Workers Hammer No. 224
11 August 2013
In our article on the NHS in Workers Hammer no 222 (“Mobilise union power to defend the NHS”), we refer to the recent Stafford Hospital scandal and state that:
“In a horror story worthy of a Victorian poorhouse, somewhere between 400 and 1200 people needlessly died in Stafford Hospital between 2005 and March 2009, many of them denied pain medication, some left without being washed for up to a month.” [Emphasis added]
Whilst the Mid Staffs episode was truly horrific and it is certainly the case that healthcare in capitalist society is inevitably deficient — especially in the wake of many years of privatisation and austerity measures — I think we need to be careful about how we report and fact check statistics.
A recent article in the British Medical Journal (BMJ) by David Spiegelhalter (“Statistics behind the headlines: Have there been 13 000 needless deaths at 14 NHS trusts?”, BMJ 2013;347:f4893) points out that widely publicised statistics purporting to demonstrate that many thousands of people across a range of NHS trusts “needlessly” died have been misreported and that these statistics only indicate that there were more deaths than would normally be expected. These statistics cannot and do not purport to demonstrate that hospital patients “needlessly” died due to neglect or inadequate treatment as opposed to their deaths having been caused by a range of possible factors (something which is best determined by the scientific efforts of pathologists rather than by NHS bureaucrats or statisticians).
David Spiegelhalter’s article refers in part to the Mid Staffordshire NHS trust statistic, which originated from the Robert Francis report:
“So what about the ‘1200 needless deaths’ at Mid-Staffs? A recent BBC News story claims: ‘Data shows there were between 400 and 1200 more deaths than would have been expected between 2005 and 2008.’ But there are no published data that show this, as fully discussed in the first Francis report.”
Volume 1 of the Francis report makes this quite clear:
“Taking account of the range of opinion offered to the Inquiry, including a report from two independent experts, it has been concluded that it would be unsafe to infer from the figures that there was any particular number or range of numbers of avoidable or unnecessary deaths at the Trust. However, there is strong evidence to suggest that these figures mandated a serious investigation of the standards of care being delivered”.
— R Francis QC, “Independent Inquiry into care provided by Mid Staffordshire NHS Foundation Trust: January 2005-March 2009”, Volume 1, paragraph 74
I think that both Spiegelhalter’s article and the Francis report clearly suggest that the way that the mortality statistics have been reported in the bourgeois press (and unfortunately also in our own) is unscientific.
As with any statistic that we choose to report, I would assert that the fact that it was reported by a “reputable” bourgeois media outlet is not necessarily sufficient evidence to determine whether or not the interpretation of that statistic by a publication is accurate. The truth is concrete.