Circling The Bandwagons

 

On the 22nd of October 2015 the BBC published a report about Jeremy Hunt ‘misleading’ us about the figures for weekend deaths in hospitals.

Strangely this story resurfaced today as the BBC once again delved into the  subject, and curiously it just happened to be Prime Minister’s Questions today with Jeremy Corbyn leading with the BBC’s claim and actually quoting the BBC’s ‘research’.  No questions at all about the EU and the referendum but as Jon Pienaar told us afterwards the British public are apparently more interested in the Junior doctors’ challenge to Jeremy Hunt as the subject is closer to home.  Why is Pienaar making up excuses for Corbyn leading PMQs with a BBC story?

Not saying at all that the BBC and Corbyn have colluded in this although Guido has found a BBC employee who has been feeding Corbyn questions for PMQs.….little ‘Rosie’…who thinks Corbyn is ‘strong and Cameron ‘misleading’…

 

 

Cameron told Corbyn that yes indeed the figure of 6,000 was misleading because the true figure was 11,000….

“Now we’ve had time to go into these figures of more detail, I can tell the House that the Health Secretary was indeed guilty – he was guilty of an understatement,” Mr Cameron said.

“The true figures for excess deaths at the weekend were 11,000, not 6,000.  So perhaps the right honourable gentleman will now withdraw his totally unjustified attack on the Health Secretary?”

What did the BBC choose to report in its news bulletins? (03:02)  They aired Corbyn’s question in full but then oddly didn’t feel the need to give Cameron’s reply to that question instead telling us he said that there were misleadiing figures but they came from the BMA….he did indeed say that but that was not his answer to Corbyn’s question…which was that there are 11,000 deaths at the weekends above what might be expected on weekdays.

But were Hunt and Cameron misleading?

This is what the BMJ article concluded…..

Appropriate support services in hospitals are usually reduced from late Friday through the weekend, leading to disruption on Monday morning. This could go some way towards explaining our finding of a “weekend effect” extending into Friday and Monday.

We have shown a clear association between weekend admission and worse patient outcomes. Our analyses show that an increased proportion of higher risk patients are admitted on Saturday and Sunday, when services inside and outside the hospital are reduced. There is evidence that junior hospital doctors feel clinically exposed during the weekend and that hospital chief executives are concerned about levels of weekend cover. This has led to calls from the Academy of Medical Royal Colleges, Medical Education England, the Royal College of Physicians, and the Royal College of Surgeons, for a review of the way services are provided in hospitals at weekend, with a particular focus on urgent care.

So not only do more deaths occur at the weekend as a proportion of patients but the Junior Doctors are extremely concerned about it and the levels of weekend cover and although the report does indeed say that to conclude these deaths are all avoidable would be ‘rash and misleading’ they then said….

From an epidemiological perspective, however, this statistic is “not otherwise ignorable” as a source of information on risk of death and it raises challenging questions about reduced service provision at weekends.

Yes, more patients come into hospital with severe problems at the weekend but that’s ‘more’ only as a proportion of patients as in fact the number who go to hospital at the weekends is considerably lower than on week days….therefore in fact the actual numbers of severe patients is lower than on a weekday.

A higher proportion of patients were admitted to hospital as emergencies on Saturday (635 020/1 261 085; 50%) and Sunday (621 356/952 375; 65%) than on weekdays (3 951 971/13 646 048; 29%).

The study in the BMJ begins with this…

Intuitively, reduced provision of healthcare at weekends adversely affects all of these domains…..

Our previous study of all NHS hospital admissions in England during the financial year 2009-10 indicated that admission at the weekend (Saturday and Sunday) was associated with a significantly increased risk of in-hospital death compared with midweek admission.

Pretty clear where the study is pointing….weekends do result in more deaths due to reduced services.

Why is the BBC being so dishonest about this and misleading the public on what Pienaar thinks is the most important subject politically today?

The study clearly states that 11,000 extra deaths occur at weekends and yet the BBC is blatantly claiming that Cameron and Hunt are doing the ‘misleading’ and have even edited out Cameron’s answer to Corbyn…Here’s the final words from the report…..

 

The real question is of those 11,000, although the report says it would be ‘rash and misleading’ to think they could be avoidable, just how many of them could be saved with the provision of appropriate services?….clearly many could be saved, the report itself makes that clear, reduced services cause problems at the weekend…but the BBC and Corbyn want to gloss over that whilst they make strawman attacks on Cameron & Co.

The BBC weren’t so concerned about causality in previous reports when it suited them to ignore it when attacking the government on nurse numbers…the BBC used a single study to claim that a fall in nursing numbers led to deaths….but the report they based that claim upon made no such link…..

Implications of the California nurse staffing mandate for other states.

We have tried to minimize this source of potential bias by obtaining reports from nurses in states without legislation and by using in-dependent patient data to validate the better outcomes for California hospitals. Our study is cross sectional and we cannot establish causality in the associations we observe.

The BBC basing its report on a study which admits there was no causality, no baseline and little evidence elsewhere to say that staff, like HCA’s, were detrimental to patient outcomes.

 

Back in 2014 the BBC were happy to ignore reports of 13,000 patient deaths under Labour‘s stewardship of the NHS…..

Labour is accused of operating a ‘Denial Machine’….welll yeahhh…it’s called the BBC.

Professor Sir Brian Jarman, of Imperial College London, worked on a government review which will this week show that 14 hospital trusts have been responsible for up to 13,000 “excess deaths” since 2005.

He accused Labour ministers of presiding over a “denial machine” and ignoring his data on high death rates for a decade.

Sir Brian said: “We felt we were banging against a locked door. They were denying out data even though there was no real reason. At the time there was pressure from Downing Street and pressure from ministers.

“The government was in the position of providing the health service and monitoring it, it was a conflict of interest. Ministers have an electoral interest in getting out good news.”