1. Dr John Lister, Coventry University

2. Impact of health reporting Surveys continue to show that the vast majority of the public get most of their information about science from the mass media. Science and the Media Expert Group, January 2010 Misinformation or inadequate information on medical issues can kill MMR, If 70% of A&E attenders can be treated at Urgent Care Centre – are you/your child in the 70% or 30%?

3. Health affects everyone Almost no other news/specialist topic has such a universal audience in all media. Story lines include: Readers own health Availability /affordability) Health care systems – changes, costs, Quality Keeping/getting healthy New treatments/effectiveness of treatments

4. Main sources of health news Mainstream media UK (end 2013). Estimates: >50 million daily readers of newspapers >14 million accessing newspaper info online Tens of millions in news audiences for TV & radio Compare with specialist health press <300,000 weekly readers of BMJ, Health Service Journal, Nursing Standard, Nursing Times & more specialist media combined Plus online readers – maybe 1.5-2 million monthly – almost all health professionals & academics

5. Who is reporting on health? Surveys of health reporters show few have any specialist training: and most of these trained as health professionals or science degrees before becoming reporter Most specialist reporters centred in specialist health trade press: Tiny audience compared with mainstream media Few training courses in Europe, all small Few employers invest anything in training As a result: self taught journalists, trying to cope with complex stories & newsroom pressures

6. News values versus balance Mainstream news media approach stories as NEWS, not from scientific interest. Nuances dont fit well into this framework. Traditional news values (Galtung & Ruge): RELEVANCE for target audience (& NEWS) TIMELINESS (immediacy: happening now) = little time for checking, balance, or scientific critique SIMPLIFICATION – can it be described simply? ELITES: can story be linked to a famous person? NEGATIVITY: bad news sells (simplify) GOOD NEWS: also sells (simplify)

7. Reporting frames understanding – and limits response Weaknesses in reporting not limited to reporting clinical trials and medical innovation Misinformation can also disenfranchise If a story or an aspect of a story is not in the media, public dont know & cannot react Reporting of English health reforms, Obamacare Some stories achieve prominence, despite centring on inaccurate information 13,000 excess deaths in failing hospitals Rise in GP support for charging for appointments A nuanced story to rectify an inaccurate report will not reach same audience

8. Time to take POLICY seriously Various guidelines circulated on reporting clinical trials, & campaigns waged (Goldacre, BMJ, Lancet, etc): Gary Schwitzer/healthnewsreview – 10 points Science Media Centre – 10 points All seeking to ensure proper reporting of source, context, cost, timescale and critique. Problems where these principles not applied: audience misled, false expectations unjustified panic where dangers exaggerated, absolute risk not clearly defined.

9. Need to raise bar on health policy reports We need a similar framework to encourage critical reporting of HEALTH POLICY and other non- medical stories This is my attempt at developing Gary Schwitzers ten points for wider health reporting

10. Think before you report No wish to tell journalists what to think or say But crucial to ensure that more thinking & critique are developed Ways to critique rather than recycle endless stream of press releases & PR-guided material Ways to put stories in context – political, social, economic – and find news stories that may otherwise be missed. Angles to explore the story – local, clinical, practical, managerial, statistical, financial, etc. Ways to bring in balancing voices

11. An ethical journalist must be a critical journalist Ways to do the job better, with more satisfaction, value added and possible feedback Without critical approach, journalist is simply transmitting ethical approach of PR/ news source Stenographer, loudspeaker or messenger – not a journalist offering any professional input Randolph Hearst News is what people dont want you to know: everything else is advertising Better health journalism benefits us all.