This week: Matt Tee, chief executive of the Independent Press Standards Organisation
(Re)Introducing ‘The Bedpan’: The Bedpan is HSJ’s weekly interview series with influential figures from (usually) outside the health world who nevertheless have interesting views on the challenges facing the NHS. The Bedpan is named after Nye Bevan’s apocryphal quote and pays particular attention to how politics impacts the NHS and vice versa. The series began in October and has featured interviews with Spectator editor Fraser Nelson, Institute of Fiscal Studies director Paul Johnson and Dr Sarah Wollaston MP, among others.
Why he matters: The NHS and health issues are meat and drink for the national and local newspapers regulated by IPSO. Just as well that Mr Tee has a significant NHS/government pedigree. He was permanent secretary for government communications at the Cabinet Office between 2008 and 2011, having previously been the chief executive of NHS Direct and the Department of Health’s communication director.
“We get fewer health complaints than you might expect”, says the IPSO chief.
This is due to “three main drivers”. The first is the presence of specialist health correspondents “many of who have been doing the job for quite a long time [and] know their onions”.
The second driver is that “local newspapers, with some exceptions, tend to be very proud of their local health services. The stories they write about health tend to be of a celebratory nature”.
Third he says that NHS organisations – in contrast to other subjects of significant press attention – are “fairly loath to [complain to IPSO], it’s seen as a fairly big thing to do.” This disappoints Mr Tee, who thinks the NHS should set a “lower bar” for taking its concerns to the press regulator.
The relatively low level of complaints is also, he suggests, driven by the press cleaning up its act in the wake of the phone hacking scandal and the Leveson inquiry – which also gave birth to IPSO as the newspaper industry attempted to stave off state regulation.
Before that wake-up call, Mr Tee says there “would have been a reasonable [number] of journalists” who thought that, for example, sneaking on to hospital wards was “OK if you could get away with it”.
Miracles and scares
Along with a change of attitude towards privacy, Mr Tee also suggests the press broadly reflects societal changes. This means its coverage of issues, many affecting the NHS, like race, gender and mental wellbeing, has become more sympathetic.
Arguably the biggest impact on the NHS from media coverage is not associated with coverage of the service itself, but the latest miracle cure or health scare.
‘One of the standard things that newspapers will write is to say that the chance of something has doubled – when what they actually mean is that it’s gone from one in 10,000 to two in 10,000’
These are stories that have been the speciality of papers such as the Daily Mail and Express for decades. Mr Tee believes “changes in the editorial staff at some of the mid-market papers have changed the tone of some of that coverage”.
In general, he says newspaper journalists have also got better at interpreting statistics, meaning there is less sensationalism. That said, he admits the problem is far from fixed – with many press releases still continuing to exaggerate or distort the findings of medical research. This is especially problematic as they provide tempting copy for over-stretched editorial teams to fill ever-expanding online space.
There is also the tendency, says the regulator chief, for journalists to use shortcuts in explaining research-based stories. For example, “one of the standard things that newspapers will write is to say that the chance of something has doubled – when what they actually mean is that it’s gone from one in 10,000 to two in 10,000.”
When this lazy journalism is consumed by a public which, in Mr Tees words, are “very bad at understanding risk”, misconceptions can easily be formed.
Few “fixed points of truth”
Perhaps the most famous case of the press misleading the public was the coverage of the Lancet paper on MMR which suggested a link with autism.
“Our editors’ code says you should take care ‘not to publish inaccurate, misleading or distorted information or images’. Now, in the case of the Lancet article on MMR, a newspaper would I think quite reasonably say ‘we are citing a research study in a peer reviewed and respected journal’. And I think that, as a press regulator, we would be hard pushed to say they hadn’t taken due care in the way that they published [those stories].”
The issue becomes more complicated, however, Mr Tee explains, when you remember that at the time of the controversy, the right for parents to ask for separate vaccines for their children was a “campaigning issue”, including for a number of journalists and newspapers.
“One of the things that the editor’s code specifically allows [for] is newspapers to be campaigning outlets. They have to not misrepresent in doing that, but they are not required to be balanced.”
This may, he speculates, have led some journalists to be less forensic about the study than they might have been – for example, noting how few patients were included in the research.
This partial view of the world is seen even more clearly in coverage of issues like climate change.
“There are still widely respected academics who take a contrary view on several of the aspects of climate change and [those views] are reported in our newspapers” says Mr Tee. “That in itself is not misleading. It is not a requirement for a newspaper to say the overwhelming degree of evidence says climate change is real if they’ve taken care in the generation of that story. There are times where I would like my fixed points of truth to be the one that everybody followed. Unfortunately, the world isn’t always like that.”
Even when newspapers are minded to take issue with anti-vaxxers, climate change deniers and the like, Mr Tee points out it is not always simple to do so.
“Let’s take a speech by a politician which some might characterise as being littered with lies. If you took the entirety of the article reporting on that speech to point out everything that was untrue… it would be unreadable. So, what you end up with is reporters thinking, ‘I’ve got to concentrate on the main [thrust of the speech]’ and an awful lot goes by the wayside. If you look at people in the online space who do challenge [what they perceive of as lies] there’s a real danger [of looking] a bit obsessed.”
Political lying is now a “practice”
That’s a look no professional journalist wants to carry, but Mr Tee acknowledges it is becoming harder to maintain an even keel – especially when reporting on politics, which in the UK of course commonly means writing about the NHS.
“I worked in government and with politicians for many years and my experience would be that, generally speaking, you could trust a politician to tell the truth”, he says.
This truth may be “embellished” and presented in a way to support their argument, but “you’d have looked quite hard to find a case of a politician deliberately telling an untruth.”
Today, says Mr Tee, that while “it’s not as prevalent in this country as it is in some others, I do think that we’re in a time where there are some politicians for whom [lying] is a practice.”
The starting point of IPSO’s regulation of the press is “the importance of freedom of expression”, says Mr Tee. There needs to be “very good evidence” that reporting on something can directly cause harm for the regulator to believe it should be restricted.
One good example of where that evidence threshold has been passed, explains Mr Tee, is restrictions placed on the reporting of inquests. “There is very good evidence that if you cover too much detail of how somebody has taken their own life, that can lead to an imitative effect”.
There is much debate about whether the subject, detail and tone of some media coverage – including the use of images and other content derived from social media – can have a deleterious impact on a reader’s mental or physical health.
Mr Tee believes “we’re not yet at a point where there is a body of evidence” that says freedom of expression should be widely curtailed because of this concern.
For example, Mr Tee acknowledges that even stories rubbishing the claims of anti-vaxxers may lead to some readers questioning the official line, but the says the regulator “would need pretty significant evidence” to show that coverage “not only leads to people going to anti-vaccine websites but is leading to a situation where people aren’t getting their kids vaccinated” before it acted.
He does, however, stress that IPSO’s editor’s code is “a high… but minimum standard” and that “up and down the land” newsrooms debate how far their responsibility extends. “It’s about decency, it’s about [asking] ‘would our readers want to read this?’.”
The IPSO chief states most editors take the “feedback they get [on sensitive issues] very seriously. Particularly influential are “pressure groups like the Samaritans”. He claims that mental health organisations in particular are “finding there is a really productive engagement that they can have at a pretty senior level in national newspapers.”
Overwhelming the bad with good
Turning to the coverage the NHS receives in 2019, Mr Tee laments the fate of his successors in the DH press office.
During the first decade of this century, Mr Tee remembers that government media management was about “trying to overwhelm the bad with the positive”, a tactic helped by the amount of investment going into the service.
Back then government spin doctors could get involved in story trading – offering a stronger positive story in exchange for the dropping or downplaying of the original, negative, piece being researched by a journalist.
The current travails of the service and the government means “those who are currently trying to manage the media [are not] able to pull things out of a hat like that.”
That said, he believes that the existence of an independent, non-political figure at the head of the NHS has softened media coverage.
Simon Stevens, he says, “is the embodiment of something that the country holds dear” and journalists “don’t want to beat him up too much because he’s not a politician”. It is not so much an issue of him getting an “easier ride”, more that he is asked different, less confrontational questions.
Coming up: Gambling Commission chair Bill Moyes, and Department of Health and Social Care permanent secretary Sir Chris Wormald.
If there is any political or influential figure you would like me to interview, please email email@example.com or if you are reading this on the website leave them in the comments box.
The past five Bedpans
You can read all 23 Bedpans here