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Last Updated: Friday, 31 March 2006, 21:05 GMT 22:05 UK
Response to the Lancet
Sunday 2 April 2006
22:15 GMT on BBC One
Online at bbc.co.uk/panorama

The Lancet has today published a number of significant allegations about this coming Sunday's Panorama programme, unaware of its actual contents and the considerable care that has gone into its production over many months.

  • Panorama has been engaged in extensive communication with the Bradford Teaching Hospitals NHS Foundation Trust on the matters raised by our research both on and off camera over a period of more than nine months.

  • We would welcome public debate about the issues of public policy and patients' rights raised by the programme. The trust have suggested that this should have taken place prior to broadcast. We believe this public debate will be informed following the transmission of Panorama's programme - The Hospital That Failed Women.

  • Bradford Teaching Hospitals NHS Foundation Trust has been provided with the contents of the statistical research featured in the programme. The findings have been clearly put to the trust. We are more than satisfied that the hospital has all the information it needs to be able to respond publicly to the film.

  • We believe the primary responsibility for addressing concerns raised about the treatment of patients lies with Bradford Teaching Hospitals NHS Foundation Trust. Bradford have had possession of Prof Coleman's report and its findings since July 2005. The report was reviewed by Dr David Spiegelhalter who conducted significant work in relation to the Shipman and Bristol inquiries. The hospital has had Dr David Spiegelhalter's final commentary since before Christmas. Following transmission we would be happy to discuss with the Healthcare Commission how we might help them pursue this matter.

With reference to the Lancet's press release we would make the following points:

  • Re point one - the programme reports that by the early 1990s there was international recognition that most women who had breast conserving surgery should receive radiotherapy. (We would refer you to the National Institute of Health Consensus Statement which was published in 1990.)

  • Re point two - Panorama focuses on the efforts of a medical team not one surgeon. The surgeon referred to in the Lancet was part of that team but Panorama makes clear what that surgeon - through his lawyers - says were, and were not, his responsibilities.

  • Re points three and four - Prof Coleman's report has been reviewed by Dr David Spiegelhalter who advised both the Shipman and Bristol heart inquiries. Dr Spiegelhalter tells the programme that he does not regard Prof Coleman's report as "bad science" as the hospital and Sheldon contend. Dr Spiegalhalter who has since seen Sheldon's review has since told Panorama that he regards Coleman's report as a good job on the data available and "comparable to the analysis carried out for the Bristol and Shipman inquiries". Dr David Spiegalhalter agreed that the hospital had low radiotherapy referral rates (as part of BCS) and was an "outlier" until the late 1990s.

  • Re points five and six - the programme reports that mortality data alone cannot be used to make definitive judgements about the quality of medical care but that it does provide leads to follow up. The programme draws no conclusion that excess mortality was caused by low radiotherapy rates. It is worth pointing out that the hospital has only ever provided Panorama with extracts of a letter from Professor Richard Lilford. Dr David Spiegalhalter said that there was evidence of excess mortality but it is this that he said needed to be treated cautiously.

Finally, we can all agree with the hospital's sentiment that the data we are now putting into the public domain should not be the "endpoint in investigating quality of care".

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