An Investigative Review into the process of establishing, managing and supporting Independent Reviews in Scotland

An Investigative Review into the process of establishing, managing and supporting Independent Reviews in Scotland, with particular reference to the Independent Review of Transvaginal Mesh.

Chapter 10: The management of external influences

331. The origins and nature of many reviews are likely to make them the subject of public, media and political attention. Many of those who agree to become members of a review will not be used to encountering such high levels of scrutiny in their lives. In addition, political interest may mean that a review member will have to engage with politicians, or be called to appear before a parliamentary committee to give evidence.

332. The cornerstones of any review are to restore public confidence and to ensure that lessons are learnt which will inform future practice.[148] Public engagement is therefore a positive and useful element of a review since it can provide feedback and benchmark progress. Use of various forms of media is the primary way to impart the progress and outputs of a review. However, media portrayal can spill over into the review member’s private life leaving them apprehensive or, worse; become a violation of their own and sometimes their family’s privacy.

333. Political interest also relates to the restoration of public confidence. However, such public and political interest may not always be mutually compatible. Independent reviews can sometimes be seen as a cynical mechanism to deflect criticism and controversy.[149]

The Mesh Review

334. A few members commented on the negative influence of external factors, primarily the media and the Public Petitions Committee of the Scottish Parliament. One noted that the involvement of the Parliamentary Committee made the Review “different”.

They went on to state that since it was a petition which was concurrently being considered by the Public Petitions Committee it changed the focus from being about evidence to one of “the politics of the topic.” They also stated that they assumed there was a certain degree of political pressure being exerted on the process. Others alluded to competing interests; namely the Cabinet Secretary, the Public Petitions Committee and individual political interest, commenting: “We seemed to have three masters.”

335. Both chairs and several members of the Mesh Review were called to give evidence to the Public Petitions Committee. For the majority, this was their first time before a Scottish Parliamentary Committee. One member described feeling “brutalised” by the way the questions were asked by Committee members. Others felt that the Chair of the Public Petitions Committee did not sufficiently intervene to ensure that those called to give evidence could do so without interruptions from the public gallery.

“As soon as I got out of the [parliament] building I got quite emotional … but I can’t really talk about it without getting emotional now.”

336. Given the origins of the Review in a petition to the Parliamentary Committee, it is unsurprising that the subject matter attracted political and public attention. However, the environment in which members had to give their evidence was neither conducive nor appropriate. Aggressive questioning from some members of the Public Petitions Committee, coupled with a full public gallery who were shouting, clapping and gesturing provided a poor environment for members of the Review to engage. Some members who attended were inexperienced and not prepared for what giving evidence entailed. It is recognised that this was an intense and emotional experience for those in the public gallery, but their right of attendance should not have been used as an opportunity to harangue those being questioned.

337. Many members described intrusive behaviour via the media due to their involvement in the Review. They also described the anxiety that such intrusions caused.

The participants recounted examples in which both they and family members (including their children) were approached by members of the media who were making enquiries about the report. This uneasy relationship with the media attention was often exacerbated by a perceived lack of support from the Scottish Government as to how to deal with such queries.

“We got put out there and we got subject to all this media because I was asked to be part of this Group. I went into this Group to try and sort out working practices in Scotland. I’ve made nothing from it, but I’ve lost a lot. Never again.”

338. Most members were unprepared to deal with the scale of public and media attention. Some contacted the Scottish Government when approached for comments by the media and some received certain advice whilst others didn’t. Some approached other agencies for assistance.

339. There seemed to be confusion over the Government’s perception of their independence versus providing adequate support to members of the Review:

“Their argument was that you are independent, if we get involved, you stop being independent.”

340. The whole process seemed haphazard and inconsistent. Some members were concerned with levels of what they regarded as invasion of their private lives for example, when journalists approached their homes.

341. It is important to recognise the right of journalists to ask critical questions of individuals who have been involved in reviews into matters of public interest. This is a cornerstone of freedom of expression in a liberal democracy. Equally, we recognise the right – and the duty – of MSPs to raise, in parliamentary proceedings, the interests of their constituents. However, the media and parliamentarians have a responsibility to examine and report on the work and findings of independent review groups in the spirit of fair, reasonable and constructive scrutiny. This does not always appear to have taken place in this case.

Reflections on having been a member of the Mesh Review

342. It is difficult for us to adequately describe the spectrum of emotions that we encountered from those that we met. The majority of members expressed strong, negative reactions towards their involvement in the Mesh Review. This was a combination of factors revolving around interpersonal conflicts within the group, politicisation of the review process, and treatment by the media. They felt totally unprepared for the levels of public and political scrutiny that they received. Some felt traumatized in the aftermath of the publication of the Final Report.

“I have to say that afterwards I thought I would be extraordinarily surprised if any of my peers would ever take anything on like this again.”

“It was terrible, terrible, terrible.”

343. This is a long way from the public spirit, and optimism expressed from members when they initially agreed to be part of the Mesh Review.

“I was probably too keen to be helpful and I should have said no. I mean in a lot of ways, I do wish I had said no. It was a horrendous experience.”

“Nobody has gone in with an ultimate motive or agenda. You go into this process hoping you are going to do the best for the patient and come out with a reasonable recommendation, but of course different people will have different opinions of that outcome but in retrospect the individuals need to be protected.”

344. Many members stated their regret at joining the Mesh Review and indicated that they had no intention of being involved in another governmental review in the future.

Members also suggested that governmental reviews will soon struggle to find expert members to chair and participate in such review processes if their experience was typical of how members involved in such reviews were treated.

“I suspect anyone who had chaired a Review before would absolutely not do to again! Such a poisoned chalice!”

345. Another noted that it was the fact that it was made so personal:

“You were always going to get a backlash to a Report but it’s a backlash to the individual that had not been anticipated.”

346. Those responsible for commissioning the Review should have given some consideration from the beginning, to the levels of interest that the subject matter of the Review would generate. This should have been discussed with all members of the Review, including the chairs. There was a lack of preparation or understanding over the potential level of scrutiny that the Review would attract.

347. The media interest was arguably made more intense due to questions which arose around the independence of the review process and membership resignations. Had these been addressed and resolved at the time, subsequent media interest may have been diffused or lessened.

348. The success of any review is dependent upon its members. It relies on their goodwill and citizenship to give to their time, usually alongside other commitments. They need to believe they can successfully undertake and complete their role. The comments that we received when members reflected on their experiences were highly concerning. Rather than their membership having enhanced their professional expertise and knowledge, it has left them emotionally traumatized and their confidence eroded. This resulted in many members reluctant or refusing to consider undertaking a similar role again. Everyone we spoke to agreed that there had to be a better way to commissioning, managing and reporting on an independent review. It is hoped that this report can be the starting process to identifying that better way.

We recommend that if there is reason to believe that the subject under review will attract media and wider public interest, there should be support and media training for both the chair and members of the review.

We recommend that training should be provided and reassurances given to members that advice and support to manage media scrutiny is available.


Email: David Bishop

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