29 March 2011

Helen's Story: Stafford Hospital

The first time that I became aware of Helen Moss was at the Midstaffs foundation trust AGM in 2009.
To call this a lively meeting would be an understatement. The pressure group were out in force and well organised. It was the first time that many ordinary members of the trust were exposed to the level of anger the pressure group is capable of producing. In the AGM Helen Moss was called to answer a question on “hand overs”. The group all stood up with placards, and shouted “we want you to go”.  The ordinary members in the room were visibly shocked.
Over the following weeks there were frequent photographs in the local press of the protest group holding placards demanding the resignation of Helen Moss. The reasons for their demand were never explored.
Eventually the protest group got their way. She gave up the job and moved away.
Earlier this year there was an interview in the local press with the head of the protest group which set this in context. I have no way of knowing how accurate this account may be. The report indicates that It came back to a phone call from her to Helen. It was clear that there was no meeting of minds. The head of the protest group describes “a switch” going off in her head, and she made up her mind to get Helen out of her job.
There have been demands from the protest group for the sacking of all the staff, and for closing the hospital ward by ward and clearing out any staff that were not up to their jobs, but in the case of Helen it was personal.
28th March 2011 was the first day in which I had an opportunity to hear Helen’s story. Full transcript here She is a quietly spoken, intelligent woman, trying hard to answer difficult, and at time hostile questions with precision.
It is clear that she took up her job as director of nursing at a very difficult time. The staff numbers had been allowed to run down as part of the cost saving exercise to get the hospital back into line financially. The pressure of working constantly with not enough staff was beginning to tell and staff morale was low.
Helen gave the best description I have yet heard of the peculiar culture that is said to have existed at the hospital. There was nothing at Stafford to attract ambitious young nurses, Stafford did not look like a hospital that offered a career path. Many of the nurses that came did so directly from the university, and therefore did not gather experience in the wider world of the NHS. It was, as we had heard from other witnesses an enclosed world, with not enough challenges from outside. There were things that were being done to ensure greater quality in many hospitals which did not seem to have taken off in Stafford.  (All of these issues have been actively addressed now).
Helen was faced with a big problem. She needed to do what she could to change the culture of the hospital, and she also had the task of trying to recruit more nursing staff to get things up to “establishment”. She did not have as much money as she felt she would need for this task. This is a task that was as time went by becoming increasingly difficult. Nurses were reluctant to come into a hospital which was understaffed The effects of the under staffing led to the complaints from the pressure group. As the pressure group’s campaign gathered force there were the growing pressures of media attention.
It became impossible to recruit the full time staff the hospital needed at the speed that it needed to do it. This was like running a bath with the plug out. Recruitment was going on constantly, but staff turnover was accelerating. 
This article which takes us back to October 2008 before the issues of the health care commission report gives us a snap shot of the growing pressures.
The Health Care Commission investigation was experienced by the staff who were trying to make the hospital work as an additional burden. Helen, like many of the staff who have spoken before, talks about how difficult and hostile this investigation process was. It was clear that the HCC was not there to help the hospital.
The inquiry focused in on Helen’s understanding of the mortality figures. This is now a standard part of the questioning to virtually all witnesses. Helen’s evidence here is important because she was there and in charge of clinical governance at the time that the figures were an issue. Her testimony is in line with that we have heard from all those people who were part of the hospital and had reason to understand the mortality figures.
The Dr Foster figures first became an issue in 2007. This was the time at which the Dr Foster system was shifting from being a management tool that some hospitals had brought into, to being a tool that foundation trusts, or hospitals seeking to become foundation trusts, were required to use in order to show their “performance”. It was clearly know in the hospital from before the issue of the figures, that their coding of cases was not being done properly.
They had expected to come in with a coding figure of 114 which was moderately high, but a last minute change in the methodology by which the Dr Foster company generated the figures led to a significantly higher figure of 127. This put the hospital in the “worst” 5 in the country.
The hospital were alarmed by this and immediately sought advice. The Dr Foster company provided re-assurance. It was clear to them too that the coding was “shallow” and that this would have led to an elevated HSMR figure. They thought that the high figures could be adequately explained by this.
The Hospital did not leave it at that they took a series of steps. They recruited a new coding manager. This was necessary, because funding was now partially dependant on HSMR level. The coding manager worked with a newly formed mortality group, which reviewed deaths over the previous year. This we have heard from Eric Morton was cross referenced by the PCT with GPs case notes, and it verified that the coding had been done wrongly in many cases, and that a misleading figure was therefore produced.

The Mortality group began the task of focusing in on the fine detail of mortality figures to see if there were any patterns. Or any indication of underlying problems.
As the coding manager began to take on new cases, the mortality rates being produced by this new “robust” data dropped steadily from high, to average, to well below the national average.
The hospital sought advice from the SHA and Birmingham university. Research was carried out into the Dr Foster Methodology.  (This has led in 2010 to changes in the way in which mortality is measured on a national basis.)  The Birmingham research did also spell out that the Hosptial should not rely exclusively on the coding, and should explore ant other areas of weakness which might account for the high figures. This feeds back to the work that the mortality group was undertaking.
The hospital took on board the advice from the university that the HSMR figures in themselves could not provide a reliable picture of the quality of service and advised on looking at other ways of measuring the quality of work including performance dashboards, which look at a wide range of indicators.
Through all this careful painstaking work there were problem areas being identified, and the hospital sought expert advice from the college of surgeons to produce a report on one specific area where concerns had been raised.
The Healthcare commission for reasons which have yet to be explored chose not to accept the line which was accepted by the Hospital, the PCT, the SHA, Birmingham university, and even we hear from the Dr Foster company, that “it was the coding” and they came in to carry out their investigation.
The HCC did not share information with the hospital during this process, and because of that the hospital called in Price Waterhouse Cooper to give them advice on what they needed to do to improve matters.
Helen was asked about her reaction to the horror stories that are now so familiar to everyone through the press about poor care in the hospital. She like virtually all the people who have been asked this question expressed the shock she had felt. She also showed that there was nothing in her own experience of the hospital that prepared her for these stories.
She did carry out regular visits to wards all over the hospital as a key part of her job. She had staff expressing to her their frustration about staffing levels and staffing mix. She was actively working to satisfy this through the recruitment process, and through a staff mix review, that was put in place to help push for the extra funding that was needed to bring staffing up to the right levels. She did not in her frequent visits to the wards see anything in line with the stories told in the press, and she did not have nursing staff coming to her and saying that the staffing levels had reached the point where it was impossible for them to do their job.
The impression that I was left with at the end of this evidence was of a genuine caring and hardworking person, who had tried to do a difficult job under difficult circumstances, and was in the end defeated by a unique set of circumstances. This article shows the kind of pressure that she was under.
I would have liked the inquiry to invite her to say what she had felt about being on the receiving end of such pressure. I am sorry that they did not ask her this.
Helen gave the apology to the bereaved which is now a standard part of most people's evidence.
Here is the coverage of the day from BBC and Express and Star.

28 March 2011

The press coverage of the 26th March march is depressingly predictable.

The time that I worked out that the March for the Alternative might be quite big was when I went into the Hobbycraft shop to buy a bit of display board for a placard.
Stafford Hobbycraft is not exactly what you would regard as a hot bed of radical action. People go there for beads and feathers and paint. I mentioned to the lady at the till that I was planning a poster for the protest march, and she surprised me by saying there had been lots of people coming in for ribbons for the protest.
As our small coach hit the motorway it was pretty clear that we were playing tag with dozens of coaches all heading in the same direction, union groups, from Wolverhampton, Pensioners groups, librarians, Sure Start.
The queue for the loos when we stopped at the service station were impossibly full of middle aged women like myself. No point queuing not enough time to avoid holding up the coach. 
Virtually all the people I spoke to on the coach had in common that they had not been on a protest march since the 1980s. One mature lady who worked for a PCT and was waiting to see if she would be transferred to one of the new GP consortiums told me that her 6 year old granddaughter had shamed her into coming onto the march.
Wembley coach park was already packed by the time we got there and in central London the march was well underway, so we assembled our banners and crammed into the tube, with an assortment of strangers all bound in the same direction.  
In central london we joined the end of the march – which steadily became longer and longer. We could see no beginning and no end. We were hoping that we would make it to Hyde Park, but soon it became clear that this was unlikely. There were so many people, and the movement was less of a march and more of a slow shuffle. It was all good natured and patient, and we got into conversation. People helped each other to get snacks out of back packs and take turns on carrying posters. We admired the posters carried by the other people around us. I could see The RCN banners carried by our group, Unison, firefighters, Librarians, University groups, lecturers and students. The union of journalists, various branches of the Labour party. There were lots of people carrying posters in support of the NHS. There were surprising groups like the Writers' Guild.
A favourite poster was “Drama therapists against the cuts”. We all agreed this is the kind of people doing valuable but little understood work, that would be very likely to suffer now. 
A young girl carried a poster saying “its my birthday, so if you are going to kettle me it better involve cake”.
A small group from Wales sang a-capella. 
A group carried a coffin with the words RIP Adult Social Care.
There were stilt walkers wearing tutus in Unison colours.
The GMB cycled by in amazingly creative cycle floats.
An elderly communist sat with his feet up on one of the benches, handing out leaflets to anyone who wanted to take them.
A young man handed out flyers for a seminar on community organising in Venezuala. 
There was a bit of chanting – but nothing compared to the march I had attended in October around the Conservative party conference. The October protest had involved many people who were politically active,  that understood what was happening, and knew there was a need to challenge it. The people marching on March 26th were not protest veterans. They were quiet people who have gradually seen what the government are doing, and know they are not happy.
Occasionally groups from the Socialist Workers party worked their way through the crowd, and tried to stimulate more noise.
I noticed one small incident involved the photographers. There were photo lenses everywhere. There were little clusters of photographers on every vantage point each looking for a potentially valuable definitive photo of the event. One cluster was clearly getting frustrated that we were not more strident. They chanted for us “You say Cut back, We say fight back”. It was as if they were trying to “teach us” to protest in a way that they might use.
As we passed under each of the bridges we were under close observation from yet more photographers, and by watchful policemen. The photographers were again keen to make things more lively. I could see that there are set roles that the press want protestors to fulfil.
We kept walking – so very slowly – by the time we got to the Houses of parliament it was clear that we would not make it Hyde park. By the time we got to Trafalgar square we needed to peel off and make it back to the coach.  We began to get news of problems in Oxford street as relatives left text messages. But this may as well have been in a different country – it was nothing to do with our experience of the day. Here is another account by Mary Hamilton
Even where trouble occurred it probably hardly justifies the Sunday headlines. Here is an account from the Uncut protests. Another by Dominic Campbell from Fortnum and Masons, and one from Trafalgar square. Here is an account of the hard core protestors have become known as the Black bloc.
On Sunday we hear that Vince Cable is telling us that there won’t be any change of policy in response to a protest. I actually do not believe this. Comforting though it might be for the government to believe that this was “the usual suspects” stirring up trouble, and rejecting the eminently reasonable plans of the coalition, it is pretty clear from the many accounts that are coming out about the day that this was a protest by Middle England. It is reasonable people coming together calmly in an organised fashion to express their concern. If the government wishes to ignore it then that is their choice. There will be a price to pay.
The press also need to consider their role here. The right wing press at present wish to present this overwhelmingly peaceful mass protest as something else. If ordinary people protesting peacefully cannot have their voice heard then this will lead to trouble. People will either be forced to become more radical than they wish to be, or they will take the view that there is no point in engaging with politics at all. That no one will listen.  There is a growing feeling that the press need to be more careful in the way that they report. also here.
I think there is a challenge to the Labour party too. As a Labour party member, an activist still bruised by the experience of the general election, it is easy to feel frustrated that people did not understand at the time when we could have made a difference. Now we have to take on a different role, and assist people to express their wishes effectively. Ed Miliband's speech at Hyde Park indicates the scale of this challenge.
What happened on the 26th March is that 250,000 to 500,000 people took a day to come to London, and say listen to us. We have a right to be heard. They represent many more who would have liked to come. What this government has not yet grasped is that government must be by consent. They may judge that what they are doing is for the good of the people, but if they cannot carry people with them it is doomed to failure.
The government has chosen to use the media over the course of many months to denigrate the work of millions of public servants. It has chosen to say that the work done by many involves “non jobs”. The people who filled the streets of London beg to differ with this opinion. They know that the services they give and the services they rely on matter.
The government has believed that it can afford to confront the large swath of middle Britain that was represented in this march, and that creating division between private and public sector is beneficial to their cause. This is misguided. The problems that we are facing can only be dealt with by communicating better, and by coming together through a clear understanding of the facts.  We cannot do this without accurate information. We have to be able to trust the press to help us do this. 

Why allow the truth to get in the way of vicious calumny?

This is the front page of today's Mail on Sunday. Just above the main headline, in itself quite a clever if hyperbolic pun, is a lie. 

Next to an image of Gordon Brown is a headline suggesting that yet another piece of evidence, trumpeted as 'EXCLUSIVE', has been been uncovered by the paper and will merely add to a long list of reasons to hate this man.

Anyone catching sight of the cover would immediately be given the impression that this selfish, heartless and despicable ex-Prime Minister had turfed a heavily pregnant woman out of her seat on a plane so that he could enjoy sumptuous luxury!

Were you to read the accompanying article (Istyosty link)  inside the paper, however, you would find a completely different, and more truthful, account of what actually happened.

The story in the Mail on Sunday journalist Glen Owen's words unfolds thus:

Gordon Brown sparked a mutiny on a British Airways flight after he was blamed for an attempt to downgrade a heavily pregnant woman and Red Cross doctor into more cramped seats.
The extraordinary scenes - dubbed Mutiny On The Brown-ty - unfolded on a flight from Abu Dhabi to London, when passengers lost their seats before the former Prime Minister's six-strong entourage got on board.
It prompted an angry war of words with an 'aggressive' Brown aide, and led to a formal complaint to BA and an offer of compensation described as 'derisory' by those involved.
During the first, hour-long leg from Oman to Abu Dhabi, the displaced passengers stared resentfully at the six empty seats in business class, known as Club World by BA.
At Abu Dhabi they were livid to see Mr Brown board the plane with his team and take up the £3,000-a-head places.
The passengers immediately concluded that they had been 'bumped' to make way for Mr Brown, a suggestion the airline strongly denies.
According to the Mail on Sunday, an argument ensued. We're left in no doubt as to who were the more aggressive passengers and who were the innocent.

Then comes perhaps the humorous aspect of the piece. Apparently, Gordon Brown's people and BA have conspired to try to limit the embarassment:

A spokeswoman for the airline said Mr Brown's arrival on the flight was a coincidence, and he had been unfairly blamed by the mutinous passengers.
'The situation had absolutely nothing to do with Gordon Brown,' she said. 'We have apologised to [the complainant] and we have offered to pay compensation.

'It is very rare for a customer not to be able to travel in the cabin that they have booked and we are extremely sorry that this happened on this flight. Gordon Brown and his party were booked in advance and were not involved in any way.'
 And from Gordon Brown's office:
Mr Brown's office was contacted on Friday. Yesterday afternoon, his spokeswoman sent a text message saying 'I assume you have read the BA statement and are now not ­running the story', making it clear that BA and the former PM's office had been in discussions.
She released a statement that said: 'As BA has made clear, the arrangements were nothing to do with Mr Brown, who had booked his flight and seats well in advance and made no requests for - nor received - any special treatment.
'As BA will confirm, all questions about bookings, overbookings and allocations of seats are not - and could not be - a matter for Mr Brown but for British Airways.'
They try so hard to pin the rap on their victim, that although the whole episode turns out to have been a malicious piece of fiction from a discontented traveller, they place the hook to a potentially harmful piece on the front page so that an impression is given even if not warranted.

The Daily Mail and the Mail on Sunday have 'previous' where this particular victim is concerned:
Note use of words: 'SQUALID', 'cynically', 'bids'.
This was one of many front pages which graced the newsstands just after the General Election in May 2010. The Conservatives and the Liberal Democrats were negotiating a deal which would pave the way for a coalition of the two parties. 

The deposed Prime Minister, Gordon Brown, was obliged to remain temporarily at No 10 Downing Street until the Queen had formally invited David Cameron to take over as Prime Minister. Despite many explanations as to why he had not left after five days, all of the Right - leaning press and Sky News simply 'neglected' to publicise the reason for his remaining in place.


The Sun was relentless in its assertion that Gordon Brown was behaving in an unreasonable manner.

The examples here are just a snapshot of the lengths to which certain papers will go in order to blacken and discredit a subject. 

Perhaps Gordon Brown is fair game? Perhaps any celebrity written about in sneering or untruthful articles, or pictured in unflattering poses is fair game? Shouldn't they perhaps expect such treatment as part of being in the public eye?

That aside, what about the reader? Do we not deserve truth and balance? How many of us read an article in one of the papers renowned for its propensity for fiction and bias and think twice before swallowing the bait hook line and sinker?

There are times when it is crucial that the public have the truth laid before them, when the media have an absolute duty to be honest and balanced.

How many of us vote at an election after having been fed by the British media a pack of lies or manipulated facts and statistics deliberately concocted to sway our opinion? I fear the number would be far greater than we think....

Rosie Robertson

25 March 2011

The Met, The Media & Bereaved Families...

I would hope that you will join me in being absolutely outraged by the actions considered to have been possibly undertaken by newspapers who appear to have essentially arranged the hacking of phones of bereaved parents of girls who were abducted and murdered.  http://is.gd/yr9cCH  and  http://is.gd/A1JiOF.

Following months and years of allegations, rumours, challenges, sniggers, sneers, procrastinations and denials we are now seeing that further questions merely bring about further questions ! This whole saga is becoming murkier and murkier...  who would want to touch it ?  But at what cost do we not touch it.... ?

This saga began with a few people concerned that their phones had been hacked realising that stories printed could only have been ascertained via their mobiles. Since those days the story has grown to such an extent that we are now questioning the actions and motives of all those involved from journalists, private investigators, newspaper editors, owners of big media organisations, The Met, latterly the Director of Public Prosecutions and even the PM has been brought into it !  The British Prime Minister !! Excuse me..  but whatever political party we may or may not belong to the Office of the Prime Minister has been brought into question. Private dinners, inviting Murdoch through the back door not the front door of No 10. What does that say ?  And let's not forget Coulson...  he was there at the beginning of this tale - will he be there when we get to the end ?  When the DPP & a Senior Officer of the Met start throwing accusations at each other, as alleged, then there are serious questions...  we need the answers !

I believe this has become very serious. In fact I would go so far as to say there is an odour... an odour of corruption about this whole affair.  I thought this a while ago but the latest headlines, where innocent, distressed, bereaved families have been targeted, just takes it to a different level.  Before this, I feel there may have been a question mark amongst the public, ordinary people who go about their daily lives never questioning that they could be targeted, believing such happenings were the territory of the rich and famous.  But how wrong can an assumption be...   I feel people will now start to sit up and take notice.  I hope so because there are far-reaching implications.

But what can we do about it?  Write to every newspaper editor,write to the DPP, petition the PM, contact the police... ?  But hang on - these are the people/organisations who are involved in this scandal !  Get my point ?

No, we support those who are trying to get to the bottom of this whole sordid, pernicious affair.  We show our support for Tom Watson and Chris Bryant !  They are our representatives on this.  And whilst pursuing, their lives might not be so easy...  they deserve our support ! They, along with those who are taking legal action, rather than accepting pay-offs, are the one's who will lead us to the truth... and importantly, by doing so, hopefully restore our faith in our long trusted institutions...  

Finally, I cannot say how sick I feel that these parents may have been targeted... 

21 March 2011

Sun of 'GOTCHA!' ?

Britain, since last Friday, has become embroiled in yet another dispute in a distant land; this time Libya. Setting aside the wisdom or moral foundation of such an intervention in the troubles of a country whose leader, Colonel Gaddafi, we have hitherto cultivated as a 'friend', the coverage in the printed media especially stirs memories of a journalistic style prevalent in the tabloid press during the Falklands War. 

One has only to cast a cursory glance at the front pages to get a sense of the way the Government, the military, the Gaddafi supporters and the 'rebels' amongst the Libyan people will be portrayed in the ensuing acres of newsprint and page after page of online content linked to each paper. 

For example, two of the front pages of today's tabloids:  

Daily Mail
The Sun
During the Falklands War, the Editor of The Sun was Kelvin MacKenzie and as his assistant at that time, Roy Greenslade was privy to the atmosphere in the Newsroom and the slant MacKenzie was keen to engender, although not actually agreeing to it himself!

In 2002, twenty years after the war, Greenslade wrote
Most people probably think of the Falklands as Thatcher's war. For me - and I suspect, for a good many other journalists, that bizarre spasm of post-imperial imperialism was really the Sun's war. Or, to be more precise, Kelvin's war. Kelvin MacKenzie's Falklands coverage - xenophobic, bloody-minded, ruthless, often reckless, black-humoured and ultimately triumphalist - captured the zeitgeist. Here was a new Britain and a new kind of newspaper heralding the emergence of a transformed culture.
The vocabulary in many of the ensuing articles and headlines throughout the whole of that war added to and encouraged a feeling of patriotism and justified might:

And most evocative of all, with today's headline in mind:
(Meaning that Britain had captured Georgia, two airstrips and three warplanes.)

The horrors of war reduced to the level of a score-line in a football match?

Today, Kelvin MacKenzie is no longer the Sun's Editor, but many of the circumstances which led to the paper's individual stance on the Falklands war are eerily applicable today. 

Whereas in 1982 there was an apparent need to defend a British outpost and military base, there is a suspicion that it is our dependence on Libya for oil and its importance as a buffer against terrorist groups which has escalated this military action, not merely the atruistic desire to hurry to the aid of those seeking their democratic rights.

Although Margaret Thatcher's Government was wholly Conservative politically and we have a Coalition now, there is a feeling amongst many observers that a flagging popularity and waning public confidence in its policies have prompted an eagerness to embark on a military adventure in order to shore up a weakening image. 

The Sun is well known to be a supporter of this Government so far and  the prospect of this latest war seems to have driven the editorial staff to rummage through the archives and revive the old, familiar jingoistic Union flag - waving battle cries!

I am 'lucky' enough to be able to access the iPad version of the Sun Online. Today's output includes a long, very detailed round-up of events in Libya over the weekend, interspersed with excellent images and an occasonal video clip taken from Sky News

On the whole, this article written by Virginia Wheeler (Defence Editor) and David Willetts (Defence Correspondent)  is a balanced and fair representation of what occurred. 

Another shorter article written by Tony Newton-Dunn (Political Editor) and Virginia Wheeler, headed : "Where is Gaddafi?" seeks to depict the Libyan leader as someone cowed and snivelling in the face of UN Coalition bombardment of his Military bases assets.

He is variously described as 'cowardly', 'Mad Dog', 'monster' and the whole piece conjures images of a cur driven to ground with his tail between his legs.

Included in the same article, is a 'Gaddafi Crime-sheet' and a contribution headed 'Tyrant Has to Go' written by Professor Mark Almond of Balliol College Oxford and Bilkent University, Turkey, who seeks to explain why the 'rebels' need help to fight Gaddafi's forces.

Whatever one's feelings as to the character and worthiness of Gaddafi as a leader of his people, the language used in articles purporting to bring accurate facts and impartial relating of events is highly emotive here, perspective and balance missing - as was the case many a time all those years back in 1982 when the same paper brought us its version of the Falklands War....

Rosie Robertson

19 March 2011

"Journalist Wall of Shame "

This is a website dedicated to the less than helpful or edifying journalism its creator has seen since the Japan eathquake of last Friday.

I'll let the site's creator speak for him/her self:

Why Bad Journalism Has Driven Me To Desperate Ends

In retrospect, I should have had this idea before, but I guess today I just hit critical mass (not sure if it’s appropriate to use a nuclear energy turn of phrase here): one too many pieces of bad journalism.

So I decided to start a wiki Bad Journalism Wall of Shame and invite some of the other people who were frustrated with some of the shoddy, alarmist, and shocking wrong journalism we’ve seen since last Friday’s Tohoku quake.

I take everything I read with a grain of salt these days, and have for many years.  When I read an article or see a television report that makes sensational claims, I try to fact check on my own, because I no longer trust most journalists to have done it for me.  

One glance at the list of newspapers included on the site shows that the British press does not escape criticism!

There are examples of articles covering the Japanese eathquake, tsunami and subsequent nuclear emergency, and reasons why the contributors find them particularly reprehensible.

Rosie Robertson 

17 March 2011

Proof that Journalism Not a 'Feather-bedded' Profession?

An image sent from Japan, by Alex Thomson of Channel 4 News, showing journalists taking a well-earned rest from their coverage of the aftermath of Japan's earthquake, tsunami and nuclear problems.

Last night, this tweet appeared : 

okorih arumakan
I want to thank @ crews for delivering water to the evacuators instead of just going for the report. Amazing team.

It is sometimes all too easy to criticise the media and to forget that in order for us, the public, to be given a true portrayal of events and issues, the news gatherers, not least recently, find themselves in precarious positions. 

We have seen remarkable scenes, accompanied by careful and thoughtful words, delivered to our computers, TVs and in the press, from the Middle East, New Zealand and Australia. This is true for most of those sending back film and written reports from Japan.

Channel 4 News are not alone in the excellence of their work. The BBC News output, together with the majority of that of Sky News has at times brought unique angles and surprising points of view to us here in Britain from places beleaguered by natural disasters or the violence of tyrants meted out to citizens embroiled in their struggle for democracy.

One has only to glance at the front pages of the press, however, and to read some of the articles offered to their readers, to glean that the journalism and coverage of such momentous events is not always of such commendable quality. For example:
Cheltenham? - or Japan?

Serious, in - depth journalism?

Rosie Robertson

16 March 2011

No Panic, Daily Mail.

Since last Friday, 11th March 2011, the majority of the world 's media have rightly focused their attention on the terrible plight of hundreds of thousands of Japanese people. 

Visited at 2.46 p.m. by a very powerful earthquake, magnitude 9.0, the Eastern seaboard of Japan was then almost obliterated by a tsunami which destroyed many towns and villages along the coast, killing an, as yet, indeterminate number of people. 

Representatives of the media descended on the areas affected. From the UK, most of the well-known 24 hour news stations' anchor men and women as well as countless journalists from the press are there, relaying moving stories , painting vivid pictures of the scenes they are witnessing and enabling readers, listeners and viewers alike to see for themselves the extent of this disaster.

Most of the reporters, thankfully, are producing high-quality, truthful and effective columns and pieces to camera . We are able, through the thoughtful, intelligent and honest accounts from journalists like Channel 4's Jon Snow and Alex Thompson, to see and hear for ourselves the dignity and sheer tenacity of fellow human beings trying to cope with extreme danger and its aftermath. These journalists are often in dangerous situations themselves.

Now added to earthquake and tsunami, we are watching a nuclear power plant seemingly rapidly running out of control and which may affect the health of many of those lucky enough to survive the earlier events.

Most News outlets have been reporting, and we have been able to see for ourselves, how marvellously stoic and forbearing the Japanese people have been and continue to be. Reporters constantly refer in admiration to the way these people are kind to those in need, thoughtful to strangers and work together to make the best of what most of us would find only in our worst nightmares.

As Channel 4 News' Alex Thomson says in his blog:

 Over here there is no chaos. No mayhem. There is a nuclear power station with some heating issues. There is a forest fire, a blizzard tonight and coastal obliteration on an unimaginable scale.
But this is Japan. They do not panic. They do not do mayhem. They don’t litter and they don’t loot.

Further examples of the sheer forbearance of the Japanese people can be found here in this video sent by George Alagiah from BBC News: here

Most of the media have been restrained and accurate in their reporting of events in Japan. Some have not. The Daily Mail today, tells us in banner headline on the front page that Japan's people are 'in the grip of nuclear panic' and includes the word 'apocalypse' in the same headline. 

The purpose of this hyperbole is no doubt to ratchet up the drama of the piece and sell more copies, but what it does do, in actual fact, is a disservice to many thousands of human beings behaving in a way many of the rest of us doubt we would be able to emulate.

How much more effective and honest, then, is this style of front page and headline -

No unwarranted exaggeration, no hype and more importantly, no lack of respect for the victims of this tragedy.

Rosie Robertson

11 March 2011

Stafford Hospital: what the Royal College of Nursing saw.

The thing that you keep finding with the Stafford Hospital story is that there are so many things that don’t quite fit.

The press have their simple story of a uniquely bad hospital where hundreds of people are dying of poor care, and then right in the middle of the healthcare commission investigation you get this letter from the CEO of the Royal College of nursing talking in glowing terms about his visit to the hospital, and the great work that is happening there. This was a letter that in the words of the inquiry caused the pressure group to "take umbrage." It is perhaps characteristic of an inward looking group, which has been successful in commanding the attention of the press, that they assumed that Peter Carter must know all about them and was deliberately contradicting their story. The fact was that he is a busy man, he knew nothing about them at this stage and he was merely reporting the very positive visit he had to the hospital.

The Royal College of nursing is of great importance to the Stafford Hospital story, because this is the body that represents the nurses. Poor nursing care is central to the stories that the media has to tell on Stafford Hospital, and to other hospitals highlighted by the recent ombudsman’s report.  The Evidence of Peter Carter, CEO of the RCN gives us a lot of highly useful information Full transcript.

There is a useful snippet if personal information about Peter Carter. He says of himself:
"I've built my reputation on calling it as I see it. And I certainly wouldn't have been used as an instrument to do someone else's bidding". He also tells us of the highly relevant subject of his thesis completed 1998 “was on why nurses abuse patients”
The royal college has a dual role. It is the body which advises on the professional standards of the nursing profession and it is also a union for nursing staff.
Peter Carter has a responsibility for the entire RCN. Funded by membership subscriptions there is a staff of 300 staff at head office; they take care of its 416,000 nursing staff in hospitals, and care homes. As someone with such a huge organisation it is clear that he has to rely on the information that is filtered up to him.
It was clear that in the case of Stafford he was heard nothing. This is not unusual. He would only hear about concerns in a particular hospital in exceptional circumstances.
Sue Adams is one of the RCN’s Stewards at Stafford, Her personal experience is of staff who were under pressure, but were coping, and that she received no information of any serious concerns about patient care. She also says that because she had to fit her union duties in on a voluntary basis around her own heavy workload, that she was in no position to go hunting for problems. It is clear that her superior in the union was also coping with a heavy workload, and was seen by some of the staff as too close to management to be an obvious channel for complaints about workload.
If we look beyond Stafford, the RCN carried out research that correlates staff mix – the ratio of Qualified to unqualified staff, to quality of care.  It is clear that if this falls below a certain level then there is a strong likelihood that patient care may suffer.
Sue Adams own evidence also shows in a pretty clear way what happens when the ratio of patient to staff levels is badly balanced

 I was absolutely aware of the staff shortages and the lack of qualified staff on duty in some areas that had been reported to me. But I can honestly say that none of the staff were saying that the nursing care was not being given.
You've already described how nurses would come and speak to you about concerns they had, and indeed you say in your statement that, at times, your members had burning issues that they wanted to discuss with you, but not about failings in nursing care.

They felt that they were trying to give the best care they could with the numbers that they had, but weren't able -- weren't able to deliver the care that they knew the patients wanted, needed and deserved. With the best will in the world, if there were three nurses on duty and five people buzz for a commode and each patient needs two nurses to get them out on to the commode, they can only help one patient at a time, and by the time they get to patient 5, that patient hasn't had the care that they need and may well have been incontinent
Sue said that there were real concerns about the staffing levels and staffing mix and that she actively encouraged staff to put in incident forms whenever they felt the staffing levels were wrong. This may possibly explain the persistent stories of someone having seen complaints forms in a bin. This was mentioned in Sue Adams evidence, but the details of this are not clear. Maybe we will eventually hear the full facts of this, but then again maybe we will not. There is nothing certain about it.

Robert Francis has clearly understood the crucial question of staffing levels and mix and asked good questions about who should be responsible for stipulating staff and staff mix levels. Peter Carter was very clear that this is something that it is completely inappropriate to leave to local discretion – it has to come from Government and it needs to be enforced by the Care Quality Commission. This is a message that needs to get through to this government as it directly contradicts the direction of the health bill proposals.

Well, first of all, Mr Francis, I actually think it should start at government level. I think it's wholly unacceptable that this is left to local employers. So, first of all, from the top there should be a compulsion on people to do impact assessments and to be clear about what their staffing is. But I would also put this into the remit of the Care Quality Commission. And I think that with their inspections and visits, they should have a real focus on staffing levels and they should be tasked to take employers to task on this.
Peter Carter was asked in some detail about his visit to Stafford and the letter that he wrote to the press which gave such offence to the pressure group. he had been shown a series of presentations on different wards which included work they were doing on infection control, and monitoring pressure sores  He also did what he habitually does on such visits and had a private discussion with several groups of patients.

Here are some of the exchanges about that visit.

When I go on visits I always obviously talk directly to nurses and other staff, but one of the things I always ask to do, and it's never denied to me, is I ask to  speak to patients, and I think that's really important. And how I do this, I've got a kind of tried and tested way of doing it, is I put it to the -- the people that are escorting me around "Well, look, I want to ask patients at first-hand what they feel about their care, but it's going to be pretty intimidating if there's a small entourage with me". You know, you can hardly say to a patient "How do you feel about the nursing care?" if there are four or five nurses around. So what I do is I tend to go into, say, a four-bedded dormitory by myself and I simply say "Look, I'm Peter Carter from the Royal College of Nursing, I'm fishing here today, do you mind if I ask you about your care?" I do it in the a very low-level way. I've never been refused and people -- people talk.And at my visit to Mid Staffs, all of the people  that I spoke with, could not have been more fulsome in their praise. I mean, look, I had -- I didn't know any of the people at Mid Staffs. There's no pre-existing allegiances. I mean, had people been saying to me "I'm  glad someone's asking me, you know, I've got some real concerns about what's going on", I would have raised it with Helen Moss, I would have said -- but it was -- it was entirely the opposite. Really, really glowing  tributes about what people were saying on the wards that I visited.

He explains this apparent contradiction in a simple way – A hospital is made up of a series of microclimates. Individuals matter. A gifted sister can make a great difference. Some wards will run well, others not so well. This does give us a clear picture that at the time when the HCC investigation was in full swing there were certainly some areas of the hospital (it could of course be argued that he was only shown the good bits) where things were not merely adequate, but very good.

I'm astonished that -- I mean, I consider myself experienced. I'm astonished that you could go and visit a few wards and get such a really good feel-good factor, to then subsequently know that in part -- and we've -- we've got to be clear, it's parts of the hospital. The Healthcare Commission's inquiry was not into Mid Staffs per se. It was into the A&E, the medical wards and some other aspects of care. And it's not uncommon, and I've used it my statement, that hospitals are a series of microclimates. You can go to one ward with an excellent ward sister that's well managed and it's everything that you could wish. You can go to another ward and the care can be very poor. And that, I think, is what confuses people. All I'm saying is I called it straight and what I saw it felt really good.
He later returned to the hospital before the issue of the HCC report and held an open forum attended by 92 staff. Staff at this forum told him of their appreciation of his letter

Look, we feel the whole hospital has been traduced here and yet many of us provide excellent nursing care". And in fact some of them were appreciative of my letters because they felt that reflected the truth.

But also the staff were also more open about the problems they were experiencing in other areas. I mentioned the open forum that I had, the word "Beirut"(which has become a part of the mythology of the Stafford hospital Story) in relation to EAU was mentioned then.
When the Healthcare commission report and the press frenzy that accompanied it came out this came as a great shock to Mr Carter, as it did not accord with his experience, and he had certainly not had any indication of the level of problems raised by the report through the RCN channels.
There was an exploration of the reasons why he had not heard anything. This is the central question that the Inquiry is trying to ask, and it always does come down to a complex mix of reasons. It is from the evidence of an increasing number of the witnesses pretty clear that if there were problems they were not at all obvious even to those who were working in the hospital. There is still no sense at all that anyone one understands the scale. Are we looking at a handful of individuals in a few wards, or were the problems more widespread?
The inquiry explores this further – which is right – because if the indications are not coming from the nurses who are there giving the day to day care, then where are they going to come from.

“ I think you're critical, I think, of Monitor and the PCT and other agencies for  not spotting what was going on. But, of course, if your  members aren't coming forward to you, if there's a general culture of people not being open about what's  going on, it's very difficult for anybody to find out, isn't it?

I genuinely believe the vast majority of the nurses at  Mid Staffs were nothing other than decent people, it is fair to say that, for a whole collection of reasons, which I'm happy to explore with you, people were not more open about the deficiencies in care. Now, I've already given one explanation is that people felt, well, if you're cutting 150 jobs, there was a heads down mentality, and there's also evidence that a lot of good nurses decided to leave
Robert Francis askes about Whistle blowing. Does it work?

Yes, Mr Francis. Look, I think there's a huge problem with this. I mean, first of all, I'm sure you and your colleagues will be aware of this that sometimes ministers think that in Whitehall you have a piece of legislation and it solves the problem. And in my experience that's rarely the case.
A particular issue that Peter Carter raised which I feel has a crucial bearing on the future of the quality of care is the matter of Nursing care assistants. I think it is clear that he believes we are looking at care being delivered by under regulated, untrained and un-unionised workers. He finds that a matter of concern, and so do I.
For the record, I think it's important to clarify, the RCN has 416,000 members, only 8,000 are healthcare assistants. So healthcare assistants are a tiny part of the membership. I just thought that was right for the record. The problem is the vast majority of healthcare assistants are not in any organisation at all. They'd be very welcome to join the RCN. In addition to that, the RCN is currently lobbying that we think healthcare assistants should be properly regulated and they should be trained. If I may go on  just to add, you have -- have a phenomena at the moment -- and by the way, through -- across all sectors, both care homes, residential homes and hospitals, there are nearly half a million healthcare assistants. So it's a huge component of the workforce. And the problem at the moment is in the absence of any mandatory training, it's left to local employers. Now, there are some trusts that do it really well. They employ people, they induct them, they train them and teach them all of the skills that are needed. Sadly, at the at the other end of the spectrum, we've come across instances where people have no training at all. They're literally given a tunic, it looks like a nurse's uniform. They're put on wards and they pick it up as they go along. Now, we say that's wholly unacceptable.
Mr Carter was asked about some aspects of the HCC report.
He makes it clear that he has no knowledge of the mortality statistics which he sees as the responsibility of the trust, the PCT and the SHA.
Perhaps because of this gap in his specific knowledge he accepts what he has heard about the HCC report without question.
But there are issues raised in the HCC report that did really upset him, as they did anyone who was concerned about the provision of good health care.
Receptionists were triaging patients in A&E, patients being left in excrement, nurses in the cardiac unit had not had the cardiac sciences training and so were turning off the cardiac monitors, intravenous infusions were not running properly.
All these are real and serious concerns. All have been dealt with. What neither the HCC report or any of the subsequent reports have really told us is the extent of the problem.

What I feel from reading Peter Carter’s evidence is that he has got to the heart of the matter. The hospital is not a single entity, it is a series of microclimates which are all behaving in their own unique way. There is nothing contradictory in saying that there was very good practice side by side with very poor practice.

I believe there is also a fundamental message here. Care in the end is delivered by individuals. If we want good care we have to look after the people who are delivering it in the right way. Competition and driving down costs is very unlikely to deliver the quality of care that we would like to see, and we have to encourage staff to find their voice and know that they can and should speak out strongly when things are not as they should be.

There is also a message with regard to the role of the press. The press have been too concerned to deliver a simple coherent story. They would be serving us better by showing the facts in their full complexity. Good and bad co-exist. If the wellbeing of the staff is central to the quality of care that is delivered then what has been perceived as a prolonged and unbalanced press campaign to vilify the staff is counterproductive.

5 March 2011

Richard Peppiatt's Resignation from the Daily Star

Late yesterday afternoon, the Guardian reported a remarkable resignation here. A journalist working at the Star newspaper wrote an angry and scathing letter, here , to Richard Desmond, owner of the Daily Star, giving the reasons for his leaving what must have appeared secure employment with the paper.

The journalist, Richard Peppiatt,admitted in his letter that he had been guilty of submitting stories about celebrities which were untrue and concocting others which had no basis in fact whatsoever. 

Kelly Brook, often the subject of articles in the Daily Star, once asked where the stories came from. Peppiatt in his missive to Desmond says:

"Maybe I should answer that one. I made it up. Not that it was my choice; I was told to. At 6pm and staring at a blank page I simply plucked it from my arse. Not that it was all bad. I pocketed a £150 bonus. You may have read some of my other earth-shattering exclusives."

To many of us , this admission is remarkable. 

We may have suspected the dearth of veracity in some of the articles we read in such papers, but to have our suspicions confirmed in such a powerful way in Peppiatt's letter leaves us sighing 'At Last! One of them has held up his hands and told the truth!'

What seems to have been the straw which broke Peppiatt's journalistic back was his being 'forced' to write articles denigrating Muslims and aimed at a faction of the public only too willing to believe the worst of this group in our society. He writes in his letter to Desmond:

"The decision came inside my local newsstand, whilst picking up the morning papers. As I chatted with Mohammed, the Muslim owner, his blinking eyes settled on my pile of print, and then, slowly, rose to meet my face.
"English Defence League to become a political party" growled out from the countertop.
Squirming, I abandoned the change in my pocket and flung a note in his direction, the clatter of the till a welcome relief from the silence that had engulfed us. I slunk off toward the tube.
If he was hurt that my 25p had funded such hate-mongering, he'd be rightly appalled that I'd sat in the war cabinet itself as this incendiary tale was twisted and bent to fit an agenda seemingly decided before the EDL's leader Tommy Robinson had even been interviewed.
Asked if his group were to become a political party I was told the ex-BNP goon had replied: "Not for now."
But further up the newsprint chain it appears a story, too good to allow the mere spectre of reality to restrain, was spotted. It almost never came to this. I nearly walked out last summer when the Daily Star got all flushed about taxpayer-funded Muslim-only loos.
A newsworthy tale were said toilets Muslim-only. Or taxpayer-funded. Undeterred by the nuisance of truth, we omitted a few facts, plucked a couple of quotes, and suddenly anyone would think a Rochdale shopping centre had hired Osama Bin Laden to stand by the taps, handing out paper towels.
I was personally tasked with writing a gloating follow-up declaring our postmodern victory in "blocking" the non-existent Islamic cisterns of evil."

Many of us interested in daily news outlets had been aware for some time that the mood and direction of the Daily Star had (not so subtly) changed and that the Editor or Desmond himself had decided to throw their support behind the EDL and redouble efforts to stir up public antipathy against Muslims. 
As Peppiatt himself states:

"Our caustic "us and them" narrative needs nailing home every day or two, and when asked to wield the hammer I was too scared for my career, and my bank account, to refuse."

Is this not what many of us had suspected all along? 

To be so overtly supportive of such a movement is unusual for a British daily, and it will be interesting to see whether the stance of the paper changes now with Peppiatt's revelations.

The Guardian also prints a reply from the Daily Star:

"Richard Peppiatt worked purely as a casual reporter at the Daily Star for almost two years. Recently he became unhappy after he was passed over for several staff positions. He refers to a Kelly Brook story: in fact, he approached and offered the newspaper that story, vouched for its accuracy, and then asked for and received an extra freelance fee for doing so. Since he wrote his email we have discovered that he was privately warned very recently by senior reporters on the paper after suggesting he would make up quotes. Regarding the allegations over the paper's coverage of Islam, he was only ever involved in a very minor way with such articles, and never voiced either privately or officially any disquiet over the tone of the coverage. For the record, the Daily Star editorial policy does not hold any negativity towards Islam and the paper has never, and does not endorse, the EDL."

Is this a suggestion that the revelations in Peppiatt's letter of resignation are simply bitter vitriolic outpourings from what is a 'rogue reporter'?

Where have we heard that before, News of the World?

In an ideal world, Peppiatt would be the first of many journalists grafting for these papers to come to their senses and rediscover the ethos and principles they must have had when rookies. They owe it to the rest of us.

Healthy democratic choice in any country is completely dependent on the truth. Facts must be presented honestly to the public for an informed choice to be made. 

Update March 9th:

As well as new links to this story under the 'Journalists' tab on this blog, I have come across this recent podcast which adds more detail in an interview with Sean Ellis.

"Ex Daily Star journo Rich Peppiatt" speaks to the Pod Delusion: here 

 A podcast in which he offers further, more detailed reasons for the tone of his resignation letter. 

A fascinating insight, perhaps, into the way papers like the Daily Star operate.... 

Rosie Robertson