In a new research paper, University of Oxford researchers Eleanor Barry and Trish Greenhalgh describe how the UK national press is unfairly treating primary care. Assessing over 400 stories, they found that GPs are regularly criticised, with the majority of stories painting a picture of a primary care service on the brink of crisis.
The stories offer an unfair and unrealistic portrayal of the reality, researchers believe and they argue this could have a negative impact on GP recruitment. Practice Business goes behind the headlines
Researchers Barry and Greenhalgh analysed over 400 articles on general practice, and 100 on hospital specialties, to understand how our national press treats healthcare providers. Overwhelmingly, the articles depicted primary care as being in crisis, suffering staff shortages, poor accessibility and inefficient organisation.
GPs, personally, were portrayed as ‘clinically incompetent and lacking in virtues.’ Patient care was criticised, with doctors seen as the architects of the crisis, rather than those responsible for funding the health service. However, when the researchers analysed a smaller sample of hospital specialties they noted the service was portrayed as being in crisis – but this was the fault of the government.
In one particular example, after studying articles published during the annual winter pressures, the researchers found journalists happy to point the finger at primary care. ‘Most stories that covered this crisis depicted the government as assigning part of the blame to general practice,’ they state. In particular, stories supported the government’s push for GPs to offer 7-day opening, criticising GPs for failing to accept this change in conditions quickly enough.
One-in-eight articles focused on poor clinical performance by GPs, with only one article recording the positive clinical impact a GP had on a patient’s health. The researchers noted that some newspapers highlighted problems with female GPS, who were unable to work full time due to family commitments; the same criticism was not levelled at hospital doctors, however, who were portrayed as heroically striving to deliver the ‘best care in difficult circumstances’.
Impact of negativity
This bad press can have a dramatic impact on the NHS – both as a healthcare provider and as an employer. The NHS is facing a recruitment crisis, with the growing number of GP vacancies, arguably, the biggest impediment to the success of the recently published NHS Long Term Plan.
In 2014 Professor Neil Munro said, in the BMJ, that, alongside other issues, ‘negative press from the media contribute significantly to the current decline in popularity of general practice.’ Barry and Greenhalgh agree, arguing that the medical graduates who base their opinions on the headlines could develop a negative view of the profession that may lead them to discount primary care as a career choice.
Barry and Greenhalgh describe how criticism of GPs often focused on the individual, not economic and/or political circumstances. They describe the coverage as suggesting GPs had an ‘unwillingness to work hard’ and believe that general practice is likely to be perceived by students as ‘low-status, under-resourced, under- staffed and high-stress.’ This is in stark contrast to the ‘life-saving heroes’ portrayed in secondary care.
Ironically, a quarter of all articles described the diminishing general practice workforce, seemingly unaware of the damage that such stories could have on recruitment. The researchers noted that, where articles tackled the recruitment challenge facing primary care, the current problems were attributed to rising workloads and indemnity costs, low morale and exhaustion.
While not explicitly tackled in the report, the continued negative coverage of primary care is leading to continued frustration with the service and a belief that it is failing. Barry and Greenhalgh want to redress the balance, stating that, ‘Work needs to be done to encourage the lay press to convey a more balanced view of general practice, and not to blame its current crisis on GPs themselves.’
In a media environment that is based on salacious headlines, and stories that focus on the negatives rather than the positives, the story of the everyday, primary care, heroes of the NHS is unlikely to be compelling enough for editors, and, sadly, readers too.
Encouraging journalists to present a more balanced view of the health service is a positive aspiration – but who would do this, and how it would happen is, sadly, something Barry and Greenhalgh – and many others concerned with the state of our media – don’t currently have an answer for.
You can read the full paper on the BMJ website here.