TV news must exhibit more credible research on major issues

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Dr John Robertson brings Part 3 in his series of analysis of TV news in the run-up to the Scottish Parliamentary Elections in May. This chapter covers  January 22 – 27

Friday 22nd January: 

STV return to Govanhill, scene of their very dramatic piece on poverty and degradation the previous week. This time it’s quite low-key as they follow a local landlord who seems to place the blame entirely on tenants and speaks well of council spending on the problem. No link is made to the First Minister (who is also the local MSP).

Dr John Robertson
Dr John Robertson

The biggest story on Reporting Scotland was the Scottish Government’s decision to cut spending on measures designed to reduce carbon emissions. The report seemed quite informative, sort of balanced and, with my lack of expertise in the environmental field, difficult to criticise. I did, of course, have a quick look around for related alternative reporting in the last few days. Most interesting was this quote in the Energy & Technology magazine about a report from Scottish Carbon Capture & Storage (SCCS) at Edinburgh University:

‘Scotland could cost-effectively become Europe’s carbon capture and storage hub, building on existing infrastructure to save decommissioning cost, a new report has suggested.’

Edinburgh University’s Professor Hazeldine writes in the report:

‘By starting with a modest industrial and power CCS cluster in Central Scotland that can make use of existing pipelines and offshore infrastructure to establish CO₂ storage in the Central North Sea quickly and affordably, the study indicates how this could develop into a new large-scale industry for the UK while helping solve Europe’s CO₂ storage challenge.’

So, perhaps most important for a better balance in the RS report would have been a reminder that it was the UK government which had scrapped a £1bn(!) carbon capture competition in the UK with Scotland very well-placed to win and to host it. The RS report seems to place all blame with the SG, unfairly.

Monday 25th January:

STV had an extended piece launching the period of 100 days before the Scottish election. This had good information value. Quite a bit was unavoidably favourable to the SNP using the recent poll predicting disaster for the other parties. There was a less than flattering video sequence showing Kezia climbing with difficulty into play apparatus for bairns.  TV’s Have I Got News For You may find use for this sequence later. Meanwhile, Nicola was caught sitting comfortably in a school Art class, in Ayr, apparently making another pair of killer heels for herself. The report made time for both the opinion poll results and the SG announcement of money for new schools (see below). RS were to somehow miss both.

STV reported again on the storm-damaged viaduct, late in the show, giving it a four-sentence update with little drama. RS were to find more to worry us about:

Safety on the west coast railway line! A high speed train was allowed to cross this viaduct despite serious storm damage. Rail accident investigators are investigating what they call a dangerous occurrence.’ (my emphasis)

They allowed it to cross? These people must be psychopaths: Had they no feelings for the folk on board when they stood there and watched it go by? Oh, they weren’t standing near, knowing it was dangerous? They were miles away and didn’t know it was dangerous yet? So, who ‘allowed’ it to cross?  Mind you, it was a high speed train and that must be more dangerous, flashing across the bridge in seconds before it could collapse…or isn’t that safer than a slow train lingering with all its weight or even stopping on the dangerous bridge?

For STV’s four sentences, RS were to allocate more than 20 sentences and to repeat the more dramatic phrases for effect. Did the investigators actually say ‘dangerous occurrence’. If so why don’t we see and hear them say it on screen? ‘Rail Engineer’ David Shirres (retired but not mentioned as such) didn’t say that and got only a very short time to essentially reassure us that he knew the safety checks had been done only last year, with divers finding no cracks.

This is another tired and exaggerated story like RS reporting of the Forth Road Bridge crack for more than a week, every night. The STV comparison and the expert’s lack of excitement tell us that safety procedures were implemented as soon as was humanly possible and there really is no story here other than another attempt to scare the voter. Likewise we had more gloom and doom about the roads and a too long piece on one woman who had skidded off a road and got a fright. My mum will be moving back to England. It’s far too dangerous in Scotland, what with the failing hospitals and that.

RS, while unable to find time for the opinion poll results and some useful information about the next election (like STV) or about the SG announcement of more than £200 million for work on new schools, gave us an extended piece on taxation including more ‘Scotland is too wee and too remote to have higher taxes’ guff and far too much of Ruth Davidson cheering these right-wing notions, with not a word of contradiction.

Tuesday 26th:

‘GPs under pressure! Scotland’s doctors warn that cash-strapped practices mean that patients are losing out. The Scottish Government maintains it is tackling the problem.’

‘Calling for cash! Council leaders give Scottish Government until tomorrow to agree a final deal on local authority funding.’

STV headlined dramatically on these stories. The second is kind of funny like: ‘Schoolboy gives his parents until tomorrow to agree a final deal on his pocket money!’ The rest of the report to be fair was balanced and clear. Who wrote the headline? I know it was a wee boy on work-placement.

The GP story, however, was a very poor piece of journalism which largely let the Royal College of General Practitioners tell the story as they wanted it to be heard. One reporter clearly thought he had become a GP!

Here are some more of the quotes: ‘Doctors have accused the Scottish Government of treating GP services as dispensible (Surely they mean the pharmacies; they’re dispensible if they’re any good). They’re warning a crisis in getting an appointment with a doctor will get worse.  The Royal College of General Practitioners say a decade of funding cuts is already impacting on patients. The Scottish Government says it is investing in primary care and is increasing the number of training places for GPs. In the past decade GPs have seen their share of funding fall every year and they say they’re suffering a recruitment crisis with patients waiting longer for appointments. Doctors fear the cuts are part of a wider strategy to limit the role of GPs.’

There are some dramatic claims in these quotes. We will hear actual evidence for none of them because no actual research has been done. The last sentence gives away the real motivations of the RCGP.

We then hear from Doctors Miles Mack, Kelly Boyd and Euan Paterson, all very worried:

The reporter actually feeds Dr Boyd with: ‘So patient care really will suffer in your opinion?’ Who trained this lad in questioning technique?

Dr Boyd:  ‘I think it’s inevitable if we have less time to do more with less money.’

The reporter finishes by reminding us, evidence-free, that this is not a local thing but a problem: ‘Right across the country!’

After some time, Government Minister Shona Robinson gets four sentences to hint that there’s more to primary care than just the GPs. STV would have done well to ask her more on this issue. To find out what is really going on and not just politicking by the RCGP, have a look at ‘Implementing the Healthcare Quality Strategy for NHS Scotland.’ There’s a reference below.

Here’s the thing.  What is the Royal College of General Practitioners? It sounds high-falutin’ but it’s really only a trades union like the EIS, UNITE or the RMT. It acts in the interests of its members and maybe of the truth where that suits ‘their/wir members’ aspirations’. Remember GPs are mostly just undergraduate degree holders with no real experience of how to do research. Remember Dr Miles Mack? He’s the chairman of two of the RCGP’s three committees and the also interviewed Dr Euan Paterson, he’s on the RCGP council too. So two out of three of those interviewed are not randomly sampled GPs but council members of the RCGP. I’ve finished marking undergraduate research projects but this would be in deep trouble if only for the beginner’s mistake of bias by sampling.

Looking at the RCGP website, the most recent announcement of any relevance was on the 19th January so it’s not clear why STV had taken so long to hear of this. The announcement relates to a 2015 piece of research by the Commonwealth Fund of 675 GPs in England, 136 from Scotland, 110 from Wales and 80 from Northern Ireland which found them to report themselves as the most stressed GPs in the international study. Further, there is no sign of a breakdown of the Scottish responses (only 136 out of 1001). So, we have no objective idea from this of what Scottish GPs are actually saying. I’ve written to ask for these data. As of today (28th) they’ve replied favourably so should be able to report next week.

So, STV have you been duped? This is a highly biased, partisan, methodologically-flawed and simply unreliable piece of ‘research’ presented as if it were much more with the probable consequence of further scaring Scotland’s elderly population. I award you the Eleanor Bradford Prize for Journalism!

Now watch this boys and girls.

‘Deaths for heart disease and stroke have both fallen by a third since 2007, according to new statistics published today. Mortality rates for coronary heart disease have dropped by 36 per cent under this government (since 2007). Mortality rates from stroke have fallen 33 per cent over the same period.’

This is from a Scottish Government website, so we need to be careful, but they got it from an NHS website reporting on research that can be downloaded and evaluated. The data is scientifically obtained from actual health outcomes and not just self-reporting of stress. So, there’s a good chance it will be accurate. No research is ever guaranteed to be perfect but this is pretty good compared with something, emanating from members of a profession, on how, a tiny sample of them, say they feel about things.

In the National newspaper, they headlined this: ‘SNP good for your heart.’ Pushing it a bit, I know, but the piece was light-hearted.

Sally McNair: 'genuine and unpretentious'
Sally McNair: ‘genuine and unpretentious’

I’ve used a lot of words on the above so I’ll be brief with Reporting Scotland. Presenter Sally McNair has a genuine, unpretentious style I like and gave no sign of unprofessional bias. RS headlined with good news about progress on the new road bridge and featured a very long piece on the forthcoming election campaign. It was pretty balanced and free of wee sneaky digs at the SNP. Was this something to do with Sally’s kindly kharma, I wonder? Glen Campbell had a very long piece on continuity or lack of it in membership of Holyrood along with strange portraits of former FMs. What was it for? Escapes me.

Wednesday 27th:

Both STV and RS gave considerable attention, correctly, to the disturbing report from the Medical Welfare Commission on the suicide while in care, of a 44 year-old woman on the autistic spectrum. STV headlined the story and began quite a full report with:

‘A failure to care. Why one woman took her own life after mental health services let her down.’

‘There is a call for a review of specialist services for adults on the autistic spectrum following the suicide of a woman in care. The 44 year-old took her own life after being moved to a care home which did not fit her needs. The Scottish Government says it will look closely at the recommendations of the Mental Welfare Commission’s investigation.’

The report seemed thorough and appeared to make a clear case that there are serious problems in this aspect of care in the SNHS which may not have improved in the four years since the incident took place and which, on this basis, the Scottish Government needs to deal with. Further investigation reveals a distinct lack of rigour in this report which I’ll discuss in the richer context of the RS report, below.

RS headline with the suggestion that Forth Road Bridge maintenance of the part which failed, could have been done five years ago but by the end of the full report, an expert insists the problems could not have been foreseen. Time and space prevent me looking closer at this and the RS report on the above suicide case is worth comparison.

Later, RS open the story of the suicide case with: ‘A mental health watchdog has called for a full review of services for adults with autism following its investigation into the suicide of a woman in a care home.’

Is ‘watchdog’ the best term for a commission? Does it suggest a starting point of not trusting the SNHS rather than a more constructive approach? Last year, RS suggested that a ‘hit squad’ had gone into the RAH in Paisley.

Eleanor Bradford tells us: ‘There’s concern her story might not be unusual’ and the MHC rep does reinforce that with ‘Services are extremely patchy and it’s something we think could be happening to other people.’ Now I’ve been attacked before for perceived insensitivity but I’m just being rigorous about evidence so, where is the evidence? If the MHC do have these suspicions, why haven’t they done or commissioned the research in the last four years? If people with autism are self-harming or worse because they’ve been placed in the wrong care, we need to know, accurately, so that government has to act. But again, as is often the case when RS reports on the SNHS, there is no evidence offered, only anecdotal rumour.

Ms Bradford peppers her report with unsubstantiated accusations of failure, in simplistic blaming terminology:

‘No one from the hospital discharging her told the care home she’d tried to take her life four times already.’

 ‘They were left to rely on the advice of a local GP who’d never met her and didn’t have her medical history.’

Here’s what the report actually says:

‘The director of operations at the care home told us very plainly that they would have been absolutely clear with referrers when they admitted Ms MN that they were not equipped to care for people who were suicidal.’ There a revealing section in the report where the director and the ward manager seem to be saying different things about who was responsible in an attempt perhaps, to protect themselves.

But:

 ‘The Senior Care Nurse told us they had meetings, phone calls, and provided documentation such as 12 risk assessments. She believed they had been very thorough in trying to pass over as much information as they possibly could. The SCN and the consultant psychiatrist also had a discussion with the care home manager about the medication they were using.’

As early as March, several months before the suicide:

‘The care home had a report on a file written by the social worker in March 2012 which clearly recorded that Ms MN had a diagnosis of……Self-harm and suicide. Ms MN has overdosed on medication in the past. The social worker also provided a thorough single shared assessment, a risk management plan and copies of care programme approach (CPA) documentation. The care home was further provided with a joint Health Board A / Council A “Working with Risk” form. The “summary of assessment” was that Ms MN had attempted suicide and self-harm in the past.’

The care home also had a copy of a psychiatric summary written by the consultant psychiatrist in March 2009:

‘There have been numerous reported attempts at self-harm including overdose, ingestion of bleach and attempted hanging…She regularly threatens to go to a high place in order to throw herself off, to run in front of a car or to electrocute herself with a domestic appliance.’

Those soundbites are worth checking. I searched the report for about thirty variations on those phrases. They’re not there. So they’re made up; simple.

Ms Bradford goes on to say: ‘One of the most shocking aspects of this is that initially hospital  bosses didn’t think there was any need of an investigation and when they did finally carry one out it was positive about the standard of care and they felt there were no lessons to be learned.’

‘Hospital bosses, bosses?’ Really, this is more Daily Mail stereotyping of NHS managers. Maybe it is shocking but how are we to know without a fuller evidence-based analysis of the flaws in the positive report. Is it possible it had some merit? How are we to know? As for the MHC report it had been produced by only three people – a director, a nurse officer and a social worker. There’s no sign of an independent, trained researcher and no sign of even PhDs amongst the team. Speaking on behalf of SCARE  (Scottish College of Applied Research Experts), I recommend all future reports are made valid and reliable by someone who learned what those words mean. Remember the director’s words, echoed by Bradford: ‘Services are extremely patchy and it’s something we think could be happening to other people.’ This is important, we need to know. Research officers are not expensive. Hire some!

After reading the full report (I’m retired, remember), I am left with a clear picture of the enormity of the challenge Ms MN posed to carers in the SNHS before her transfer but mostly, it is the failure of the private care home to attract and to retain any skilled staff-members because of its unattractive pay and conditions that shocks me most.

‘The care home charged £2,200 per week. Ms MN contributed £96.35 of her benefits per week towards the cost. The care home manager told us that staff turnover in the unit was high…when they opened the unit, they took on quite a few nurses who were newly qualified, but they gained a bit of experience and went on to jobs in the NHS…support workers were on the minimum wage and were often working really complex cases….the two support workers who we interviewed as part of this investigation had previously worked in shops and bars.. when she first started she didn’t get an induction or any training… “thrown into working on the floor basically.’ Note the care home manager thought newly qualified nurses were all he needed.

Maybe if Ms MN had gone to a state-funded and regulated care home with qualified, fairly paid, permanent and experienced staff, things might have been different. Ms MN had survived to the age of 44 after many years of care in the SNHS system. Once in the private sector, all goes wrong. I don’t suppose either STV or RS would find such clearly irresponsible and leftish notions attractive.

This report has got too big and heavy so I’m going to stop here and start Number 4 tomorrow (Thursday 28th). As for the numbers, I’m struggling to see the value so far away from the election but may return to them anew.

Dr John Robertson, Ayr, 28th January 2016

Footnote: See No.1 for introductory comments on the planned series of reports.

Sources:

Heart Disaase and Stroke at: http://www.wired-gov.net/wg/news.nsf/articles/Heart+disease+and+stroke+26012016134800?open

and: http://www.isdscotland.org/Health-Topics/Stroke/Publications/index.asp#1584

Pultarova, T. (2016) ‘Scotland could become Europe’s CCS hub’, Energy and Technology

19 January 2016 at: http://eandt.theiet.org/news/2016/jan/scottish-carbon-capture-hub.cfm

RCGP Website at: http://www.rcgp.org.uk/news.aspx

Implementing the Healthcare Quality Strategy for NHS Scotland at: http://www.gov.scot/resource/doc/321597/0103382.pdf

SCCS (2016) Scottish CO hub ‘is a unique opportunity for the UK’ SCCS

19 January 2016 at: http://www.sccs.org.uk/news/266-scottish-co2-hub-is-a-unique-opportunity-for-the-uk

SNP on course to win 73 seats in new Holyrood 2016 poll at: http://www.scotsman.com/news/snp-on-course-to-win-73-seats-in-new-holyrood-2016-poll-1-4009898#ixzz3yIGyqPKk

Nicola Sturgeon announces £230m school building project at: http://www.scotsman.com/news/politics/nicola-sturgeon-announces-230m-school-building-project-1-4010429

The Death of Ms MN MHC Report in full at: http://www.mwcscot.org.uk/media/244671/ms_mn_investigation_full_report.pdf