12 Jun 2011 05:15
I was really gratified to hear from Paula Williams about how she viewed the issues I raised: a thoroughly professional response. She explained how the problems had arisen and what she had done to get corrections put in place, including re-voicing the filmed interview. What happened was because of drops in the connection of information going down the line and was an identifiably reasonable but unwished-for occurrence on all sides. Paula’s was a great response and thanks to her industry and assiduousness, the facts have been corrected and the issue sorted, with similar responsiveness from actors further down the line. Hers is a sort of professionalism that many could learn from and points out the need for the person at the point of contact—be that a journalist or a primary health-service provider—to have the influence to ensure that things further down the line are joined up to the start and kept on track (if I may fudge my metaphors). I’m happy to say that this is what occurred with my experience of Sky News. Keep up the good work!
On Friday last, I did an interview with Sky news. This led to a spin off piece on the web: http://bit.ly/klUFpK Unfortunately, there is little in what I was quoted as saying that I actually said. And the year of my infection was 1981, not 1991; you would hope that basic facts like these would be covered correctly by responsible journalists. Not only is it a question of sloppy journalism (by Jane Chilton), but it is indicative of a similar problem in health-services: there is a large bureaucracy where the journalist responsible for interviewing (the delightful Paula Williams) is not responsible for anything that happens downstream of the interview. It is the same process of a diffusion of responsibility and a lack, therefore, of accountability that occurred in the bureaucratic machines that made a number of social catastrophes possible: the Holocaust, the NASA disaster with the Challenger shuttle, and others analysed in Professor Guy B. Adams’ book “Unmasking Administrative Evil (Rethinking Public Administration)“. It is a prime mechanism of ensuring the same banal evil today and one on which the NHS relies to evade accountability in its services.
In health-services, we have a clinician—typically a physician—who has primary contact with a patient. Yet, then the patient gets handed on, to other clinicians, other departments, administrators, etc. There is typically a lack of continuity of care, of case-management, of anything that refers to the patient’s health-needs other than attacking a disease. When there are problems, the patient has to chase each one of them down—on top of dealing with the challenges of being ill—and try and rectify them in a system such as the NHS that is typically resistant to any inquiry or challenge at all. Confidentiality is breached, the wrong medications are prescribed—or medications prescribed that cause serious toxicity when combined—a clinician acts outside her area of expertise and says a self-determined patient has a personality disorder and pejorative comments are written in the medical notes, which the patient can’t rectify to provide a more balanced picture. If there were one responsible clinician for a patient’s services, there would be one point of contact for the patient to rectify problems, instead of those problems cascading along a system through which responsibility diffuses and accountability vanishes.
But it is also one of the prime mechanisms that I have addressed in the design of health-services that prevent such problems in the first place (see the paper on Participative Medical Governance).
While I would like to say that it has been 20 years, rather than 30, that I have lived with HIV, it would not be accurate: living for those extra ten years with HIV changed the course of my life (some music-lovers might give thanks …). Getting facts wrong on the news is not as grievous, of course, as making a mess of a patient’s services, but the issues are the same. Who will take responsibility for the misinformation and rectify it? If the facts are important enough to report, they should be important enough to get right. Unless it’s just truth-free stories that Sky News looks for: perhaps Sky News is Britains’s version of Fox News in the USA—now notorious for its lack of journalistic or any other form of integrity. It will depend on whether Sky News makes the corrections or not; if they do, I shall let it be known and hope, perhaps naively, that it doesn’t get it so wrong again.