Why is BBC news coverage so different in Scotland? – the revealing case of A&E waiting times performance

By stewartb

I was in two minds about writing this. After all, the release of NHS A&E waiting time statistics is a regular occurrence – weekly in Scotland, monthly in England. And don’t we know about the weekly releases from NHS Scotland – especially those alert to BBC Scotland’s news!

However, 13 October sees the release of the latest A&E performance statistics for NHS England (for the month of September) and they are record breaking – for the wrong reasons! Newsworthy? I’ll return to these statistics later but as a starter I’ll share this extract from the official NHS England report:

‘56.9% of patients were seen within 4 hours in type 1 A&E departments compared to 58.0% in August 2022, 64.0% in September 2021 and 76.9% in September 2019. This is the lowest reported performance since the collection began.’ (my emphasis)

Source: NHS England (2022) A&E Attendances and Emergency Admissions September 2022 Statistical Commentary (https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/ae-attendances-and-emergency-admissions-2022-23/ )

Reflecting on the BBC

Nowadays, my second action after looking at the monthly NHS England data is to check the coverage on the BBC News website: as of 16.30 hours today, 13 October there is NO coverage of this record, worst ever performance.  Surprising?

On 20 September 2022, the Scotland page of the BBC News website had this headline: ‘Scotland’s A&E waiting times worst on record’.  Moreover, on 21 December 2021 the BBC News website even ran an article with this headline: ‘Scottish A&E waiting times second worst on record’!

The 20 September article on A&E in Scotland devoted, typically, a substantial part of its content to quotes from opposition MSPs. Some of the quotes were alarmist to say the least and they were directed not to the management of individual hospitals or health boards that are performing (statistically) poorly – and not all hospitals or health boards are – but to the Scottish Government and personally, to the cabinet secretary for health.

Sandesh Gulhane, Scottish Tory health spokesman is quoted saying: “The health secretary can’t ignore these dire stats. He must come up with an alternative strategy to tackle this crisis in Scotland’s NHS, as his flimsy Covid Recovery Plan clearly isn’t working.”

Scottish Labour health spokeswoman Jackie Baillie is quoted saying: ”If we are to avoid a full-blown humanitarian crisis this winter then the government must act now,”

Now opposition politicians will do what opposition politicians do. They choose the topics to focus on, they choose the tone in which they wish to express their criticisms. They decide whether to be constructive or just plain negative; to show an awareness of context and maintain perspective, or not. However they choose to go about holding a ‘government to account’, outside of parliament they rely on their comments being amplified by the news media, including media outlets that have a supposed public service mission.

It is in this context that questions about BBC coverage of NHS Scotland arises. In short, there is abundant evidence that BBC coverage of A&E performance and other health matters in Scotland is substantially different from that in the rest of the UK. There are more news articles on for example A&E from BBC Scotland; the headlines and general framing by BBC Scotland is more consistently negative; the content of the news coverage from BBC Scotland on NHS Scotland is much more politicised – very often articles on NHS England and NHS Wales have little or no reference to political comment. For the avoidance of doubt, my fundamental issue with all this is NOT the ‘holding government to account’ but rather the evident differences between BBC editorial policy and practice in Scotland and the rUK. 

The ‘problem’ would be alleviated if BBC Scotland’s coverage provided ‘context’, notably on the significance of Westminster’s powers over the public finances of the government in Edinburgh – and in Belfast and Cardiff too. It would be alleviated if BBC Scotland provided ‘perspective’, notably on the performance of the NHS elsewhere in the UK. As best as I can see, BBC Scotland rarely does any of this.

On one occasion when I spotted that BBC Scotland did offer ‘perspective’ it did so in what one might see as a highly dubious way. You can judge for yourself from this extract taken from the same article on A&E in Scotland published 20 September.

‘Figures for NHS England, which are released monthly, showed 71.4% of patients were seen within four hours in August, although the performance at the busiest type 1 A&Es was just 58%.’

Having focused on the performance of NHS Scotland’s main A&E departments – 63.5% within four hours – the BBC opts to give prominence to a 71.4% figure for NHS England.   Why? This figure is for ALL types of emergency departments in England and therefore is in NO WAY comparable to the performance figure in Scotland!

Moreover, the ‘just 58%’ reference is significant NOT because these are for the ‘busiest’. It is because these are of a particular type of A&E department (departments that will range in size and in ‘busy-ness’) viz. all type 1 departments characterised by 24 hour, consultant-led services, departments we would all recognise as ‘A&E’. ONLY the type 1s are directly comparable to the ‘main’ A&E departments in NHS Scotland, the focus of the BBC Scotland article. Was BBC Scotland seeking to mislead?

And so following on from all the above, it is legitimate to ask why the difference between the BBC in Scotland and elsewhere in the UK.  Without satisfactory explanation, might one land on political bias as an hypothesis? The BBC would surely wish to clear up any such concern!

A&E performance statistics for NHS England

Returning to the latest release of waiting time statistics for NHS England, we learn:

‘Emergency admissions via type 1 A&E departments is 6.7% lower than September 2021 and 9.6% lower than September 2019. Growth over the last 3 months, compared to the same period last year, is -8.6% and over the last 12 months, compared to the preceding 12 months, is -2.4%.’

There were 1,302,577 Type 1 A&E attendances in September 2022. There were 1,304,378 Type 1 attendances in August 2022. But despite this relatively stable figure:

‘56.9% of patients were seen within 4 hours in type 1 A&E departments compared to 58.0% in August 2022, 64.0% in September 2021 and 76.9% in September 2019. This is the lowest reported performance since the collection began.’

And on ‘trolley waits’ i.e. the time from ‘decision to admit to admission’:

‘There were 132,000 four-hour delays from decision to admit to admission this month, which compares to 105,000 in September 2021 and 64,900 in September 2019.’

‘Of these, 32,800 were delayed over twelve hours (from decision to admit to admission), which compares to 5,024 in September 2021 and 458 in September 2019.’

In the previous month, August 2022, there were 28,756 patients experiencing trolley waist of over 12 hours.

End note

Nothing newsworthy here? No humanitarian crisis in England (or Wales) exercising the Labour opposition in Westminster? Do journalists not want to know whether Dr Gulhane thinks his Tory colleagues in Westminster have solved A&E waiting times?

Or is it time for some grown up politics, for a general acknowledgement that the NHS in all parts of the UK is struggling and regrettably, matters may well get worse before they get better? And an acknowledgement too that if risks to NHS services this winter can be mitigated by a step-change, rapid increase in resourcing, ONLY the Westminster government has the ability to bring this about – for all. Pigs might fly!