John Menadue’s sizzling critique of the media

The Centre for Policy Development’s founder, John Menadue was at the New News Conference in Melbourne recently. While there was much talk of how digital media is revolutionising the way we create and interact with news, John reminded the audience that while Web 2.0 may be exciting, content remains the critical issue. And we have still some way to go in working out how to resource and support those content-makers (this is an issue beyond journalism) who have the will and the skills to provide some much-needed scrutiny and analysis of the health sector and health spending and policy more broadly.

Menadue also made a number of suggestions for how some of society’s powerful institutions (not only the media) could help contribute to a more informed understanding of complex health issues.

Below are John Menadue’s speaking notes, first published in Croakey, Crikey’s health blog:

Under-resourced mainstream media is not in a healthy state. It is failing significantly, with a few notable exceptions, in the health field as in most other fields. It is much more than just the shrillness of the Murdoch media. With so little news to break or analyse, it is not surprising that journalists spend such an inordinate amount of time-sharing opinions with each other.

Can online media fill the vacuum? Crikey/Croaky, Centre for Policy Development and others are in the field, but they will take time to grow. The important issue for online media to recognise is that technology is the easy part. The hard part is content both information and analysis.

In pay television for example, we have excellent new technology that has given us more channels and better pictures, but the improvement in content is marginal. We have more choices, but little increase in value. Online media is much cheaper to produce and deliver, but the continuing problem will be access to good content at reasonable cost. Bloggers give us worthwhile and diverse opinions, but are not particularly strong on the dissemination of factual information.

The Australian polity and the media are in a downward spiral, almost a death wish. Disappointment and disillusionment with politics and the media is widespread and growing.

Trivia and personalities prevailed in the media in the last election campaign. The best example of trivia that I can recall was the Australian Financial Review’s portrayal of Julia Gillard saying ‘Nauru’ instead of ‘East Timor’. As the AFR put it ‘Gillard’s Nauru gaff rocks asylum seekers’ stance’. Really? I have been getting my four children’s names confused for the last 50 years! Even Kerry O’Brien mis-speaks the ABC for the ALP.

Politicians are clearly running away from the big ticket issues – particularly climate change and the two or three track economy that the mining boom is foisting on Australia. Politicians listen closely to lobbyists on these big-ticket issues – 900 full-time of them, or 34 for every Cabinet minister. Journalists are under-resourced to examine policy issues and in many cases have become the mouthpiece of special interests with their well-funded public relations activities. The Australian Centre for Independent Journalism at UTS found in a survey of the 10 major metropolitan newspapers published in Crikey in March this year that 55% of content was PR driven, and 24% of content had little or no significant journalist input. In the specific field of health/science and medicine, the survey found that 52% of content was PR driven, with 23% of content having little or no significant journalist input.

Before I come specifically to health, let me mention the problem in the wider media context.

The Rudd Government introduced timid climate change proposals and then over-compensated the polluters. Frightened by a ‘big new tax’, the government ran away. The result of the power of special interests and the failure of the media to explain has resulted in what Ross Garnaut has described as a ‘diabolical problem’.

For a $7 m advertising campaign, the three wealthy foreign-owned miners saved themselves $7 b in taxes. There were some media commentators, Ross Gittins and Ian Verrender, who wrote cogently on the issues, but much of the media, which was the beneficiary of the miners’ advertising money, either diverted public attention from what was at stake or clambered in political support of the foreign miners. I wonder how those same journalists will react when Chinese state-owned enterprises follow BHP, Rio Tinto and Xstrata in running future political campaigns against the Australian government.  The media was missing in action on this big-ticket item.

On asylum seekers, the government and the media, and particularly the ABC, failed to frame the debate with facts. Television news and current affairs obviously worked on the assumption that if there were no pictures, there was no news. It was easy to get pictures of asylum seekers’ boats floundering in the Arafura Sea, but it is hard to get worthwhile pictures of asylum seekers’ coming by air, despite the fact that over 90% of asylum seekers come by air and not by boat. Tony Abbott said that Australia was being ‘invaded’ by asylum seekers, yet neither the government nor the media took the trouble to point out that asylum seekers represented only 1% of our migration intake.

Special interests in health, as in other areas of public policy, hold sway, with the public and the community largely excluded. The health media has gone missing on the following.

At the April COAG meeting, State governments and their health bureaucracies were left in control of hospitals. Kevin Rudd described it as the ‘greatest reform in health since Medicare’. That was nonsense. John Brumby and the states won the arguments over hospitals and got a lot more money to boot. Where were the professional and searching journalists in mainstream media? We were all overwhelmed by the spin.
Compared with many other countries, we have a much higher number of hospital beds. Australian governments have an obsession with hospitals at the expense of non-hospital care. But no journalist to my knowledge has examined this obsession we have with hospitals and hospital beds.
The media is yet to examine the gaming that goes into waiting lists. These waiting lists are more rubbery than Goodyear tyres.
The AMA resists any significance change in archaic work practices in health which if implemented could give this country enormous improvements in productivity. Health is our largest sector and our largest employer. There is serious concern about lack of national productivity improvements in recent years, but the potential for health sector productivity improvements is scarcely ever mentioned by mainstream media.
Many media economists extol competition, but the Australian Pharmacy Guild maintains its protection from competition through location rules, the cap of 5,000 on the number of community pharmacies, and the exclusion of pharmacies from supermarkets. But scarcely a peep from mainstream health journalists.
The media responds to hot button issues like a particular death in a hospital, but scarcely examines the systemic problems that cause about 10,000 avoidable deaths in our hospitals each year or 200 each week. That is the equivalent of one Bali bombing or one Victorian bushfire every week of the year.
The health insurance industry retains its corporate welfare subsidy of $5 b per annum. Yet the mainstream media spends more time publishing the views of this highly protected industry, rather than examining alternate policies to produce better public outcomes.
At the last election, pathology companies, such as Primary Healthcare Ltd, ran ads against the government’s attempt to curb burgeoning pathology costs. It was obviously affecting their profits. In the 8 years to 2008-09, pathology services, paid for by Medicare, have increased 62% and benefits paid increased by 71% – way ahead of inflation. Put another way, medical services per person from 1995-96 to 2008-09 have fallen by 5% for consultations, but risen 30% for procedures and 65% for diagnostic, including pathology. No wonder the government needs to act. Whilst Australian Financial Review journalists were talking up the problems of the pathology sector, nowhere did they frame the discussion with some facts about the enormous growth in pathology and the excessive level of referrals. Their stories seemed like public relations handouts from Primary Healthcare Ltd with minimal journalistic input.
How can the information base be improved to promote public health and a healthy media?

The health sector is so large, complex and technical that it is difficult to understand. This is a problem for all, including journalists. It is also true for ministers, both federal and state, who are easily captured by their health bureaucrats with their mastery of detail.

The best-informed health commentary is, and I hope you will excuse me for saying it, in Crikey/Croakey and CPD. But their resources are limited and their readership falls far short of mainstream media. Hopefully such organizations will continue to grow and develop. But content is the hard and expensive part.
Health information and policy advice is biased heavily in favour of governments and their bureaucracies. They are able to dominate the debate with this monopoly of information. With the balance of power now to be held by Independents in the House of Representatives and with the Senate to be controlled by the Greens from July 1 next year, there is a unique opportunity to substantially expand the resources, both quantity and quality, available to members of parliament through parliamentary committees and the parliamentary library. The media and the community would be much better informed. (By far the best information I was able to find recently on asylum seekers came not from the Minister for Immigration and Citizenship and his department, but from the Australian parliamentary library.) The proposed parliamentary budget office will also be a considerable help, but it will be limited to budget and fiscal matters which are only one part of a much wider agenda of economic policy.
Julia Gillard was rightly criticised for her proposed citizens’ assembly on climate change. It was obviously a diversion from the main issue. But she had a point about our need in many policy areas, including health, for a better-informed community that will enable our leaders to make some tough decisions. I have been a long-term advocate of citizens’ assemblies, deliberative polling, and citizens’ juries to explore at every level, local, state and national, informed community views on hard issues in health. We need community groups who are informed by experts and not dependent on the Herald Sun or the Daily Telegraph.
The federal government has proposed a number of authorities to report on health performance, eg the National Performance Authority will report on emergency departments and elective surgery waiting times, adverse events, patient satisfaction and financial management. There will also be an Independent Pricing Authority and a permanent Australian Commission on Safety and Quality in healthcare.  All these new monitoring authorities will be helpful in providing the information-base for more informed reporting and public discussion.
This new information will not only help public policy, but also provide better information to consumers to help each of us make better decisions about our own health ‘My hospital’ similar to ‘my school’ should also be helpful.
The establishment of an Australian health commission would also facilitate better public understanding and analysis of health issues. Such a commission would implement government health programs, subject of course to the government setting out the principles and policies that should guide the commission, eg universality, equity, subsidiarity, pooled funding, etc. I foresee this commission working in the same way as the Reserve Bank in the economic field. The Reserve Bank has proved itself to be independent and largely immune from pressure from special interests. Importantly the Reserve Bank, as should an Australian health commission, facilitates and leads an informed debate on health issues and policies. That would better equip the media and us all in understanding.
Other health authorities, such as Medicare and the Australian Institute of Health and Welfare, should be instructed to facilitate public discussion on important health issues and help us get away from the current debates that are really a two-way discussion between the minister and special interests. The information they supply must be much more customer-friendly, and highlight the key issues where greater public understanding is necessary. It would make for a better-informed media. The key issue that we don’t discuss in health is that we can’t have all we want and that priorities and hard choices have to be made.
There are many ways in which public interest journalism in health can be advanced. With the failure of under-resourced mainstream journalism, the key is enhanced information and independent advice to facilitate a more informed parliament, media and community which would in turn make it easier for adaptive leaders to make the necessary but hard decisions in health.

New technology is important but the real problem is access to good content. As in all media, the key is not so much technology as content.

If you want to hear more from John Menadue on what is wrong with our media and some ideas on how we might fix it, you can listen to his conversation with Deborah Cameron on ABC’s 702 Mornings here.

Blog Comments

John, I totally agree with everything you say. However, I don’t see that ordinary people can do anything to change the media. Mr Murdoch has far too much power in so many countries. Is there anything Australians can do? I feel as though the populace are being manipulated. It’s extraordinary and it’s getting worse and worse.

Mr Menadue, your ideas are as much in vogue as flares and long hair was in the 70’s. As a Whitlam acolyte, sounds like you are still maintaining the rage……By the way Wendy Stephen, you and your kids can rest safely tonight. Big bad Rupert hasn’t implanted the micro chips in the brain just yet………

I wonder, Skipper, whether you’d be so relaxed about Murdoch’s stranglehold on Australian opinions if he was actively pushing a left-wing agenda? When Big Brother is your friend you don’t need to fear Big Brother. But Rupert has no need of micro-chips. His Fox network in the US has convinced a quarter of Americans that Obama is a muslim, a foreigner and a communist who’s planning to introduce death squads along with his health care bill.

very valued comments from a vastly experienced participent in political life.

It’s self evident that very few of us know the politicians that we vote for and that our opinions of them are via the media.

From the moment that Abbott took Liberal leadership, the opinion polls went volatile.

The notion that the media weren’t significantly involved contradicts even rudimentary analysis.

Thanks John for shining light into this seditious corner.

Inquiry into commercial media and ABC? Absolutely!

I totally agree with John Menadue and his comments on journalists during the last election. For many years now I have accepted the truth that facts are the last thing the newspapers are going to examine for its readers. However. if you want to know what the bloke at the next desk thinks or what my cat had for breakfast go ahead and make Mr Murdoch richer and more famous every day. I think I will pass.

The one thing that newspapers do better than anyone else is in presenting lengthy, detailed analyses of what’s really going on, yet this is the very thing that newspapers are increasingly ignoring in their desperate attempt to “compete” against sound and pictures. The Sydney Morning Herald’s tone gets more and more hysterical, as if they believe that their readers need bigger and bigger shock therapy to keep them from slipping into a coma. It’s my belief that only by concentrating on genuine news and making entertainment secondary can they survive. They need to be level-headed, calm and reasoned, sensible and untethered to causes or back-scratching. I bypass about 90% of the articles now because I can see that they’re mostly promoting something, selling something or screaming that the sky is falling. The financial journalists, with the notable exceptions of Ian Verrender and Ross Gittins (and Kenneth Davidson in Melbourne ), write as if they’re embedded with the people they’re supposed to be scrutinising. The entertainment journalists write as if they’re roadies on the tour bus. The political journalists write as if parliament is a Punch and Judy show. If our newspapers were describing a single canoeist they’d be screaming “He’s going left! He’s going right! He’s going left! He’s going right!” , having no interest in telling us where the canoe’s actually heading. It’s too depressing for words.

Yes indeed but newspapers are business, business is obliged to make profit for the shareholders. Is there any law suggesting the media owes the electorate accurate information? Why for example is there nothing similar to a recent post be Zach Carter on Alternet, a supposedly a site given to publishing reasonable accurate information, at politicians/
which sets out moneys garnered by politicians for their favours? Pearse when writing of the coal lobby indicates similar may occur here but gives no data – perhaps because he would be sued or because such data is well hidden?

I totally agree – but what’s the solution? I told my wife 18 months ago that the answer to the financial crisis was to take out two bankers every friday and shoot them. Should we do the same to lobbyists? Editors? Proprietors? Good luck, John.

A few weeks ago, the International Day of Peace Alliance conducted a Youth Peace Parliament. We older participants were amazed to hear that the young people understood that the media presented any particular issue from the same side. They also noted that the issues given the most media attention were often quite unimportant in the greater scheme of things.

This is a very good and very important piece. As mentioned, the reluctance of media persons to deal with issues in any reasonably informed manner is a feature of almost all coverage. In the education debates the print media gave no coverage to a major conference on curriculum issues held at Melbourne University in February this year attended by very distinguished experts from the UK including Professor Celia Hoyles a maths expert – an area of great concern we are told – and no coverage to an important seminar on the Myschool website and the NAPLAN tests and socioeconomic indicators used by the site held in July and addressed by leading experts in their field.

Numerous people from overseas who have very important contributions to make to the debate have visited Australia in the last couple of years but with the exception of the ABC they have been ignored. Meanwhile the ill-informed assertions of special interest groups pursuing positional goods and the equally ill-informed politicians dominate the media-waves obscuring the vitally important and very well supported evidence about teachers and their salaries and professional development needs, about the nature of effective teaching and the value of small classes for younger children and so on. The visit by Professor John Hattie, who has undertaken extensive review of literature about teaching, a couple of months ago was picked up only by ABC’s Radio National.

Recognising the battle lines may help. While it appears that the mainstream media look corrupt and desperate they are in panic addled death throws.
News Ltd for example is fighting a battle for it’s survival in the face of massive fragmentation from very very disruptive technologies. News lost a fortune on MySpace and is becoming increasingly marginalised by YouTube, FaceBook and Twitter’s opinionated amateurs and pseudo journalists. But the ‘journalists’ are learning fast and organising themselves. Crikey is but one example and when they find some ethical investment they may take off. Look too at YouTube TV just launching now. No traditional media control here.
Which brings me to the greatest threat to News Ltd. The socialist vampire that is the NBN. The NBN platform is of course neutral and will entirely undermine FoxTel, SkyTV and associated cableTV and satellite platforms. That is why the once nominally technology advocating paper The Australian has turned luddite and News ltd’s print and broadcast media are on “exterminate” NBN setting.
Fellows, as a co-founder and now over viewer of a fledgling youth driven media production unit (YC Media) I can report to you that there are seeds of hope sprouting some green shoots. Naive ? Perhaps, but their greatest asset is they don’t know who and what they’re up against. Frances Kendall’s comment is telling about young people. One hopes they read a little history so as to learn from some of our contemporary challenges.

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