Practice boundaries: how it was reported
In the fourth article in the series, Dr George Farrelly turns his attention to the media’s role in the practice boundaries pilots
My impression over the past two years has been that the mainstream press has with respect to issues surrounding the Health and Social Care Bill, with a few exceptions, favoured the Government’s cause more than the voices critical of the ‘reforms’, including a large number of medical and nursing bodies. There is evidence, for example, that the BBC was institutionally biased in favour of the Government’s position, giving their voice far greater space and weight, often leaving unreported any dissenting views.1
With respect to coverage of the issue of GP practice boundaries, I discovered an interesting dynamic. About six months ago I read The Department of Health’s press release for the launch of the pilot ‘Choice of GP Practice’.2 I then Googled some of the phrases in the press release and discovered that a large number of online media outlets, including serious newspapers, were carrying essentially the same ‘story’ as put out by the press release, often with identical wording.
An experienced GP reading the press release will quickly notice a number of silly claims.
For example, the press release supposes that the pilot ‘will also come as a relief to people who are moving home and wish to remain with their preferred practice, and families who would like a practice near to their children’s school’.
A practice near the children’s school: this means you need an appointment to see your GP either just before school starts in the morning or after it lets out in the afternoon. Or you could just hang around in the local playground until your appointment. What do you do during school holidays; or if your child is sick and not going to school?
Did any of the articles spot these absurdities? No. They just repeated them.
Having discovered this, I then contacted a few health editors from respected newspapers. I promised I would not publish their names or responses on my blog, and I said I wanted to understand how it was that these claims weren’t given more critical consideration (I provided them with information showing why I felt the promises in the press release were unworkable, as with the example above).
The answers were as follows:
- if I had known what you have told me when I wrote the article I would have written a different story;
- we have a very quick turnaround in the current 24-hour news environment and do not have time to check things;
- we rely on information from the BMA, doctors, and think-tanks.
What seems to happen is this: the more serious journalists take the press release and write an article which is a bit more elaborate than the press release, but the core message is the same. The less serious journalists and outlets simply cut, paste and publish.
And then there is another side to this. Without a DH press release, no story is published: the journalists seem reliant on the DH to supply the content with the issue of GP boundaries.
The fact that two of the boroughs involved in the pilot have boycotted the pilot for quite significant reasons went unreported in the mainstream press.3 Did the DH report this? Of course not. The journalists are simply not following the issue.
Andrew Lansley said to the RCGP conference: ‘I’m not abolishing practice boundaries…’ but in the press release was quoted, ‘…I believe patients should have the freedom to choose a GP practice that suits their lives, and not be restricted by geographical boundaries.’4 Why is this duplicity needed?
This sort of thing would, it seems to me, not happen in the financial sphere: financial journalists are numerate and understand the world of finance and would spot quite quickly were the Treasury to issue statements of the same standard as the DH’s press releases. But in the case of health, and specifically primary care, journalists do not really understand how the NHS works and so are easily duped.
Next week I turn to the pilot itself, currently in progress. Does it honestly set out to test the policy, warts and all, or is it another ‘pause to listen’ exercise, largely a public relations exercise, before pressing on to roll out the policy nationally?
Dr George Farrelly is a GP in East London
For further documentation, see www.gpboundaries.org
1 Huitson, O. ‘Was the BBC’s coverage of the NHS bill biased and distorted?’. The Guardian 1 October 2012. http://www.guardian.co.uk/commentisfree/2012/oct/01/bbc-coverage-nhs-bill
2 Department of Health media centre. Choose the best GP for you. 30 December 2011. http://mediacentre.dh.gov.uk/2011/12/30/choose-the-best-gp-for-you/
3 ‘LMCs stage boycott of practice boundary pilots’. Pulse magazine, 20 April 2012. http://www.pulsetoday.co.uk/newsarticle-content/-/article_display_list/13805188/lmcs-stage-boycott-of-practice-boundary-pilots
4 ‘Lansley backs away from complete abolition of practice boundaries’. Pulse magazine, 24 October 2011. http://www.pulsetoday.co.uk/lansley-backs-away-from-complete-abolition-of-practice-boundaries/12938947.article#.ULjPhmejzAw; ‘Government announces areas for £2m pilot abolishing GP practice boundaries’, Pulse magazine, 3 January 2012. http://www.pulsetoday.co.uk/government-announces-areas-for-2m-pilot-abolishing-gp-practice-boundaries/13247288.article#.ULjP-mejzAw