Views And Reviews Acute Perspective

David Oliver: The department of spin

BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i3237 (Published 10 June 2016) Cite this as: BMJ 2016;353:i3237
  1. David Oliver, consultant in geriatrics and acute general medicine
  1. Berkshire
  1. davidoliver372{at}googlemail.com

Some say don’t shoot the messenger. The professionals leading government communications offices are simply politicians’ minions. I don’t believe that.

During the current crises in healthcare, ministers may be the lightning rod for our anger. But we need to stop letting the Department of Health’s press office off the hook, challenge and expose its partial truths. The messages it pumps out, inconvenient facts omitted, seep into the media and public consciousness and are often loaded against the services and professionals it claims to support. If you don’t believe me, check the @DeptHealthPress tweets from April and May, when the junior doctors’ industrial dispute was playing out and gaping holes were exposed in NHS workforce planning, funding, and deteriorating performance. Media relations staff made a timeline of the junior doctors’ dispute, which failed to mention that it was the department that (twice) had to be exhorted to the mediator, Acas, and terminated January’s talks.1 The word “imposition” did not feature.

The press office claimed that evidence for the weekend mortality effect was “overwhelming”2—even though its existence, causes, and solutions have prompted considerable academic debate, with authors and editors disputing the spin.3

Press officers also said that, by the end of this parliament in 2020, the number of doctors trained by the NHS will have increased by 11 000 and that this government had already overseen an increase of more than 10 000 hospital nurses and doctors.4 They also made big promises about increases in the GP workforce as part of April’s Forward View.5

Strangely, the press office omitted mention of parliamentary committees flagging the disastrous failure of NHS workforce planning, with 22 000 nursing and 4000 medical vacancies.6 7 Silence reigned over gaps in trainee recruitment to posts in key medical specialties—including for those overpromised new GP trainees.8

The department’s public relations staff said that the NHS had received the sixth biggest funding increase in its history.9 The chief economist at the King’s Fund showed this to be nonsense.10 Soundbites can’t save a service already facing deficits and under further pressure to save money despite rising demand, diminishing performance, and real terms cuts to social care.

The spinners claimed that agreeing a new contract with one depleted workforce—junior doctors—would “deliver a seven day NHS.”11 Problem solved, then.

In 2013 the head of the DH press office said, “We have to be transparent and honest with the public. You can’t hide stuff and hope that nobody notices.”12 For the sake of open democracy and the future NHS, it’s vital to challenge the department at every turn. Its apolitical civil servants are supposed to work for us taxpayers—not for party headquarters.

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