And then there was Gardham

My previous post concerned Herald columnist David Torrance. However, a report in today’s Herald by their political editor Magnus Gardham caught my eye (http://www.heraldscotland.com/news/14231953.Health_care_in_Scotland_lags_behind_England__a_new_Europe_wide_report_says/?action=success#comments). It concerns a European comparison of health systems, which shows Scotland at number 16, two behind England – though only by two points out of one thousand – but a good many behind other European countries.

The political response to this was fairly predictable – oor Jackie Baillie said “The SNP asked to be judged on their record, and on the NHS we are seeing problems all across the service from A&E wards to delayed discharge to general practice and now we are lagging behind England on healthcare. Shona Robison needs to get a grip of her brief.” – but does Jackie not always say that? Just changes the name of the Minister. Meantime Jackson Carlaw, perhaps trying to be original but failing totally said “the Scottish Government has serious questions to answer about its record on A&E waiting times“. But he did get the “serious questions” meme in, so well done Jackson! And we call this “political debate” – goodness, it’s just as well there is no international league table for that (as far as I know).

Meantime, the Scottish Government said “”Simply reducing the performance of healthcare systems to a league table is misguided and ill-informed“, which might well be true since we don’t know how good their data was. Health statistics are notoriously hard to use for comparisons – variable definitions etc. However, the fact is that they find that Scotland lags 200 points behind the Netherlands. Their data would have to be AWFULLY bad to undermine the conclusion that there are things we might learn from their healthcare system. Not that we should throw our hands in the air, our health care system and our government out, but we should give some thought to the proposition that we might profit from looking at how another country organizes its health care, so that, even if we want to think our healthcare system performs well, we can help it to perform even better. Can we not have the humility to accept that things are not perfect and that we might just learn something from countries such as the Netherlands. Do we have to have a “Little Scotlander” attitude? I am sure we do some things very well, but is it not always possible to do them better than we do them now?

However to Gardham. Having reported on the dreadful news that we lag at 16th, and on a few specific findings – for instance the differences them was not significant – Gardham then turned to a few stats to give the Scottish Government a bit of a kicking (since the report didn’t really do that). He presents four pieces of evidence

  1. that the waiting time target (95% seen within four hours) was not achieved last month – true but the actual figure for December was 94.9%, which Gardham misses out.
  2. That half the hospitals didn’t achieve the 4 hour A&E waiting target. Of course it also means that half of them did, and as above, the target was achieved on a Scotland-wide basis for 94.9% of patients. As above, Gardham never lets on.
  3. That “1193 patients were found to be stuck in hospital ” which means their discharge was delayed. However, again, if we look at the data, what Gardham tells us is more important for what it doesn’t tell us rather than for what it does. The fact is that for nearly 40% of those whose discharge was delayed, it was by no more than three days,
  4. The Scottish Gernment had committed to addressing this problem. Gardham never actually says this – indeed he says nothing, allowing the implication to hang in the air – but clearly the implication of “However, 1193 patients were found to be stuck in hospital last month because they were waiting for care to be arranged, despite government pledges to end so-called bed blocking” is that this is only the case because the Government either did nothing at all, or it’s not working. But the fact is that every year this is a number which falls over the summer and rises again in winter. Comparing last December (2015) with the previous one (2014) the number whose discharge was delayed by more than three days – the more relevant number – had fallen by almost 20%.

Gardham is not some junior journalist – he is the political editor of one of Scotland’s leading newspapers (God help us). His comments on the report are nothing great, showing little in the way of insight. The report runs to 117 pages, and it’s hard to believe that Magnus did any more than read the Executive Summary. But what is more worrying is the second half of this story, where he presents the above highly misleading and distorted “facts”, with no attempt to contextualise them, other than that the report suggests there is scope for improvement in the Scottish NHS and he intends to illustrate this. But as we have shown the statistics he uses are in many respects important for what they don’t tell us – for instance that last year, the Scottish NHS was the only one in the UK whose A&E performance not only did not decline, but was the best in the UK. One would never think that, if your source of information is Magnus Gardham. These then provide a foundation for Jackie Baillie and Jackson Carlaw to offer up their usual quotes about needing to get “a grip” and “serious questions to answer”.

It’s hardly news that Gardham’s reports tend to favour Unionist opinion, and that’s fine. A debate needs two sides, and we need to know where we stand. But is his use of the above A&E and bed-blocking statistics not simply intended to mislead the reader, and if so should it be regarded as political commentary or rather poor political propaganda? But most importantly should we not expect better of the second oldest newspaper in Scotland? If their political editor wishes to proselytise a particular point of view, then this would be something that political commentators have done for years. I may not agree with him, but we need two sides (at least) for a debate. But let’s at least be honest and not distort the evidence to suit the argument.

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