Tony Kilcoyne questions how we can trust anything we’re told during COVID-19 when dentists are given misleading or misspoken advice.
With anything relatively new, in this case a novel virus and its unique challenges, things like information (data) and scientific evidence become critical in any planning strategically.
It is also important, actually critically important, that we have access to as fully accurate information as possible. Then from that we are able to plan, communicate and enact provision and advice. This minimises harm and maximises recovery before and during this crisis time.
The degree with which we and the public can trust central communications is vital. Without such trust, it means nobody believes you. Like a group of lemurs, many consider it a conspiracy, but one of continual untruths!
In public life, be it politicians, regulators or any positions of power, you can encompass these aspects in what we know as the Nolan principles of public life. They include openness, honesty, integrity etc.
So, why is it during this COVID-19 crisis, we seem to be subject to so much, how can I put this, misspoken or compromised information from those centrally, who surely have the earliest and best access to both data and scientific evidence, to fully communicate clearly to us all?
There seems too many occurrences where what speakers state simply don’t match reality. And to a degree that others in the media question if this is just an accident. The CQC is now encouraging us to speak up if we have concerns. But in reality, how easy is that if management or even Ministers and their civil servant advisers, appear to inhibit or be economic with the truth?
Who can forget these examples:
The Minister stating on national TV that all dental practices in England had received PPE supplies. When the reality is that most dental practices didn’t receive any central stock of PPE.
Or where bodies that we normally trust unquestioningly, like PHE along with others, come out with new PPE guidance for dentists. Here PHE lumps is in with other healthcare workers instead of our own separate guide. And now we’re told it is ok to not change type two masks between infected and suspected-infected patients. When previously we always changed our type two masks between every patient, even for the simplest of dental examinations pre-COVID-19.
Thus this worsening of standards in the face of a pandemic, just didn’t make sense when subject to reasoned scrutiny. Even worse, the government tells us this is evidence-based. It’s best practice and meets WHO published standards as the reasons for these changes.
It later transpired that guidelines were adjusted down to better match the lack of PPE remaining in NHS stockpiles. That’s according to Secretary of State Matt Hancock, later in the crisis, when questioned.
Last but not least we are then told by government advisers that we must accept the scientific evidence put forward and interpreted by SAGE. But non of that evidence used or its processes will be revealed or indeed be subject to external analysis or feedback until months after the event. We must all just accept it on trust. Despite the above.
Misspoken or misleading?
Such matters raise serious concerns about how information is being given, withheld or spun. Is it simply ‘misspoken’, as a senior government civil servant said about HMG’s failure to join EU joint PPE purchasing opportunities? Or is it misleading, deliberately misleading or simply censored, to hide centralised failures?
The fact we raise serious concerns and even think such things, surely tells us ‘trust’ isn’t all it should be. And neither is the government being fully honest about all the problems we face.
The danger becomes when people (politicians, civil servants, regulators, professionals etc) fear discussing mistakes or omissions openly (due to ridicule or career damage). This leads to a culture of excusing or even active-denial strategies. With even bigger problems more likely to occur, not less, which harms us all.
You can bring in all the whistleblowing regulations, guardians or policies you like. But if the culture of bullying or top-down pressures remain stuck in denial, then candour becomes a continual casualty. Despite our past enquiries.
The NHS has a duty of care as an employer; the government has a duty under human rights to properly prepare for such pandemics. Especially one it knew was coming and it’s likely extent. But most of all, this is a matter of trust.
Lose or weaken such trust, then you lose so much more as a society. You lose it’s very fabric.
We need to get rid of this culture of fear that denies or ultimately censors admitting mistakes and omissions. We need to encourage then create a culture of openness and transparency.
Only then can we can learn openly from past and current errors. And then improve performance, create continual trust and actually make true progress. We call it blackbox thinking. Let’s make Lord Nolan proud!
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