16633-23 NHS Greater Glasgow and Clyde v Sunday Mail

Decision of the Complaints Committee – 16633-23 NHS Greater Glasgow and Clyde v Sunday Mail

Summary of Complaint

1. NHS Greater Glasgow and Clyde complained to the Independent Press Standards Organisation that the Sunday Mail breached Clause 1 (Accuracy) of the Editors’ Code of Practice in the following articles:

• An article headlined "Blunders in £842m hospital failed my battling little girl" published on 12 November 2022

• An article headlined "Scandal hospital kid's room with leaking air conditioning, mould and missing tap filters - UNSAFE" published on 27 November 2022

2. The first article reported that a child with Pearson Syndrome had died, after having been treated at a hospital operated by the complainant. It said: “A little girl with one of the world’s rarest genetic conditions was misdiagnosed with cancer and suffered from a catalogue of failings at a troubled hospital.” It went on to report that the family had shared a dossier which outlined the following issues: “A specialist in Pearson Syndrome waited three years for a referral”; “She was wrongly diagnosed with cancer before the condition was discovered”; the child “was treated for at least 17 infections, including Sepsis, most of which her family said they knew nothing about”; and “[s]he died from an infection which the hospital said could have been from a pet or paddling pool.”

3. It also quoted the child’s mother, who reportedly said: “We were told that she was unwell because ‘it’s just the cancer’ but that wasn’t true. She didn’t even have cancer. When she got diagnosed with Pearson’s, we were told her illnesses were ‘just the Pearson’s’. Nobody explained to us that these were infections [she] had and no mention of them being related, or possibly related, to the hospital whatsoever. Every single one, we were not informed of.”

4. The article further stated that the child was “transferred to the Schiehallion cancer ward at the RHC [Royal Hospital for Children] after being wrongly diagnosed with a rare type of blood cancer called myelodysplasia” and that she was “treated for at least 17 infections – 16 of which her family claim they were never told about.” It then said that in December 2018, “her diagnosis was changed from cancer to Pearson Syndrome and the family asked for a referral to a Great Ormond Street specialist.” The article also reported that, after the family had requested their daughter be referred, “[c]ase notes show that two years later the family had still to receive a referral”. The article said that the child’s uncle had “contacted Great Ormond Street directly, only to be told they had nobody by [the child’s] name on file and had no idea there was a child with Pearson’s in Scotland”.

5. The article included a comment from the complainant at the end of the article. This comment read: “Records show regular communications from doctors and nurses throughout [the child’s] treatment – including specific advice on infections and infection control. When the family raised these issues in 2021, this was fully investigated and their complaint was not upheld. A separate issue regarding referral to a second centre was also investigated and we apologised to the family at the time.”

6. The first article under complaint also appeared online in substantially the same format under the headline, “Scots mum slams £842million hospital after infections leading to daughter's death hidden”.

7. The second article reported on the same child and focused on the conditions of the hospital room she had been treated in. Below the headline it said “CLAIMS” and included the subheading: “Family of tragic girl tell of health hazards on ward”. The article went on to report that: “Safety devices to protect patients from infections at a scandal-hit hospital were missing in a ward treating a five-year-old girl who later died”. It further said that “her family noticed leaking air conditioning and missing water filters in her room” and she was “misdiagnosed with cancer and suffered infections as a patient”. The article further quoted the child’s mother, who reportedly said: “When [my daughter] was in ward 3C, the room was a state, with mould on the wall, water leaking from the air-conditioner vents and the tap didn’t have the proper filter on it.” The article also included a comment from the child’s uncle, who reportedly said: “We were already very worried about [the child] going into that hospital because of the infections she picked up”.

8. The article included the complainant’s statement at the end of the article: “[the child] was cared for in the appropriate ward for her clinical needs. During [her] admission, there were no reported issues about mould in the showers or on the walls. The use of filters on taps is based on a risk assessment. This case was fully investigated and ultimately handled through our formal complaints process.”

9. This article also appeared online in substantially the same format under the headline, “Safety devices missing from ward at scandal-hit Scot hospital where young girl died”. This version included the sub-heading: “[The child] was at the Royal Hospital for Children in Glasgow last year after developing an infection, when her family noticed leaking air conditioning and missing water filters in her room.”

10. Before the first article was published, the publication contacted the complainant on 11 November 2022,sending an email which presented the family’s claims that they were unhappy with the following: a named doctor; that they did not know the child had been treated for numerous infections while at the hospital; and that she was wrongly diagnosed with cancer and had not received the correct diagnosis of Pearson syndrome for two years. The complainant responded with “background notes”, “strictly off the record notes”, and a statement which said:

We would like once again to extend our condolences to [the child’s] family. While we are restricted in what we can say due to our obligations to patient confidentiality, we can confirm records show regular communications from doctors and nurses throughout [the child’s] treatment – including specific advice on infections and infection control. When the family raised these issues in 2021, this was fully investigated and their complaint was not upheld. A separate issue regarding referral to a second centre was also investigated and we apologised to the family at the time. Our highly experienced teams at the Royal Hospital for Children look after some of the sickest patients in the country, striving at all times to deliver high-quality person-centred care. They also work hard to support the families and carers of their young patients who are in a very distressing situation, and central to that support is a commitment to openness and transparency in all that they do.

The publication replied with follow-up questions about the doctor and infections, which the complainant responded to.

11. The publication contacted the complainant a second time – prior to the publication of the second article – by email on 24 November 2023. This email included claims that taps in the room where the child was treated didn't have the water filters and that there was also mould on the wall. The complainant responded with “background notes” and a statement which said:

We once again wish to extend our sincere condolences to [the child’s] family. [The child] was cared for in the appropriate ward for her clinical needs. During the period of [the child’s] admission there were no reported issues about mould in the showers or that mould was growing on the walls. The use of filters on taps is based on a risk assessment. When concerns are raised by patients or their families, an informal approach to addressing queries is initially used and is entirely appropriate and in line with our procedures. This case was also fully investigated and ultimately handled through our formal complaints process, with the family receiving a full report of the findings. Our highly experienced teams at the Royal Hospital for Children look after some of the sickest patients in the country, striving at all times to deliver high-quality person-centred care.

12. The complainant complained directly to the publication, however its complaint was not resolved in direct correspondence and it therefore made a complaint to IPSO.

13. The complainant said that the articles were inaccurate in breach of Clause 1. Firstly, it said that both articles had incorrectly reported that the child had been misdiagnosed with cancer. The complainant said that cancer had been considered while diagnosing the child, along with other conditions, and it had not been ruled out until the child had received a diagnosis of Pearson Syndrome. However, it said there was no formal diagnosis of cancer or treatment for cancer. It said this had been communicated to the newspaper prior to the article’s publication. It further said that the first article had referred to “Schiehallion cancer ward” whereas the correct name was Schiehallion Unit or Ward 2A/2B, and this ward did not just treat children with cancer. It said that this had contributed to the misleading impression that the child had received a cancer diagnosis.

14. During IPSO’s investigation, the complainant offered further clarification on the child’s medical history. It said that she had been given the working diagnosis of myelodysplasia and that, in some cases, this could develop into blood cancer. However, there was no evidence at any stage in her treatment that blood cancer had developed. It said that the child’s condition was extensively investigated and a large number of inherited and genetically determined conditions were initially ruled out on testing, resulting in the eventual diagnosis of Pearson Syndrome.

15. The complainant also complained under Clause 1, as it said that both articles had implied that the child’s infections had been acquired at the hospital, despite the complainant informing the publication that this could not be said with any certainty and in one instance the child was admitted to the hospital with an existing infection.

16. Further, the complainant said that the doctor who had referred the child to Great Ormond Street Hospital did not work for the hospital trust. It said that omitting this from both articles gave the misleading impression that the issues with the referral were the responsibility of NHS Greater Glasgow and Clyde, which it said was not the case. It said it had also made this clear to the newspaper before the articles’ publication.

17. The complainant also described language used in the articles – such as “catalogue of failings”, “blunders”, “unsafe”, “scandal” and “health hazards” – as pejorative and inaccurate. It said that, prior to publication it had addressed the various claims put to it, and had proven them to be inaccurate – therefore, there was no basis for the article’s use of these terms.

18. The complainant also said that the first article had suggested that the family were unaware of the infections, whereas it said records showed regular communications from doctors and nurses throughout the child’s treatment – and this communication included specific advice on infections and infection control. It said this had given a misleading impression of the care the child had received.

19. The complainant also said the second article was inaccurate, as the headline stated as fact that there was mould in the room the child was treated in, and the text of the article had quoted the mother discussing the mould. It said it had made clear to the publication that there had been no reports of mould in the room, and this was communicated to it prior to the article’s publication.

20. The complainant also believed the headline of the second article had inaccurately stated as fact that there were “missing” tap filters; it also considered that the article breached Clause 1 by quoting the child’s mother, who had said the tap in her child’s room “didn’t have the proper filter on it’. The complainant said that, following a series of infections in 2018, water filters were fitted to taps as an added level of protection for the most immunocompromised children. However, following investigation of the infections, it was deemed that filters were not necessary in other wards in the hospital. It said it was “clinically appropriate” for the child’s room to be without filters and that the article had misleadingly suggested that this was the fault of staff or the hospital, and as a result given a misleading impression of the care received by the child.

21. The publication did not accept a breach of the Code, nor accept that an apology was appropriate. It said that it had sight of NHS documents which had been provided to it by the child’s family, and had referred to these prior to publication. It said these documents confirmed there had been a diagnosis of myelodysplasia – which is a rare type of blood cancer – and that she was treated at the Schiehallion Unit, which is a child cancer ward. The publication provided the NHS documents in question to IPSO. It further said that, when it had put this claim to the complainant, it had not responded to this point. The publication further said that the NHS and Blood Cancer UK had described myelodysplasia as a “type of rare blood cancer”, therefore it was reasonable to describe the child as having been misdiagnosed with cancer. The publication provided links to the respective websites to demonstrate this.

22. The publication also did not consider the name of the ward to be significant in the context of the article. It said that the hospital’s website stated: “Every year more than 100 children are treated in wards 2A and 2B - known to many as the Schiehallion wards - for cancer and blood disorders” and included a quote which said: “We named the ward after the mountain - Schiehallion - to mirror the journey for children with cancer.” It also said that the ward had also been widely reported as a “cancer ward” and provided links to online articles to demonstrate this. The publication said that, given the child’s medical documents showed that she was initially diagnosed and treated for a type of myelodysplasia, which the NHS and Blood Cancer UK described as a “type of rare blood cancer”, it was reasonable for the publication to refer to the ward as a “cancer ward”.

23. While it did not accept a breach of the Code, on 17 January, 20 days after the complainant contacted the publication, it offered to add an online clarification to both articles which would make clear the complainant’s position on the misdiagnosis of cancer claim. However, it said that it was unable to do this as the complainant had not provided an additional on-the-record statement on this matter. On 10 February, the publication updated both online articles with a footnote correction which said:

“It’s claimed the position NHS medics took on cancer is that it was considered a possibility along with other conditions until it could be ruled out. This is said to be the correct pattern of investigation and they did not consider it a formal diagnosis at the time. Sources have insisted that [the child] wasn’t treated for cancer at the time.”

24. The publication said that the article said the infections could have been linked to the hospital, which was not inaccurate.

25. The publication said that the various “pejorative” language under complaint was not inaccurate – it said that these statements were based on the child’s care and the history of a hospital which was subject to a public inquiry. It said these were tabloid terms and appropriate summarisations of the family’s claims.

26. The publication did not accept its reporting of the delayed referral was inaccurate – it said the family had complained about the lack of referral; and this had been investigated by the NHS Board and acknowledged by the complainant in correspondence with the family. It further said it had not referred to the individual responsible for the referral by name, and that this claim had been presented within the article as the family's view of the situation. It also said that the complainant’s statement had made clear the circumstances of the referral: “A separate issue regarding referral to a second centre was also investigated and we apologised to the family at the time, and the matter has been investigated by the NHS board.”

27. The publication said the family had told it that they were unaware of the infections, and it had accurately reported their position on the matter and correctly attributed this claim to them.

28. In regard to the alleged mould, the publication said it was clear from the article that this was the view of the family, who had made a complaint to the hospital about this issue. It said that it had also included the complainant’s position regarding the mould in the article. It then said that the second article’s print headline was not significantly inaccurate, as the Editors' Code makes clear headlines should be read in conjunction with the text of the article, and the body of the article made clear these were the concerns of the family, rather than that any finding of fact had been made as to the existence of the mould. The publication said this was made clear by the word “CLAIMS” directly under the headline, followed by the subheading: “'Family of tragic girl tell of health hazards on ward”.

29. It further said that in May 2023 an inquiry had found mould and leaks in various wards at the hospital between 2017 - 2019, the time the child attended the hospital. The publication provided a link to this inquiry document.

30. Although it did not accept a breach of the Code on the above point, on 27 June, the publication offered to publish the following print correction on page 2:

In regards to the headline of our article 'Scandal hospital kid's room with leaking air conditioning, mould and missing tap filters - Unsafe', 27 November 2022, we would like to clarify that these were claims made by the family, as clarified in the article. Since this article was published, a Scottish Hospitals Inquiry published in May 2023 found issues of mould, contaminated water, and dirty air conditioning units within the hospital.

31. The publication said the second article had made clear it was the belief of the family that there should have been tap filters, and this was made clear by the article’s use of quotation marks and the fact that the statement was attributed to the child’s mother. It also noted that the complainant’s comment had been included in the article so that its position on the allegation was clear.

32. The newspaper said it had given the complainant a fair opportunity to respond to the claims contained in the article prior to publication. It acknowledged that the complainant had provided information which had not appeared in the article, however, it disputed that this information had been ignored. Rather, it said that it had taken it into account as the position of one party involved in the report, and balanced it against the position of the other party involved – the child’s family. It said it used a number of sources to inform the article, and that these had all been taken into consideration. It also said that the complainant had provided “off the record” and background notes and noted that if something was pivotal to the complainant’s position it should have been included in the “on the record” notes – it could not attribute statements that were made as background and/or off the record notes to the hospital in its reporting.

33. The complainant said it did not consider it to be morally appropriate to publish a further statement on the specificities of the child’s diagnosis.

34. The complainant said that the mould inquiry document the publication had provided came with an accompanying document which said: “the underlining in paragraph 2 is a reminder that no one should read the HOIC as setting out a narrative of proved facts. The HOIC does no more than set out what people have said as regards their concerns. The job of the Inquiry is to go on and investigate those concerns. The HOIC will frame that investigation.” It said this these issues were currently under investigation and no findings had been made.

Relevant Clause Provisions

Clause 1 (Accuracy)

i) The Press must take care not to publish inaccurate, misleading or distorted information or images, including headlines not supported by the text.

ii) A significant inaccuracy, misleading statement or distortion must be corrected, promptly and with due prominence, and — where appropriate — an apology published. In cases involving IPSO, due prominence should be as required by the regulator.

iii) A fair opportunity to reply to significant inaccuracies should be given, when reasonably called for.

iv) The Press, while free to editorialise and campaign, must distinguish clearly between comment, conjecture and fact.

Findings of the Committee

35. The Committee noted that both articles presented the family’s perspective on the quality of care the child had received. The first article made this clear through the use of first-person in the first article’s headline – “Blunders in £842m hospital failed my battling little girl” – and further indicated these were the family’s claims in the subheading: “Family claims pet or pool were blamed for infection”. Similarly, the second article’s prominent subheading stated: “Family of tragic girl tell of health hazards on ward”. Both articles also included quotes from family members which had been clearly attributed through the use of quotation marks. The Committee took this into account when considering the alleged inaccuracies, where Clause 1 (iv) makes clear that newspapers can publish comment and conjecture, provided it is distinguished from fact.

36. The Committee first considered the claim, made in both articles, that the child had been misdiagnosed with cancer and treated in the “Schiehallion cancer ward”. The Committee noted the complainant’s position that the child had never been formally diagnosed with cancer, but that she was diagnosed with myelodysplasia – a condition which the hospital said could turn into blood cancer.

37. The publication had had sight of medical documents which referenced myelodysplasia and had put this claim to the Trust, but the Trust had said it was unable to provide an on-the-record statement on this claim. However, both the NHS and Blood Cancer UK websites clearly refer to myelodysplasia as a “type of rare blood cancer”, a reference that the complainant did not dispute in the latter stages of IPSO's investigation. Where the child had received a working diagnosis of a disorder which was described by both the NHS and Blood Cancer UK as a “type of rare blood cancer”, and then was subsequently diagnosed correctly with Pearson Syndrome, the Committee did not consider that it was significantly inaccurate to state that the child had first been misdiagnosed with cancer. The Committee also found that referring to the ward the child was treated in as a “cancer ward” was not significantly inaccurate, particularly where the hospital’s website explained this ward treated “cancer and blood disorders”. There was no breach of Clause 1 on these points.

38. The complainant expressed concerns that the articles claimed the infections had been acquired at the hospital. However, the Committee noted that the first article had set out the complainant’s position on where she may have acquired the infections and had not claimed the infections had been acquired at the hospital. Rather, the article had presented the family’s speculation on the possible source of the infections. The second article reported the child had developed an infection after the “family noticed leaking air conditioning and missing water filters in her room” and quoted the child’s uncle as having said: “We were already very worried about [the child] going into that hospital because of the infections she picked up”. The Committee considered this was presented as the family’s interpretation of events and as such the article had sufficiently distinguished between the child’s family’s conjecture and established fact. The Committee also noted that no one could say for certain where the child had acquired the infections, including the complainant, and that the complainant had not alleged that the mother’s speculation had been inaccurately reported. For these reasons, there was no breach of Clause 1 on this point.

39. The article had omitted the fact that the doctor who referred the child to a specialist had not been working for NHS Greater Glasgow and Clyde when the referral had been made, which the complainant said was misleading. Newspapers have the right to choose which pieces of information they publish, as long as this does not lead to a breach of the Code. In this case, it was not in dispute that there had been delays to the child’s referral as reported in the article and omitting which trust the doctor worked for did not render the article significantly misleading. The article did not report that the consultant who referred the child was working for the complainant at the time and the article also made clear that the complainant disputed the family’s claims about a lack of communication over the referral. The article had also included the complainant’s statement on the issue: “A separate issue regarding referral to a second centre was also investigated and we apologised to the family at the time”. For these reasons, there was no breach of Clause 1.

40. The Committee considered the allegedly pejorative language which appeared in the articles under complaint. The articles were clearly presented as the perspective of the family, and had quoted the mother and uncle who had clearly expressed concern with various issues related to the child’s care. Where the article had sufficiently set out the basis for these characterisations, and Clause 1 does not prevent the use of pejorative or critical language, there was no breach of Clause 1 on this point.

41. Turning to the alleged inaccuracy regarding updates about the child’s infections, which appeared only in the first article, the Committee once again noted that the article made clear that the views presented were those of the child’s family. While the Committee noted the complainant’s position that it had regularly updated the family, the article presented the family’s subjective opinion of whether they were adequately updated on the status of the child’s infections. Where this was clearly distinguished as the family’s view and the article had also included the complainant’s position, there was no breach of Clause 1 on this point.

42. The second article had suggested there was mould in the room where the child had received treatment. The Committee noted that the publication was able to provide evidence that there had been several reported sightings of mould in the hospital, and that the concerns in the article were framed as the family’s concerns with the hospital room. The complainant’s position on mould had also been included at the end of the article. Therefore, the Committee considered that the publication had taken sufficient care to distinguish between comment and fact, and the headline was supported by the text of the article. There was no breach of Clause 1.

43. In regard to “missing” tap filters, the Committee noted that in some clinical settings, filters on the taps are deemed appropriate to prevent infection for very vulnerable patients. The Committee noted the complainant’s position that it did not consider that tap filters were clinically necessary in this specific case and that its statement on the issue was included in the article: “The use of filters on taps is based on a risk assessment”. The article had also reported the mother’s view – clearly distinguished as such – that the taps in the room were not fitted with filters which she believed to be appropriate in her child’s case, given the number of infections from which the child was suffering. The Committee was satisfied that it was not inaccurate, misleading, or distorted to present the mother’s view that these were “missing”, in circumstances where the complainant’s position that filters on the taps were not necessary was also included. There was no breach of Clause 1 on this point.

Conclusions

44. The complaint was not upheld.

Remedial action required

45. N/A

Date complaint received: 14/02/2023

Date complaint concluded by IPSO: 19/10/2023