Why does Reporting Scotland’s ‘dysfunctional’ breast cancer department have ‘average’ death rate?


Should read: ‘after BBC attack’

In fact, the department looks ‘average’ and by no means ‘dysfunctional’. See the statistics below.


On the evening of April 1st, Reporting Scotland said of NHS Tayside’s Oncology Department at Ninewells in Dundee:

‘The report today pointed to the possibility of a dysfunctional department. ‘Detectives’ spoke of pharmacy and nursing staff who said they had concerns about the change of procedures, but they felt they were not being listened to.’

Only Reporting Scotland used the word ‘dysfunctional’. The BBC website and all the papers I looked at (8) did not use the term. Though only 14 out of the 304 patients (4.6%) who received the reduced-dose therapy, to reduce terrible side-effects, are being investigated, NHS Tayside have been bullied into a review just as NHS Glasgow were over pigeon poo-related infections.

Reporting Scotland did not think to look for any contextual evidence to support their accusation of the department being dysfunctional. Given the potential anxiety-inducing consequences for hundreds of patients of using that term, I suppose they didn’t care.

Some time ago, I had an exchange with a Reporting Scotland editor who told me it was all very well for academics go on about peer-reviewed sources of evidence. I just didn’t understand journalism. Maybe he felt they were working so fast and to tight dead-lines, that it was unreasonable to expect them to spend hours poring over the evidence. This took me ten minutes to find.

rates headers




There are three useful ways of measuring these rates, used by scientists world-wide. In all three, NHS Tayside has an average rate of mortality per 100 000 persons, for its breast cancer patients and lower than for some other (dysfunctional?) health boards:

Measure          NHS Tayside    Scotland          NHS Grampian  

EASR                  18                            17.5                   19

WASR                8.3                             7.8                   8.6

SMR                   101.1                        100                  108.4

These are not statistically significant variations in a total sample of 424 deaths, in NHS Tayside, over a period of 5 years.

So, NHS Tayside is just average, but BBC Reporting Scotland can only dream of such success.




5 thoughts on “Why does Reporting Scotland’s ‘dysfunctional’ breast cancer department have ‘average’ death rate?

  1. Brian Powell April 6, 2019 / 10:25 am

    The BBC is the perfect UK corporate body, presenters getting a couple of hundred grand a year for doing absolutely minimum of work.

    Liked by 1 person

  2. anne April 6, 2019 / 1:02 pm

    Wait for the full details to emerge. So far this sounds like a problem with medical ethics re ‘informed’ consent (‘informed’ being an oxymoron where breast and other cancers are concerned, because we dont have the knowledge as yet to predict individual outcomes accurately). Were these women given the choice of dose level together with an evidence-based likelihood of a worse outcome?


  3. Alasdair Macdonald April 6, 2019 / 1:07 pm

    When my late brother in law was being treated for cancer, I used to ferry him to and from Ninewells Oncology Department. He always said he was well treated and dosages were discussed with him. He had medications for other unrelated conditions and, so dosages of the various prescribed drugs had on occasions to be varied depending on stages of treatment and, even transient things, such as when he had ‘sniffles’.

    For a number of years now, my own GP surgery has routinely discussed dosages with me. For example, I am on a small dosage of blood thinners and, about a year ago, I sliced the tip off a finger while slicing a tomato! As I had difficulty getting the bleeding to stop I had to go to A&E, where there were two other men, one a professional chef, with the same injury! In my case, the A&E staff, immediately discontinued my blood thinner and instructed me to resume after 10 days. So, dosage variation is a sensible practice.

    Liked by 1 person

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