Only facts can kill healthcare fiction

The DoH infuriated the tabloids by excluding them from a briefing on the flu-vaccine shortage. An ex-DoH head of news assesses how to deal with scare stories

Despite bird-flu hysteria and predictions of one of the coldest winters for years, the Government completely failed to anticipate that demand for flu vaccines would outstrip supply.

On top of that, PRWeek's story last week on how the Department of Health got in a flap when vaccine stocks were down - and then made a complete hash of telling us about it - further highlights poor comms judgement. The Government failed to get the facts across clearly, caused confusion and tarnished reputations.

To recap, DoH head of press Jon Hibbs issued an apology after a selective media briefing to which the Daily Express, Daily Mail, Daily Mirror, The Sun and the Press Association were not invited.

Hibbs, to his credit, took full public responsibility for failing to handle the matter correctly. He acknowledged that it was his call, and that he got it wrong - it was a proper spokesman's apology for a poor corporate decision.

Proper planning would have engaged comms and policy officials not only at the DoH, but also at Number 10, who could have suggested, opposed or supported a decision to brief selectively. Responsible ministers at the DoH also usually approve such plans on high-profile issues.

Hibbs spoke of a hope of avoiding 'unnecessary scaremongering' and the DoH's right to decide 'who should be briefed and when'. The PA and the mass-market tabloids, scaremongers? Well, maybe. But we hear no complaints from the Government when one of its positive messages is delivered via the popular media. As for the DoH's right to decide who should be briefed and when, of course it can choose, but talk about rights can so often be, as the philosopher Jeremy Bentham once said, 'nonsense on stilts'.

Address fallouts quickly
In this case, press officers fell out with individual reporters. When this happens, it can seriously damage the relationships between government and the media. Such relationship breakdowns should be addressed quickly by both the department and news organisation concerned.

Perhaps even more critical is the question of how the Government encourages journalists not to go over the top with scare stories. The DoH press office is normally seen as handling itself well in this area: the rows are usually about policy rather than presentation. It is politics, more often than PROs' incompetence,  that skews public health information.

Selective briefing on the breaking of a new element in a major public health issue cannot be a good idea if you want to avoid another scare story - or a furore about it. Transparency, fair dealing and consistency generate trust, of course. And yes, it is much easier said than done, but not exactly rocket science where good media relations is concerned.

No one really believed the government when it held out for so long against the possibility of BSE being able to infect humans. The Daily Mirror famously splashed the link as an 'exclusive' from an unofficial briefing, putting the government on the back foot just as it was about to announce the evidence proving a link.

Interdepartmental disputes about competing priorities should not preclude independence and frankness about the available evidence. Clear messages, helping people to make informed decisions in confusing situations, need to be delivered repeatedly, even in the midst of a full-blown public debate generating more heat than light.

Open dialogue and explanation can often prevent the sensationalism that surrounds a culture of secrecy and elitism. Integral thinking for the long term has to win the battle against  short-term expediency. Take the MMR debate. In communications terms, the affair seemed to go well from the DoH's perspective, irrespective of where one stood on the issue of public choice. The Government was clearly in it for the long haul and remained clear and consistent in its messaging. The mistrust that surrounded messages on MMR was the price of the mishandling of the BSE affair.

Unnecessary defensiveness and inappropriate briefing can also cause problems, even when open to all. In 2002, a knee-jerk reaction to 'leaked' information about the slightly increased risk of deep vein thrombosis for users of the third-generation contraceptive pill caused a major scare.

In fact, pregnant women were more than twice as likely to suffer from DVT as those taking the third-generation pill, while factors such as smoking put women at an even higher risk - contextual statistics that got lost in coverage of the issue.

The communication of a clear message to women on the third-generation pill, with the purpose of offering them an informed choice, got off to a bad start. By the time the clear and most basic message got across - that the added risk of DVT from the pill was slight (especially when compared with other risk factors) - much damage had been done.

Compromise needed
What, how and who to brief is taken seriously by many - perhaps by too many - in Whitehall, not just government comms specialists.

We may never know who advised what, and which arguments from which quarter led to Hibbs' decision to brief selectively on the flu-vaccine shortage. But the concerns voiced on both sides are real enough.

Where public health is concerned, we still lack a well-understood and shared language around risk. It is also clear that in general, trust, never great between government and the media, is at a low ebb. If there are journalists or news organisations that cannot be trusted to avoid turning announcements into factually incorrect coverage, you must continually engage them in an honest discussion about the issues, and establish ground rules and procedures that both sides can stick to.

Some sections of the media will always have a sensationalist agenda, but that does not mean that both sides in the game should not look to minimise the potential for facts to get blurred when people's lives and health are at stake.

Roy Sutherwood is a freelance consultant and adviser to Four Communications' healthcare arm. He was head of news at the Department of Health from 1997 to 1999.

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