Is Whitehall discouraging broadcasters from criticising the NPfIT?

NHS Connecting for Health, which runs part of the National Programme for IT [NPfIT], is to write to the BBC about parts of its documentary “Wiring the NHS”.

The Radio 4 documentary on the NPfIT included a slip of the tongue by Dr Gillian Braunold, Clinical Director for the NPfIT summary care record and HealthSpace.


Dr Braunold spoke to the BBC about trials of the summary care record in which some GPs are allowing limited information in medical records on their patients to be uploaded to a national database run by BT.

The Radio 4 documentary said there were campaigns to help those who wished to “opt out” of having their medical records transferred to the national data “spine”. Before records are transferred as part of the trials, officials mail thousands of leaflets to patients to explain their rights on opting out.

The BBC presenter said Dr Braunold was unconcerned about the numbers of patients opting out. Dr Braunold told the BBC:

“So far we have mailed 500,000 patients across six primary care trusts and we’ve had half a million who don’t want to take part. I think that’s fine.”

At face value Dr Braunold was saying that every person who’d received a leaflet had opted out of having their summary medical record uploaded to the data spine.

We asked Connecting for Health for its reaction, expecting its spokeswoman to say that it was a slip of the tongue. But she said Connecting for Health would be writing to the BBC to “get this altered”.

The spokeswoman said:

“One of figures quoted by Dr Gillian Braunold in last night’s Radio 4 documentary was not correct. Of the 500,000 patients written [to] so far less than 1% of these have chosen not to have a care record created. We are approaching the BBC to get this altered.”

It’s not clear how the BBC would alter a documentary that has been broadcast. That would be rewriting history, which was the job of the functionary Winston Smith in Orwell’s 1984. On behalf of The Party, Winston Smith spent much of his working life rectifying “malreported” or “malquoted” facts.

We also asked NHS Connecting for Health about the claim by the BBC that Richard Granger, Director General of NHS IT, had been “prevented” from taking part in the broadcast. The spokeswoman for NHS Connecting for Health said: “We were surprised by this and are in contact with the producers of the programme for an explanation over this remark.”

We put two further questions to NHS Connecting for Health about the documentary, to which Computer Weekly had contributed.

a) The [BBC] programme said that it had been negotiating with David Nicholson [Chief Executive of the NHS] since January on his taking part in the broadcast and still he was unable to find the time. Why did Mr Nicholson, as the NPfIT’s overall Senior Responsible Owner [of the NPfIT] not do an interview for the BBC about the NHS programme?

b) Does the Department of Health have a communications/marketing strategy on the NPfIT to let the NHS do the talking, currently in the form of Simon Eccles and Gillian Braunold, while keeping national figures such as Mr Nicholson in the background? [Dr Simon Eccles is a consultant in emergency medicine and also promotes the NPfIT as does Dr Gillian Braunold who is a GP. We asked this question because the government is switching control of parts of the NPfIT from Whitehall to parts of the NHS – the so-called NLOP – so it would not be surprising if spokespeople for the national programme were being devolved too].

In reply to the question about why David Nicholson had not taken part in the broadcast, the CfH spokeswoman said it had not been possible to schedule his interview before transmission. The documentary’s producers said, however, they had been negotiating to include David Nicholson since January 2007 – more than eight months of negotiations.

The CfH spokeswoman said:

“Connecting for Health co-operated fully with the BBC over Wiring the NHS and provided several spokespeople to talk about various aspects of the national IT programme. These clinical and patient leads were interviewed at length and successfully dealt with all the matters aired by the broadcast. David Nicholson, the Chief Executive of the NHS, also agreed to do an interview but it wasn’t possible to schedule this before transmission, and his offer stands for any follow-up broadcast on this subject.”

On my question about whether the Department of Health has a strategy to promote the NPfIT through NHS spokespeople such as Dr Simon Eccles and Dr Gillian Braunold rather than national figures such as David Nicholson, the CfH spokeswoman said:

“This is a specious question. Dr Simon Eccles and Dr Gillian Braunold are both national figures and NPfIT clinical leads. Both have a significant media profile, and have spoken at length and on many occasions on matters which concern their particular areas of expertise. All requests for spokespeople are carefully considered and we put forward whoever is most relevant.”

Comment:

The letter from NHS Connecting for Health to BBC Radio 4 over its “Wiring the NHS” documentary will be the latest of many it has sent to broadcasters who have reported on the NPfIT. The Department of Health has a reputation among some in the media as a serial complainer.

At times CfH’s complaints to the media are undoubtedly justified; and there’s no evidence officials complain to broadcasters as a deliberate policy of discouraging the media from criticising the NPfIT.

But it’s worth looking at the consequences of its complaints.

Computer Weekly’s staff have spent the equivalent of several days responding to the complaints we’ve had from Whitehall officials over our coverage of the NPfIT. Finding the time to respond to complaints can be deterrent to broadcasters.

If television and radio journalists perceive they will receive a letter of complaint every time, or nearly every time they broadcast a programme that includes serious criticisms of the NPfIT, they may be discouraged from taking a dispassionate view of the national programme when they have choice of subjects to research and report on.

The complaints we’ve received from Whitehall have raised debating points that soak up time responding to; and there have been other complaints that quote something we haven’t said in order to refute it. Our lengthy responses have brought no acknowledgment from the Department of Health. These are two examples of debating points made in an official letter of complaint to us.

“The impression is given that a national database of patient identifiable information will be available without patients’ consent. That is not the case…

“Contrary to the impression given, the police will have no more access to patient records than now and probably less …”

The Department of Health has the right to fire off as many complaints as its officials want to write; and the BBC and other broadcasters are big enough to defend themselves.

But as media organisations try to do more with fewer staff, time becomes more of a consideration when deciding what subjects to cover. If reporting the NPfIT means factoring in time to respond to woolly or argumentative complaints from Whitehall, producers and journalists may be less inclined to cover the NPfIT – unless they decide to report on it from a wholly positive perspective. Which is what the Department of Health wants.

But it’s not healthy of course for any part of government to discourage dissent. If perceptive critics of the NPfIT did not exist David Nicholson and his colleagues would need to invent them, and give them the strongest arguments which the most skilful devil’s advocate could conjure up. John Stuart Mill made the point that it is by way of a collision of adverse and prevailing opinions that the truth has a chance of being supplied; and it’s the unvarnished truth that trusts need when they come to install systems that could make a difference to patient care – for good or ill.

Links:

Government spin – a worrying precedent

Radio 4 documentary on the NHS’s National Programme for IT

Connecting for Health pulls speakers from Europe’s largest healthcare IT conference at Harrogate

Spin and mistakes by HM Revenue and Customs

How government spin doctors reacted to a CIO’s comments that only 30% of IT projects succeed

British Computer Society criticisms of the NHS’s National Programme for IT – no response from Whitehall yet

Shredding of gateway reviews

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