Justice and Journalism Assignment

Examine one current affairs TV series being broadcast in the UK. View one program from this strand (e.g. Panorama, Channel4 Dispatches) and critically examine and analyse its content.

BBC’s Panorama Midwives Undercover program was 58 min long and aired on Thursday, 3rd of May, on BBC 1.

It investigated serious allegations into systemic failings of understaffed, underequipped and underresourced maternity units in NHS hospitals in England, using an undercover reporter as a work experience volunteer and quotes of experts, midwives, courts, government, NHS trusts managers and concerned parents. That May week, it was the only investigative program on TV which focused on a British issue.

What style of reporting did it use?

The program was narrated by Jeremy Vine, who intermittently appeared on the screen.
But “Midwives Undercover” mainly centred around the undercover footage of a hidden camera positioned in midwife units by Haley Cutts, the BBC undercover reporter who volunteered as staff support. Jeremy Vine basically bridged the different narrative parts of the program, presented facts and introduced experts or other witnesses. Vox pops were used to underline general statements and case examples were used to prove specifics. The undercover reporter Haley Cutts, was rarely allowed to address the camera directly, her footage was mainly used to hold the NHS trusts administration accountable. In the undercover footage, luckily enough the faces of the midwives were blurred to make them less identifiable.
The main questions and issues tackled were understaffing and under-resourcing of maternity units, with St Marys in Manchester and Barnet Hospital in London as case studies. This lack of patient care before, during and after birth leads to more serious mistakes being made, with avoidable deaths and injuries and lack of accountability of NHS trusts or government.
Apart from the main reporter and narrator Jeremy Vine, undercover journalist Haley Cutts appeared on the program, and expert midwife and Prof Marvis Kirkham, lecturer at Sheffield Hallam Universitycommentated the undercover footage on screen in an interview with Jeremy Vine.

Who appeared in the film?

Appearing in the film are also a lot of unidentified nurses and patients filmed undercover, and a few, who were named but their names were not subtitled. Iram and Faruk Ahmed (?) appeared as a further case study when one of their identical twins died and the other was brain damaged after a caesarian section was postponed for the next day.
Another case study is baby Abbie Everitt with her parents Mike and Carrie from Telford, she got brain-damaged and died when staff failed to respond to the abnormal heart rate of the baby.
The chief executive of Barnet and Chase Farm Hospital Trust, Averil Dongworth, is interviewed by Jeremy Vine and he tries to hold her accountable for the understaffing and under-resourcing.
A midwife called Deborah Killick (?), who is in the process of emigrating to Australia, is speaking out on the record about the atrocious work conditions for midwives in British hospitals.
Other case studies included two other couples who suffered the loss of their babies because of a lack of staff and resources.
Kathy and Ben McKay, whose baby died because of not carrying out an emergency caesarian, were also interviewed on screen.
Caithlin Coyne died immediately after birth despite of being healthy, because of the staff and doctors delaying the delivery. Her parents Karen Coyne and her husband Wayne just won a court case against the hospital because of the lack of medical care.
Shakie Dee and husband Tsuki were interviewed after a 24 hrs painful labour and the emergency caesarian showed lack of care and compassion in her case. Their healthy baby however survived the lack of medical care in the hospital.
There were also undercover interviews with mothers who were just called by their first names, such as Lilly, who did not get any pain relief when it mattered because the delivery unit was full, and Rosina who had a painful pelvic condition but did not receive any care from the midwives.
Also, a Mrs. Takour appeared on screen after she was left in a storage room waiting, and a Mrs. Osman complained on the phone about not getting any pain relief after she was forgotten on another ward.

Methodology and evidence

Many research methods were employed to provide credible evidence. The main reporter Jeremy Vine stated that the research for this investigation took about six months. A vast amount of subjective statements was collected from eye witness reports, vox pops and undercover footage, including statement made by nurses, examples from all over the country were given and more objective reports, interviews and evaluations by experts and written court case judgements, government and WHO figures, NHS and Royal College of Nursing reports were quoted.
The responses of NHS trust & hospital administration also served as evidence, as did birth and death certificates.

Some of the strongest evidence was the undercover footage of a woman who was in labour for over an hour whilst left sitting on the corridor, crying with pain and humiliation because there weren’t any beds available and the maternity and delivery units were overcrowded.
Haley Cutts also kept a diary and notes which were partly read out again.

However, there weren’t any medical records used to substantiate the personal and subjective eye witness reports of patients and midwives, nor were any doctors verifying or denying the accusations of medical neglect.

The outcome of the programme:

The moral of the story was pretty much that another big tragedy would have to happen before things would change for the better.
Some results of the investigation were already shown in the film: Six more fetal heart monitors were purchased according to a response of Barnet and Chase Hospital Trust, and the hospital’s administrations were held accountable by the BBC journalists.

However, when I enquired at the Department of Health, The Barnet and Chase Hospital Trust, the BBC, the Royal College of Midwives, and emailed Prof. Mavis Kirkham and the Haelth Commisssion to ask if the program forced any changes to be made, no specific responses were made.
St.Mary hospital in Manchester published a press release, stating they decided to build a new maternity unit which will be finished in 2009, and they also released the last years’ numbers of births.

The Royal College of Midwives also released a press statement
, in which it disassociated the midwives from lack of care provided, claiming the cause would be understaffing and under resourcing.
The BBC published the number of a dedicated telephone line, for viewers who felt deeply affected by the program.

Journalism of Engagement or not?

I felt it was a powerful piece of Journalism of Engagement. Like no other program I saw this week, i felt very agitated and would have loved to organise a protest in front of the featured hospitals against the administrators and managers of the NHS trust. As I have been working in a hospital in Germany, I can understand many of the problems shown in the video, however, luckily when I was working there as support staff, I was very well paid in comparison to what nurses and midwives and support staff are paid now and in the UK, and there were aways enough staff and beds available.

However, I felt, that the producers of the video made it easy for themselves to just blame the NHS trusts and not examine deeper into why there are not enough midwives and equipment and beds available if there are record numbers of public money spent on the NHS by the government. Nobody seems to know where it is actually disappearing to.

The program also failed to investigate if the understaffing and underresourcing is only occuring in the maternity wards in the hospitals, or if in the same hospital other wards are suffering from the same problem. It would be interesting to know if there is a discriminatory element toward pregnant mothers in the running of that hospital or if the whole hospital is run in a substandard way. It would also be interesting to be able to compare PFI hospitals to state hospitals and see if the private, profit-driven ownership of hospitals shifts the financial balance from staffing to building maintenance, therefore endangering lives by the increased priority of paying the public debt from the PFI to private investors rather than staffing and equipping hospitals properly.

In short, the program succeeded in investigating some of the causes of stillbirth and disabilities such as brain damage of babies and increased illnesses of mothers post-partum, but the causes for the understaffing and under-resourcing were not investigated.

Also, it should be remembered that it is easy to investigate state-run facilities because of the libel law and the Freedom of Information Act, but unfortunately similar reports into privately-run facilities, such as for example private hospitals, would never been aired, neither so in-depth investigated and the administration could have never been held accountable in such a way.

As the closure of maternity wards was frequently in the news in the last months, it was disappointing that the program did not mention these arguments at all, where the government says that bigger, more central situated maternity wards would improve healthcare for mother and babies, whereas most of the public seems to prefer local maternity wards and stresses that time is of the essence in difficult cases and therefore near-by maternity units would be more important to maintain than enlarge the ones further away.

The government was not held accountable at all for the understaffing and underequipment and the lack of capacity of maternity units as the film included too much whacky and shaky footage of the undercover reporter. There seems to be a danger, that if undercover reporters are used in an investigation, to overdo and exaggerate it with little substance, as it is actually quite a big financial investment, and it seems exciting for the journalists and producers involved, but it actually should just support the investigations and not be the main attraction to the program as done here.

The program is quite emotional, as the mothers and babies in the film are shown when they are in a helpless, dependent situation, and the nurses are distressed as well, and the viewer just feels so protective and disempowered that it provokes a lot of anger, luckily not against the nurses but against the management, in particular as Mrs. Dongworth did not do a particular good job in defending what’s going on in her maternity ward and comes over as an ignorant, repugnant, incompetent, greedy manager.

Credits for Panorama’s Midwives Undercover:

Reporter: Jeremy Vine
Undercover: Haley Cutts
Camera: Jarrod Roberts, Tim Sutton,
Sound: Tom Fricker, Oli Cohen
Technical Advisor: Heather Keeling
Dubbing Mixer: Ashley Jane Armstrong
Online Editor: Matt Brown
Web Producer: Paul Burnell
Production Co-ordinator: Laura Cockshoot
Production Manager: Samantha Maynard
Unit Manager: Irene Ozgar
Film Editor: Kate Dunn
Assistant Producer: Sophie Everest, Emma Cotton
Executive Producer Dave Stanford, Sam Bagnall
Produced and Directed by Anouk Curry
Editor: Sandy Smith

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