means certain that the recommendations that the Inquiry will make will be what the secretary of State wishes to hear.

But without waiting to see what the Inquiry tells us about the state of the NHS and the management needs, the structures are changing now.

Yesterday I went along to take a look at the first meeting of the joint Health scrutiny committee, which brings together the Borough and County scrutiny committees. The Chief executive and Chair of Stafford hospital were there to give a presentation and to answer questions from the assembled councillors and from the public gallery.

This new committee is set to take on the role of overseeing the performance of the Hospital and the health service in this area. It will scrutinise the performance of the brand new GP consortiums who will take on the role of commissioning the health services in this area. None of us have any idea of how well this may work.

What I saw, looking down from the public gallery was the normal assortment of middle aged, middle class, councillors, all who are in some way concerned for the good of the community, but few if any who have the requisite skills or experience to know if the health service is being run well or not. The questions from the floor were interesting. Many seemed to be based on anecdotes - things that the councillors had learned from a friend. Few seemed to ask the deep questions that are necessary at this time.

I suspect that most of the individual councillors in the committee would if asked indicate that they are not sure that they are well qualified for this job.

The Chief exec recognises their difficulty. The Councillors had raised question about being able to carry out on the spot inspections of the hospital. He was quite amenable to this, but also suggested the need to provide some basic training for councillors to give them some indication of what they might be looking for. Going in and looking round is very unlikely to give the kind of in depth insight into the workings of the hospital that we as citizens will now need these councillors to have.

The make up of the public gallery was interesting too. The pressure group were there in force. There was one gentleman who had been associated with the health councils that were disbanded some years back, one ex councillor, and myself. That was it.

I think it is worth pointing out that on the basis of a perception that may be ill founded, massive changes are being made now to the structure of the NHS. The job of scrutinising the NHS has been shifted from paid professionals who understood the task to amateurs who have got there through election to the councils and who may or may not have the necessary skills. The only members of the public who are interested enough to be there are people with a specific interest, which may or may not be representative.

At the moment this body is simply taking a look at what the Hospital and other aspects of the health service is doing. In the future it will be rubber stamping passing the responsibility for delivering service into the private sector.

20 February 2011

Political opportunism? - I wouldn't go there Mr Lansley.

When I heard Andrew Lansley’s complaint that Labours stance on the NHS was political opportunism, I almost dropped my cornflakes.

His concern may be a sign that the reality of being in government is coming home. The press is a ready-made tool for demolition. It is much harder to use it effectively as a tool to explain your plans and persuade people to like them.
Andrew Lansley is struggling to get us to like his plans. Most people still have little idea of what is proposed, and many of those that do know are giving clear indications that they do not like what is on offer. For my own part, I would like to see the process slowed right down, give Mr Lansley the time to get his points across with much greater clarity, and give him a chance to listen effectively to well informed public response to these proposals.

For Mr Lansley to make the assumption that the resistance to his plans is coming chiefly from Labour would I think be a serious mistake. What I am seeing as a labour party activist are many people who are concerned that Labour is not being nearly strong enough in its opposition to the plans. If it is opportunism to represent people, in the confusion and anger that so many people feel about these plans, then yes this is political opportunism.

My shock at hearing the words "political opportunism" from Mr Lansley springs from the fact that I live in Stafford, where we have spent the last two years finding out just what it feels like to be one of Mr Lansley's political opportunities. Perhaps this needs a little explanation.

What the world in general “knows” about Stafford is that it is the town where hundreds of people died because of poor care at the hospital. My understanding from three years of close and well informed observation of what has actually happened here is rather different.

I see a hospital that certainly has had its share of problems. Problems which are now being microscopically examined by the fifth major investigation in three years. I see this within the context of an NHS which has real and growing challenges to meet, as expectations rise, and our life expectancy continues to increase at a very rapid rate.

I also saw in Stafford a completely unique set of circumstances:
• There was a statistical system that was vulnerable to bad data, and there was bad data to invalidate its findings.
• There was an impenetrable statistical row between different sets of statisticians. Something that the press, public and politicians all struggled to understand.
• There was a forceful lady fired with the energy and anger that can only come from a difficult bereavement.
• There was a political party with an election they were determined to win, and some questionable methods of going about this.
• There was a need for the Conservative party to prove that they cared about the NHS.
• There was Andrew Lansley with his mission to change the NHS and a burning need to demonstrate that it needed changing.
• There was the media fired up by finding themselves at the centre of a cracking good story.
• And there were lawyers, lots and lots of lawyers, with an opportunity to ply their trade.

The reason why the Stafford Hospital story became a global media scandal, and persisted beyond a few days was quite simple. It was because of the claim that 400-1200 people had died as a result of poor care.

This information was credited by press and media to the healthcare commission report. I find it is still a considerable shock to people when I say “this is not actually true”. The report does not either say or imply these numbers. It makes no attempt to quantify the number of people who may have died as a result of poor care.

I cannot give you the precise source of these numbers, because they are now being attributed to a document that most members of the general public, including myself, have never seen. We do know this unpublished material was left out of the Healthcare commission report, because it was considered that it was not well based and that the public would misunderstand it. We do also know that the writer of this deleted report has made it plain that his numbers cannot be used for the purpose to which the press have repeatedly used them.

All this is public knowledge, but despite a huge amount of effort on my part it still seems impossible to quash the use of these figures. Some papers have now stopped using the figures, some have even printed a low visibility paragraph showing that they got the attribution wrong, no one has yet published the very prominent correction that is needed.

In my dealings with the press they always come back with the question “well how many people did die of poor care then?” which is a question that does not and probably never will have an answer. There is however a steadily growing body of evidence, supported by pretty well all the testimony to the public Inquiry,that there was nothing particularly unusual about the level of mortality at Stafford.

The factual errors that have been made in the reporting by Press and Media are both complex and serious. These errors, and the disproportionate reporting that has resulted from them are now the subject of a complaint to the press complaints commission and the BBC. (see clips below for a snap shot of the reporting of this case.)

Is anyone to blame for all this? I really do not know. There is a magic mirror where people see what they most desire to see. For me the Stafford Hospital story has something of this quality. So many people are involved, each one sees something different. In the centre of all this the patient figure of Robert Francis, trying to find a view point which is true and will satisfy the key players in the story.

I do not hand out blame easily:
I do not blame the statistician whose system was devalued by poor data and misused by the media.
I do not blame the lady, whose anger and grief made her a powerful media performer, and who could never have anticipated the harm that her story could bring about.
I do not blame the individual journalists presented with the impossible task of trying to make sense instantly of information that had many experts seriously puzzled.
I do not blame the lawyers for plying their trade.

I did blame Bill Cash, because I believed that he had deliberately manipulated the media, and that he had understood the material he was dealing with. After his evidence to the Inquiry I now know that I was wrong. If he is to blame, it is for failing to ask questions that he should have asked, and for speaking with apparent authority on a subject where he understood so very little.

Do I blame Andrew Lansley? Yes. At this moment I think I do.
Andrew Lansley would say of himself that he is the man who understands the health service best. It is his responsibility to understand the systems that he is now in the process of destroying, and that means he should have had a firm grasp of the detail.
Lending his authority and leading the public into believing that a massive failure of the NHS had taken place in an individual hospital, would, unless there was the clearest possible evidence that this was the case, be seen by many as an irresponsible act.

So when I think of political opportunism and the NHS, the images that spring to my mind are mostly of Andrew Lansley and some of his colleagues.
The fading photographs in my pile of press cuttings show him at the entrance to the hospital, Inside the CafĂ© headquarters of the pressure group, in the commons, on the green at Westminster, Bringing David Cameron into the centre of the picture, specifically leading public opinion to reject the “independent Public Inquiry, before it had even begun to sit, because he did not want to draw a line under this case before the 2010 election, On the party conference stage with the pressure group as one of his star turns, and on the politics show this month using the public perception of MidStaffs to justify his decision to scrap the primary care trusts, and to shore up the NHS reforms against a gathering tide of widespread opposition.

Political opportunism is perhaps something that too many politicians are guilty of. What I have seen in the complex interaction between the press, the pressure group and the political party in the case of Stafford Hospital is a kind of cleverly managed emotive opportunism that has shocked me deeply.
It is something that in the short term may have put enough votes in the right box to help tip the balance on the election of 2010, but the end result is that it damages our trust in both the press and the politicians caught up in this story.
It is the reason why I am actively campaigning now for reform of the press. We need good journalists who make their reputations by searching for the truth, and we need effective ways of challenging the press when they get it wrong. We also need a press that will also permit politicians to get their points across in an transparent and straightforward way.

So Mr Lansley, if you are thinking of using the words “political opportunism” in the future, I really could not advise you to go there.

Here is a tiny selection of some of the reporting of the Stafford Hospital Story.













18 February 2011

Whatever Happened to Balanced Reporting?

Heading up a veritable pot-pourri of gossip and comment in his Diary piece in the Mail yesterday was this by Ephraim Hardcastle : http://tinyurl.com/63ffyjt

Hardcastle is writing about the sexual assault and beating of CBS reporter, Lara Logan, in Cairo on Friday 11th February :

'Nothing excuses the Cairo sexual assault on CBS TV reporter Lara Logan, 39, the former swimwear model but she does have ‘form’ for dressing provocatively in inappropriate locations.'

Most people, reading a more factual and honest account of what happened to this woman, would have felt sympathy with her plight. Mr. Hardcastle, on the other hand, seeks merely to denigrate and blame the victim. 

Update, 6th March :

I have just come across this piece from the New York Times putting forward good reasons why we need the presence of women in war-zones. The article, by Kim Barker, mentions the treatment Lara Logan received at the hand of both her attackers in Egypt and the many hyper-critical journalists in the press and on TV. Article to be found: here.

Rosie Robertson

14 February 2011

The Stafford Inquiry - Did the Case note review help?

When the Healthcare commission brought out its report, and the press published its leaked figures and Stafford found itself at the center of a media hurricane, we all knew that very strong emotions had been unleashed. Bereaved families needed a process to help them through this. We found that many families who had previously accepted their loss read the press stories, made comparisons and became concerned about their own experience. Each family had its own questions, they needed answers.

The papers were full of demands for sackings and retribution. In this climate it was impossible to ask the Hospital to re-examine cases, trust between patients and the hospital was so badly damaged that there had to be an outsider, and Dr Laker was brought into to run an independent analysis of the case notes.

His evidence to the Inquiry has been a quiet, thoughtful day He has tried to give answers about complex questions on hospital governance, and to look at the experience he had in trying to assist the bereaved families. The complete transcript can be found here

Initially there were about 20 families who came forward, but the press were very interested in promoting this process and continued to print prominent editorial stories to support it. This was in addition to the advertisements placed by the trust. It was also around that time that googling "Stafford" would always bring up adverts for lawyers offering their services.

As the press coverage continued day in and day out the numbers of families who felt that there may have been problems in their case grew too. The pressure group and their influential supporters made it clear that Dr Lakers process was not what they wanted. They wanted a public Inquiry. They did however advocate that as many families as possible should put their names forward for casenote review, in order to build up the pressure for an Inquiry.

In the end around 200 families signed up for this process and were seen by Dr Laker and his team. This large number put the process under real pressure. Additional staff had to be appointed for the task, and there was eventually re-organisation to have the project managed by the Primary care trust, Dr Laker felt the PCT did a very professional job.

The Inquiry made the point that this 200 were a self selected group, of those who felt that they had experienced a problem. By the end of the review process 60% of this self selected group felt that they were still in some measure dissatisfied and wanted to take matters further. Many of these were involved in the group legal claim that was "settled" by the hospital in 2010.

Dr Laker was asked about the expectations of the group, and whether he felt the process had been able to meet them. One of the expectations that he found was that some families wanted him to tell them if they were “one of the 400”, referring to the problematic number used repeatedly by the press of those who “may” have died as a result of poor care. (It is the use of this number and the misleading claim that this is stated by the Healthcare Commission, which is central to the report which is now finally being investigated by the Press Complaints Commission).

Dr Laker says that answering this question from the families was by no means straightforward. There were a small number of cases – a handful – where it was possible to identify with complete clarity that some form of medical mishap had taken place, but this was unusual. There were also cases where the case note process was able to give people closure. They could see by working through the case notes with an expert, and asking the questions that they needed to ask that there had been nothing untoward. They could let their worries go.

There were other people – the majority out of this group of 200- where issues were identified and were able to be fed into the independent inquiry process that began under Robert Francis in 2009. Dr Laker felt that for many of the people that he saw, this was important. They wanted to know that their experience counted for something, and that what they had seen would help other families in the future to a better experience.

This is not a clear matter of black and white - but hundreds of shades of grey.

One thing that Dr Laker talked about that made me feel very sad, was the way in which the media focus on the hospital stirred up unresolved issues for other people, theoretically outside the scope of the case note review. Some people came forward who had stories from 10 years ago or more. Some of these had been through every possible stage of the complaints procedure, the hospital, the healthcare Commission, even the ombudsman. Some of them had their complaints upheld by the ombudsman, but this had still not enabled them to let go of their grief or anger. They felt the need to come back and be part of the Case note review, even in cases where the notes had been long ago destroyed.

The Chairman Robert Francis wondered if in cases where people had held onto their grievance for so long, if that then made is much harder to find a way to let it go. Dr Laker said

I believe that is the case. The longer it goes on the more difficult -- the more protracted it becomes. The more difficult it becomes to deal with.

Robert Francis asked a hard question. He wanted to know if Dr Laker felt that the process had in anyway helped those involved. He thought about this clearly. And the answer was that he does not know. He never had any feedback. He does not know if any of the families felt any better for this process. Here is his answer. :
I think I've indicated earlier that I have difficulty knowing how effective this process has been, because for me the test would be whether at the end of the process it has allayed any of the issues raised by families or they're able to come to terms more with what happened. I simply don't know that. A number of comments were made to members of the teams that saw families initially, that suggested that some were deriving benefit from having the initial meeting.
Certainly the comment was made on more than one occasion that it was the first time that someone had listened sympathetically to the issues that the families were raising. But that's early on in the process, and I wouldn't form a judgment on that. I would want to know, after the process has been completed, whether families derived benefit from the independent clinicalnote review process, and I simply don't know whether they did or not.

6 February 2011

Stafford Hospital Inquiry. - The Bill Cash Story.

I have indicated previously that I believe the press has played a major and malign role in the story of the Stafford Hospital. Last week I was there as the cracks in the case for the Inquiry finally became visible for all to see.

When it happened there were only two journalists there, I was aware of the enormous complexity of the story unfolding in front of us, and the real difficulties that this would give journalists in the tiny space that is available to them. I was not confident that the full story would be told, so let me tell you the story as I saw it.

Picture the Scene. The Stafford Borough Councils’ committee room is crammed with lawyers, their staff and some of the “core participants”. In the adjoining room there is the public – made up of the hard core of the protest group, the press and a scattering of people with some other interest. We were watching banks of video screens with live coverage of the inquiry, the written words that miraculously keep track with the hours of speech, and the occasional “exhibits”. We were able to peer through directly into the room where it was all happening. The space allocated to the audience is greater than it need be as the legal staff probably outnumbered the “public”.

I came because I wanted to judge for myself how thorough and well focused the Inquiry process is, and to see in particular how it went about holding to account the various MPs involved in the story.

What I saw was something intimate, forensic, careful, on occasions kind, on occasions merciless.

The first day that I saw was spent with David Kidney. The second was with Jeremy Lefroy, and Bill Cash. I have also read the transcripts from Tony Wright.
These days followed the appearance of two members of the local authority health scrutiny committee, who found themselves in the unfortunate position of having to admit that they had not actually read any of the major reports on the Hospital, and found themselves ridiculed by the press.

The press had its pre-conceptions on all of this. The Express and Star has throughout the two years of this story taken the view that David Kidney, who did not fully accord with their “local hero” was the villain of the piece, and that Bill Cash who had clamoured for the heads of a succession of people, and given the “local hero” his full support became an unlikely knight in shining armour. The press expected their view of the story to be borne out by the Inquiry room appearances. It is to the credit of the skilful people conducting these hearings that this is not what happened.

What all of the elected representatives at different levels would I think completely agree is that they are not experts on health, or statistics, or the structure of the NHS, or hospital finance, and that it can be difficult to understand clearly what is happening, especially when they are being confronted with reports assessments and ratings which are giving conflicting information. All recognise that this is an area where they have to be guided to some extent by the experts.

What all these people, and all the many other available sources of information that we have seen, will also agree is that the number of complaints that they received before the beginning of the Cure the NHS press campaign were minimal. They saw nothing out of the ordinary happening at Stafford.

Where the difference between the MPs was startling was in their activity levels. With David Kidney I already knew the colossal amount of work that he did to try and understand what the issues were, and to move things forward. I was glad to see at least a small fraction of this work was finally made visible by the Inquiry, though telling the full story of what he attempted will require a full book, which I may write at some point.

Jeremy Lefroy is clearly also committed to working hard for Stafford. What struck me from Jeremy’s testimony is the degree to which he whilst merely a candidate for Stafford he had to rely on the press for his information. This is highly dangerous. Over the last couple of years I have come to know many of the young journalists involved in covering this story. For the most part I like them. They are all decent people trying to produce good copy. They are also working under impossible pressures. It is putting an intolerable burden on them if we expect them be our main source of information about the “truth” about such complex matters, and it would be wrong to blame them too much if they sometimes get things wrong.

I am already approaching the new MP Jeremy Lefroy to request that opposition parties are given regular confidential briefings on issues of concern to ensure that battles based on garbled information are not in the future fought out through the press. In my opinion what has happened has been immensely damaging to Stafford and should never be permitted to happen again. Here or elsewhere.

What came as a shock to me, and I think to the public and the two journalists in the room with me, was the evidence from Bill Cash. For those who are not familiar with this story it was Bill Cash the MP for Stone, who acted as a mentor for the Pressure group, and was there at every available television interview, or Westminster debate to forcefully lead the demands for this Inquiry. I am giving here only a fraction of the content. You can get the full text here.

The questions began. As with all the MPs the inquiry wanted to know how much he might have known about any problems at the hospital before it became a matter of interest to the press. This was the usual story. He had just seen a trickle of individual complaints, no pattern, nothing at all remarkable.

The inquiry then looked at how he dealt with the complaints. Constituents with a problem, would either send him a letter, or visit his surgery. If they came to the surgery he would ask them to follow up this with a written account of their problem. He, or his assistant, would then take their letter, attach a standard letter to it and forward it, in the case of Health related problems to the Department of Health. At that point it would become a matter for the Department of Health to pursue with the hospital. This is in direct contrast to all the other MPs who take much more direct action, writing reports, contact the hospital, and following up the complaint.

The Inquiry wanted to know if he had found this an effective method of dealing with complaints, and if he ever felt the need for any direct contact with the hospital. Mr Cash thought that if constituents were not satisfied that they would come back to him.

The Inquiry wanted to understand Bill Cash’s level of interest in the hospital.

Q One of the criticisms that is sometimes made of MPs is that they don't get interested in something until there are headlines involved

The inquiry noted that Mr Cash had not met either Martin Yeates or his predecessor. They asked if he had visited the hospital between 2003-2008. He thought that he had not done so. They again asked if he had visited after 2008. He thought not.

The inquiry tested his knowledge of the ways in which the health service has been administered. Mr Cash has made a number of strong public comments critical of the organisational structure and of named individuals within in. It transpired that these criticisms were typically based on the opinion he formed of seeing a single report, or attending a single meeting. At the prompting of the inquiry he qualified some of his earlier statements.

It emerged that he had been invited to many seminars and briefing meetings that would have helped him to form a more rounded impression of the administrative process, and he did not attend.

He was asked about his understanding of the Mortality statistics that have formed such an important part of the entire case of the hospital.

A“I honestly can't pretend to have any scientific understanding of it at all.”

On the crucial matter of the co-morbidity coding:

Q Would you have any understanding as to whether the way in which patients were coded when first diagnosed would have upon the statistics?
A. Not at all.

There was one quietly damning piece of paper. Because he had been alerted to the possibility there was a problem by articles he read in the press, he had requested a briefing from the SHA at the time when the Healthcare commission investigation into mortality rates at the hospital were beginning in March 2008. He had personally annotated a paragraph which indicates clearly that there are problems with the systems for measuring mortality statistics, and these were being actively investigated by Birmingham University, as a key part of the HCC investigation.

With regard to the Healthcare commission investigation, whilst the other MPs involved were providing all their background material on the hospital and writing full statements, Bill Cash did something different. Cure the NHS had made contact with him in December2008 and began making regular visits to see him. He asked them to produce a report which gave their version of events, and he then forwarded this report drawn up in January 2009 to the Healthcare Commission.

The Inquiry asked Bill Cash if the comments made in the Cure report represented his own views, but he did not think it was his role to form views. So Bill Cash’s “evidence” to the HCC will have been identical to that given by the pressure group, which was also identical to the material they will have made available to the press.

This very high level of agreement between the "different voices" in the story is something that I spotted in my recent excercise of reviewing all the local press coverage for the last two years, and it troubled me. It was often difficult to distinguish between the messages coming out from the pressure group, the reporters, the editors and various speakers in the Conservative party. Bill Cash's evidence clarifies how this happened. They were all coming from the same source.

The Inquiry moved on to the publication of the HCC report. It raised with Mr Cash that he had received a draft copy of the Healthcare commission report the day before publication, and that he was quoted by the press, in the article that uses for the first time the misleading “excess death figure” of 400, that was published on the day before the official report. This highly emotive figure then completely overshadowed the release of the healthcare commission report, which neither says nor implies these figures.

In the words of the Inquiry

Q. You did, however, I think, quote the figures on a number of occasions in the press. I think you quoted the 400 figure; do you remember that?
A. I don't actually, no.
Q. I mean, I expect you would agree that one has to regard these sort of figures both in a careful way and a responsible way, because they can raise high emotions?

Following these first visits to the inquiry I am left with more questions. It is not at all unreasonable for elected members to find the information they have been confronted with confusing. Anyone would! But how far should we expect them to go to find out the truth. David Kidney and Tony Wright both asked the complex questions and were given the complex answers which form the truth in this case. They then both actively involved themselves in working to find effective solutions to the real problems that existed. Jeremy Lefroy to all appearances is trying to follow their example. Bill Cash decided that the detail was beyond him, he decided to pass on the responsibility of understanding all this complex detail to a Public Inquiry. I am left asking the question, Has Stafford gone through two years of torment, at a huge expense to the tax payer, because Bill Cash took his information from the press instead of picking up a phone to ask people who understood the detail?

We have been in an echo chamber of misinformation. It began with a set of confusing statistics, and with key people who did not understand why the figures were problematic. The myth of the “excess deaths” simply grew, sucking in the press, cure the NHS, Bill Cash, the Conservative party, and then thousands of people in Stafford and throughout the county.

It is time to switch off the echo. Stafford is being used right now as the justification for destroying the structures of the NHS. There are real threats of Hospital closures. We do not want Stafford to be one of them.
Many of the proposals of the health bill are being shown as incoherent by the evidence to the Inquiry. We need to stop these proposals whilst we still can. Structures always need reform, and local accountability is to be actively encouraged. The evidence to the Inquiry has shown us a Health scrutiny that did not scrutinise, GPs who did not communicate any concerns, Patients forums that did not understand and could not perform their role. Bill Cash has his doubts about the ability of local elected representatives to be responsible for their hospital. I agree with him. This is “big society” fantasy land.

We have had this hugely expensive inquiry to see why none of the bodies with a responsibility for the hospital agreed with Cure the NHS. Why could they not see that hundreds of people were dying unnecessarily, as the pressure group thought the Dr Foster statistics were telling them. It may be months yet before Robert Francis gives us his considered opinion, but I believe a careful reading of the evidence given by Bill Cash, in conjunction with all the previous evidence given to the inquiry, now gives us the answer. We are looking at a statistical anomaly. The pressure group were completely right in identifying some problems in basic care which still remain a real challenge both in Stafford and throughout the country. There were also a small number of tragic medical accidents, which occur sporadically throughout the country, and which have left real people with a huge burden of grief. After studying this matter now for three years I have seen no evidence at all to support the idea of large numbers of “unnecessary deaths”.

The reasoning behind the Inquiry may have been muddled, but Robert Francis will bring something good from this, as he did with the Independent Inquiry. The focus must now shift from looking for blame for the mythical 400 to working out how we can protect our health service from the chaos the health bill threatens.

1 February 2011

Can BBC substantiate their claims on Stafford Hospital?

Here we go again!

It was of course predictable that the Health and Social Care bill should bring Stafford Hospital back into the spotlight again. The public perception of what happened at Stafford, fostered by two years of press and media coverage, has been part of the "mood music" played by the Conservative party to justify the NHS reforms, with Stafford campaigners appearing on the party conference stage as evidence of the NHS at its worst.

There are certainly things within the bill that will help with the unique set of circumstances that existed in Stafford. The complaints structure was not strong enough to be able to satisfy a determined individual that their complaints had been fully addressed, so a system that is strong enough to be able to draw a line under a complaint is going to be good for all concerned.

For me the flash point when I see all these press stories regurgitating old material is my frustration that it appears to be impossible to stop the BBC using material which is factually inaccurate. This is their latest report.

Like most of the reports it refers to the numbers of excess deaths caused by poor care, with the claim that the Healthcare commission report says that 400-1200 people died as a result of poor care. This material has appeared in thousands of press and media reports.

It happens to be untrue. The Healthcare Commission report does not say this. The Robert Francis Independant Inquiry Clearly states that these figures are unsafe and the Public Inquiry has clearly indicated the source of these highly questionable "excess death figures".

More or Less, the Statistical programme broadcast by the BBC looks at the issue in some detail.

I have spent a lot of time and energy over the last two years asking the BBC and the press to produce the evidence for these figures. So far no one has obliged. The answer I normally get is "but everyone uses these figures!"

The details of all this are a very long story. I have written a detailed report which is currently with the Midstaffs Inquiry, The press complaints commission and the BBC. I will make more of this public in due course.

My concern at present is the way in which press, media and politics act as an echo chamber bouncing inaccurate material backwarks and forwards, and perpetuating misunderstanding.

I believe there is a need for a much higher standard of accuracy to avoid misreporting in the first place, and a need for a connected media complaints system, which is capable of dealing effectivly with an explosive, complex and political story which appears in a range of different places at once.

I have sent another in a series of complaints to the BBC

Factual Error or Inaccuracy
Excess death figures 400-1200 used in BBC report
do not come from Healthcare Commission report.

The BBC is continuing to make the claim that the Healthcare Commission
report on Stafford Hospital says that 400-1200 people died as a result of poor care in Stafford Hospital. This is not true. The report does not say this.

The figures are the result of a leak from an unidentified source, based on a misunderstanding of some flawed statistical material. The Robert Francis Public inquiry quite clearly states that the figures are unsafe.

I have also conducted extensive research which I have provided to the BBC to show the role played by the press and media in developing this story, This also looks at the role which the Conservative party may have played. The report that I have produced is currently also with the Press Complaints Commission and the Midstaffs inquiry.

Damage is being done to Healthcare in Stafford by this continued misreporting. There is a threat to downgrade the A&E services - due to the loss of public confidence which the misreporting has brought about.

It is time that the BBC took this matter seriously.

If anyone would like to help with this process I think it would be useful to
contact the BBC and ask them for the page reference in the Healthcare Commission
report which backs their claim of the excess deaths. It would also be useful to
know why they have not acted on the clear statement from the Midstaffs
Independant Inquiry that these figures are unsafe.