subversive ramblings 0 » reporters

Why do we resist seeing the whole picture?

Nigel — Sat, 01 Aug 2009 15:43:45 +0000

But I've barely got to sleep

There’s been a fair bit of comment on the media today about junior doctors’ hours being capped. Here’s a sample report.

Today I have read and heard only criticism of the change. There will apparently now be insufficient time to include proper training for junior doctors. We will not be able to cope with the flu pandemic. The NHS is simply not ready for this change.

Such comments are alarming in what they say about the commentators, but not surprising. Human beings (including me) are very bad at seeing both sides of an issue. We love to take sides. We love to ignore anything that doesn’t agree with our view. It takes education and an effort of will to look at and absorb the full picture.

Let’s take a historical perspective on this one.

A mountaineering friend called Hugh retrained as a medic in the eighties – not easy with a wife and baby daughter. After the main training he did the usual series of six-month placements as a Houseman (intern, junior doctor). Two of these were based at Bangor Hospital in North Wales. He enjoyed living on the edge of Snowdonia, getting involved with the Ogwen Valley Mountain Rescue Team, flying with RAF Valley rescue helicopters.

I don’t know how he fitted any of that in.

Many weeks he was on call for 100-120 hours. That’s more than 14 hours a day if you spread it over seven days. ‘On call’ sounds easy, but he could never predict when he’d be called. Sometimes he’d make it the few miles home to briefly see his family before being phoned again. There was also a room at the hospital where he could get his head down till the next summons. Trouble was his sleep cycle was shot to ribbons. When he had time to lie down he couldn’t sleep. He once told me that the primary function of the duty nurse was to stop the Houseman killing patients. He was often so tired that a faulty decision was inevitable at some point in the day. Some medical mistakes are fatal. Maybe he was exaggerating for effect. Maybe not.

Later, once established as a GP (family doctor) he got involved in pushing for junior doctors’ hours to be made less punishing and more safe.

There were two problems. Firstly, the system was controlled by senior doctors, and many of them (apparently) took the attitude that they had coped with it so what was the problem? Secondly, the NHS (UK National Health Service) was run on the basis that junior doctors would work long hours for low pay. They were one of the very few groups of workers who received less per hour for overtime than for their basic hours. It kept the NHS going on artificially reduced labour costs.

The system may have been right or wrong – there are arguments on both sides – but nearly eleven years ago we were told we had no choice but to reform. In October 1998 the EU published its Working Time Directive. We have had eleven years to make sure the transition is as smooth as possible. The day the final stage of these changes becomes law is not the time to be complaining. That time was twelve years ago. Now is the time to get stuck in and make sure things do work.

Individual doctors can choose to opt to work more than 48 hours in a week, but they must take at least 11 hours continuous rest in any 24, and at least 24 hours continuous in any seven days. If they need more training hours within this then we have to continue changing the system so that they don’t need to spend so much of their work time on the job. This would cost money. If we think it matters enough to do it then we need to identify what else (probably outside Health) to spend less money on.

But why are we hearing so much complaining today, unless the media are distorting what’s being said? We’ve had eleven years to make changes. The new hours make sense in terms of safety and of quality of life for doctors. Of course there are knock-on effects, but let’s deal with those problems rather than whingeing that they haven’t already been dealt with.

If change is inevitable why don’t we ensure it works as well as possible rather than complaining it’s wrong. And why do we so rarely look beyond our own hands-on experiences to the wider picture. There’s a world-wide recession in progress. Businesses are going bust. Many people are losing their jobs and not being able to find anything else to bring in money. People are losing their homes. This is not the time to put more money into the Health Service. It’s the time to chill a bit, accept inevitable limitations, and do what can be done with what is available.

(There’s additional information about the European Working Hours Directive at this web page.)

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Why does the media get things wrong?

Nigel — Fri, 24 Jul 2009 10:23:00 +0000

Warning: news item coming up

One evening I was phoned by an angry parent, and I didn’t know his daughter. She didn’t even go to the school I was teaching at.

This was the seventies and I was writing frequent articles and reports on Athletics for the Northampton Chronicle & Echo (and a couple of other papers). The most recent had been a report on the town schools’ athletics championships. At the event I’d been busy taking photos and talking with athletes. At the end I was kindly allowed to take a complete set of results away with me subject to returning them within 24 hours. You can imagine transcribing the top three in each event into a form suitable for the paper took a lot of time and effort.

The complaint was that the daughter was listed as coming second in her 1500m race. “She was too ill to take part, and this report is demeaning because if she’d run she would have won.”

I apologised. When I checked with the friend in charge of the girl’s team I heard that because of her illness they’d used a last-minute substitute and hadn’t thought to notify the change of name. Well, why would they if she came 2nd?

There was a nice outcome to this complaint. I ended up coaching the runner concerned, and she was a great person to work with.

It got me thinking, and the patterns in recent reporting of this swine flu thing triggered those memories.

The media misrepresent what is going wrong in two basic ways. Often they give only part of the story, and this includes occasions when a report is deliberately biased. Sometimes there are factual inaccuracies which on occasion must be deliberate lies.

Here are some thoughts, based in part on my experiences as a journalist, on why this may happen.

We get what we ask for

Journalists are trying to make a living. To do this they must attract readers. Some types of stuff sells, other stuff doesn’t, and the headline needs to attract interest.

Unfortunately there’s a difference between what we say we want and the articles or programmes that actually grab our attention. It’s called ‘being human’. Journalists respond by writing more of what we actually read. Sub-editors produce more of the headlines that work. It’s business.

For instance last week a government spokesperson giving an update briefing on the swine flu situation explained that for purposes of planning they were guessing there would be at least 18,000 deaths in England caused by the infection, but probably not more than 64,000. Which of these headlines would be most likely to grab your attention:

Government expecting 65,000 swine flu deaths

Government makes informed guesses to aid planning

No competition. We get biased headlines because they work. We get unbalanced articles because space is limited and it’s more fun reading a one-sided rant, especially if we agree with it. That brings us to the next item:

Each paper feeds its own readership

We buy some papers/magazines because they say what we agree with. Some people refuse to read anything that doesn’t reinforce their biases. The rest of us just sometimes like to relax and be reassured we’ve got it right.

If you pick up one of these publications don’t complain you get what is being sold.

Of course every publication, documentary, news item and blog has some bias. The trick is to identify what that bias is and make allowances.

Journalists aren’t statisticians or scientists or …

Journalists (and bloggers) have had finite training and experience. They don’t understand everything. They may try to interpret and summarise information properly, but they have limited time. Sometimes they don’t have the mental tools to understand what they’re reporting on, and they may not realise this.

Let me give an example. Some years ago researchers in, I think, Glasgow did some research on road accidents. They found that people taking tranquilisers were significantly more likely to be involved in a crash.

The obvious conclusion is that taking tranquilisers makes you far more likely to crash when driving.

Actually there is another equally reasonable conclusion: maybe the type of person likely to crash is also far more likely to be prescribed a tranquiliser.

Also there are several other things to check before deciding how reliable any piece of research is, but I’ll deal with those another time.

It would be nice if we could rely on every reporter and blogger to fully understand every aspect of every set of information passed to them, but that is never going to happen. It is simply not practical. Part of our responsibility as a reader or viewer is to be aware of the limitations of any report on something involving technical areas such as statistics or science.

Sometimes the facts are fuzzy

Yes, really, sometimes there are no ‘facts’, just best estimates. Our world is vast yet our resources are limited. We just do not have the means to collect all the information we would like, and much of what is collected is subject to human error at some point along the chain of collection.

For an example refer to my recent article ‘Confusion endemic’ and find the section near the end titled Why are figures about flu and flu-related deaths so unreliable?

Sometimes you’re given the wrong facts

Good media sources have solid procedures for checking facts, but even these sometimes fail. Some media appear to have deliberate procedures for lying distorting the facts in order presumably to sell more copies.

The example I gave at the start of this article illustrates the sort of problem that can arise. I was using the most reliable source available, and there was no way I could check every fact in the results list.

Conclusion of sorts

Be kind to your neighbourhood reporter/blogger. He’s probably trying hard to get everything right, but is bound to make mistakes. If you find he deliberately lies then just turn your back on him.

By the way I’m probably biased here but I love the BBC web site. (UK British Broadcasting Corporation). I’m sure they make mistakes, and I hear complaints about significant bias in how they report news, but even so their home page is my browser’s home page. Thank you BBC.

Hey, what have I missed out?

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