The scandal of the Mid Staffs NHS Trust is prompting local and national media to take a more critical look at what is going on in hospitals across the country. NHS managers, meanwhile, are thinking about how to prevent the many problems and shortcomings that they are well aware of being picked up and used unfairly by what many of them see as ill-informed reporters who are looking for a story and don’t understand the pressures and challenges they face. Caught in the middle are the NHS press officers. Alan Taman was one of them. A former member of the Oxford branch, now vice-chair of the Birmingham and Coventry branch, Alan worked for nine years as a senior PR at the Birmingham Children’s hospital, leaving the job two years ago to take up an MA in health journalism. Here he writes about the challenges of the job, and how support and advice from the NUJ helped him to resist pressure and stand by his principles.
I got on well with hospital consultants. As soon as they saw I wasn’t about to reduce their work to platitudes or risk exposes by blurting out confidential information, we got along fine. Managers, though. Well, there’s a different tribe…
I loved being a PR in the NHS. Usually. Probably because I worked in a children’s hospital and everyone wants to say nice things. Even when what has happened isn’t very nice. Reporters would do their best to cite our response, even when it was badly written, ‘managementese’ cobblers.
I’d do my best for them. Including trying to re-cast said tosh so they could at least use it. Health professionals as a group would go along with that. They saw the need. As would (most) managers. But occasionally there would be a story which raised the possibility of one of the true, great engines of the NHS: blame. The NHS runs on the stuff, it is a blame culture. That means managers can feel vulnerable about the possibility of blame from parties they barely understand and cannot control. For which they regard the media as the prime example.
This places hospital PRs in a unique version of the vice every PR has to live with. On the one hand, the pressure from journalists – many of whom are not health specialists (and that’s another gripe) and are struggling to understand so they can write for their equally non-specialist readers. That I found easy. It’s an act of translation and negotiation. Negotiating with health experts and reassuring them they won’t be mauled by the press. Translating what they say into terms the reporter can use if they can’t fully appreciate it for themselves. The happy health message goes out. Nearly all of my job was just that, spreading the good news about happy people achieving happy and often near-miraculous results. Time pressures from reporters were constant but I never found them too much.
BUT then there’s the other jaw of the vice. Expectations and impositions of managers. Most were fine, most of the time. Which allowed me to build up trust with them about trusting my colleagues and I to do the best for them with the media. Occasionally though, there would be a manager who was at best misinformed about the press, at worst downright hostile. That can be a nightmare. Made worse by the fact that a lot of NHS managers do not understand what it takes to be effective as a PR, and try to impose the same systems of control that apply, say, to running a surgery ward. Which completely misses the point on how the media and the NHS connect, and your responsibility as a PR to recognise that and manage it professionally.
The only recourse you have then is to ‘speak truth to power’: you have to say it as you think it is, not how you know they want to hear it. Ultimately they can still tell you to put out the line, but if you’ve registered objections on professional grounds and in writing at least they know it’s still going to be their neck. Thankfully I never had to push things that far. But I was willing to.
Most NHS PRs, I found, were professionals – many ex-reporters – who were doing their best to be honest and balance promotion and protection, sometimes in situations where managers were interpreting that professionalism as ‘disloyalty’. I wouldn’t be surprised if a few caved in and lied. But the NHS is the worse for that: something most NHS PRs are only too ready to agree with. The NUJ helped me both in feeling not so isolated when management were pressing (PRs often work alone and rarely are there more than a handful in any one Trust), and in offering very good advice so I could confidently press back if I needed to.