The Guest editor on Radio Today’s programme this morning was a scientist. One of the questions that the programme explored was the relationship between science and politics.
The point the editor was making is that many of the most important and difficult policy decisions that face us now involve complex scientific questions. Three major examples include Climate Change, Energy and the Ageing population.
The investigator had done the maths on this. There are very few Scientists in Parliament, many MPs are not particularly comfortable with scientific information, and there is a tendency for politicians to pay more heed to the media and public opinion than they do to scientific advice.
He had done some background research. He had looked at the manifestos produced by the different parties in the two most recent elections and found that for the two elections the work “science” did not even appear in the Conservative party manifesto.
This does seem to tie in with an uneasy suspicion I have had about some approaches I have seen to “scientific matters” by the Conservative party over this last year. This has been highlighted by the troubles we have had here with Stafford Hospital.
The report into Stafford Hospital carried out by the Healthcare commission, effectively divided into two parts. There is a section which looks in a fairly simple way at care procedures, and identifies some of the problems that were occurring. This was a matter of simple observation. There is another section of the report which looks at the way in which information was collected within the hospital and the quality of data. This is a more complex “technical” section. It in fact showed that there were real problems with the quality of the data and that because of this the HSMR figures, and the excess death figures that were an extrapolation from these figures were completely unreliable.
Journalists have in common with Politicians that they are seldom from a scientific background, and the journalists who were first on the scene to pick up the headlines from the Healthcare commission report swallowed the juicy bits ( patients stories of bad care) and ignored the bones – they did not make any effort to come to terms with the complexity of the data, and came to some seriously wrong conclusions because of this.
The fact of the matter is that there were serious problems with the data which gave alarming but essentially false figures. This triggered an investigation to look for problems in care. Some problems in care were found, and the journalists then made the mistake of saying that problems in care had caused the number of deaths that could theoretically have occurred if the initial figures had been correct. This led to the groundless but journalistically appealing idea that 400 deaths had been caused by bad care. This is something that does not incidentally occur within the report at all. It is purely something that arose during the case of the first press conference. What the question was, and whose idea it was to ask it are all now lost in the mists of time, but that is where the misinformation came from.
It is perhaps easy to say in hindsight that the government should have questioned the use of these figures more strenuously. I think this ignores the heightened emotional context. It was pretty impossible to raise any note of dissent against the unanimous voice from the media in those early days. I immediately set to work to read the report in full, but it took me over a week to be sure that I was reading it correctly, and get second opinions from people I respected, by which time the numbers of “deaths” was established as “fact” in most people’s minds.
The government did I believe do the right thing. They immediately set in train a full report to look at what had gone wrong and what needed to be done to put it right, and a second report to look at why the monitoring systems had failed to raise any serious alarms. These processes have over time given us the much less remarkable truth about some of the problems that did exist, and pointed to the way to resolve these problems.
The Conservative response was I think more questionable. They sent David Cameron down for a photo opportunity. They uncritically accepted the newspaper reports of excess deaths and made the assumption that if these deaths had occurred and there had been no warning then the monitoring systems had failed, and were therefore worthless. These assumptions permeated the Conservative party down to local councillor levels, and after a number of profoundly unhelpful and inflammatory statements to the press, efforts had to be made to take them to one side and explain some of the complexity of the situation.
The Conservative line very quickly became that trying to measure performance and set targets is a pointless operation, and that it was better just to leave it to local management to sort it out. They have extended this argument to many aspects of measuring health care performance and health outcomes.
My own impression is that they are wrong about this. Before 1997 there was very little in the way of good comparative data. Some of the information systems that have been brought in since 1997 have been problematic, people on the ground may not have understood the systems they were operating well enough to provide data of the right quality, but this is settling down. The systems are becoming more reliable, and they are providing real information that does help people improve care, and measure results.
What has happened in Stafford Hospital as a result of all the help and attention that it has received does help to prove this point. The statistical data collection systems have been overhauled and are now producing reliable data. This gives good early warning systems and this is resulting in real improvements in the quality of care.
This is a long story, but I think it does illustrate where the Conservative’s easy affinity with newspaper headlines, and discomfort with scientific or statistical data may be likely to cause problems.
The Reporter on Today went on to ask some politicians about the relationship with science. One of them, Margaret Beckett, said that there could often be real problems in dealing with scientific evidence, because there was often conflict between scientists, and the science was often complex. It is clear that she was making real attempts to understand the science, but there were times ( she quoted the example of conflicting science on what to do about badgers) when this simply doesn’t help with the difficult process of decision making.
My own feeling on this is that I want politicians to pay proper regard to scientific information, even when it is complicated, and I want a media which uses the specific skill of effective communication to make an attempt to explain complex scientific ideas, on the big problems we all face, in a way that people can understand
Just as a footnote on this it is worth looking at our own MP, David Kidney. He is not a scientist. His background is as a lawyer. He is however interestingly married to a scientist, and is very comfortable with listening to and talking with scientists.
Three of the issues in which he has taken a strong interest are Energy, Climate Change, and the Ageing population. All of these are issues in which science and data are the key to understanding the problem and finding a way forward. As a minister with the Department of Energy and Climate Change he has access to scientific opinion and makes full use of this. As someone who is closely involved in the development of policy relating to the ageing population and care he actively seeks acadmeic and scientific opinion and works closely with Stafford University Faculty of ageing.
His ability to understand and deal with scientific data – and take it beyond that so that he can present it to people who are not scientists, is well respected, and that is one reason why he was the chairman of the Science in Farming Committee.