The media is often correctly critical of the state of public health services in Australia today, highlighting the problems of access to emergency care, surgical waiting lists, adverse events and Indigenous health problems. But do they contribute to the solution of the problems? I’d argue not, and that in fact media reporting sometimes makes the underlying problems worse by distorting political and policy priorities.
Media headlines are often highly emotive and out of proportion to the actual incident or problem they are reporting. And they often quote a simple solution from an eminent clinician or academic with a vested interest — such as wanting more money, more beds or more staff. Many people may not understand the impact these media headlines have on the management of the health system.
In ministers’ offices, health departments and CEO offices, the first action each morning is not to check on the status of patients or the health system under their supervision but to check the headlines or radio comments and consider how to respond immediately.
There is a major flurry of activity that has staff, who should otherwise be managing the system, scurrying around to find information that can refute the headlines or provide evidence that the relevant government has been addressing the problem.
When a major media crisis is underway, senior management can be totally absorbed in dealing with media responses, parliamentary briefings etc, sometimes for days or weeks on end.
Problems that occur from poor management at one facility are often attributed to system-wide problems, leading to system-wide inquiries or reviews, which can distract management focus for even longer periods of paper chasing and wordsmithing. Once the media noise dies away, then the problem is forgotten and the attention of politicians, managers and bureaucrats moves to the next media story.
The process has become a bit of a game with responses to media stories often painting a rosy story when it would be more appropriate to acknowledge problems and develop meaningful solutions. When you look more closely, the significant problems in the public health system in Australia are not unique to any one state or country; they are international. This strongly suggests they are intrinsic to the traditional ways of organising health systems and as such need deep structural reform.
The media has an important part to play in bringing these problems to the attention of the public but it must promote real and sustainable change and not the pet theories of those with vested interests or who have no track record of achieving improvement.
What is needed from the media is a more balanced and analytic description of the problems, their causes and a more informed view of what is needed to fix the problem.
On the other side of the table, we also need more of those experts who have a broad understanding of the challenges facing the health system to be able to contribute to a more informed debate. Often, this is actively discouraged by political and bureaucratic processes.
The media must recognise the power it has to shape the healthcare system in Australia. At present, its influence is distorting and indeed preventing proper solutions rather than stimulating a truly informed debate.
The interplay between media and government agencies as it occurs today is a barrier to health reform – and this is an issue the National Health and Hospitals Reform Commission may need to consider in its deliberations.
Professor McGrath, a haematologist, has previously been CEO of Hunter Area Health Service and Deputy Director General of NSW Health, where she led a program of clinical service reform
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