The quality of Australian health journalism is important for public health

The print media in Australia has recently experienced a sudden and extensive loss of experienced journalists. By the end of 2012, 148 editorial staff at four major Fairfax publications had announced or confirmed their departure in the wake of redundancy offers.1 The Media Entertainment and Arts Alliance estimates that, together with recent job losses at News Limited (now News Corp Australia), the result is that the major newspaper companies shed one in seven journalism jobs during the winter of 2012.2

It is nothing new that seismic shifts in the workforce occur in the wake of technological change, financial crises and the collapse of traditional business models. The shift from print to digital media was widely foreseen as a threat to print journalism, but it is increasingly accepted as inevitable. There is disagreement about the potential impact of these job losses on the quality of journalism in Australia, however. Fairfax issued reassurances that quality will not be affected,3 whereas some departing journalists were less optimistic.4 We argue that the quality of journalism is an issue of concern for the health sector because journalistic expertise and experience play an important role in communication about health and health care, and in political life more generally.

Notwithstanding the global shift to various forms of online media, the established mainstream media (ie, newsprint, television and radio, and the online products evolving from these) continue to play an important role in the lives of most Australians, including health consumers and health professionals. Both lay people and experts often first learn about medical advances through the mainstream media,5 and health news can have a greater influence on public health-related expectations and behaviour than high-budget, government-sponsored public health campaigns.6 The media influences the use of health care interventions,7 and shapes perceptions of health and disease in far-reaching ways.6 It is therefore unsurprising that powerful interests actively seek to influence media content and the media agenda.

The influence of commercial interests on the media is exerted overtly through advertising, ownership and explicit declarations of editorial support for particular political parties, causes and interests (such as mining). Industry influence is exerted more subtly through editorial decisions about content and through other strategies that are often not obvious to readers. Industries commission and publicise research that emphasises the benefits of their products. They fund consumer and community groups that are likely to have an interest in their products and services (so-called astroturfing). They routinely pay or otherwise reward expert opinionmakers and fund the production of “educational” materials for professionals. Industries also produce their own media content, including slick media video clips that are ready to go to air.

All of these strategies have been reported in the health literature,8 and their significance is all the greater given the increasing influence of consumerism in health care, the increasing pressure on media outlets due to declining advertising revenue, and the increasing reliance of health and medical research on private sources in the wake of declining government funding for universities.

Governments are also becoming increasingly adept and sophisticated at influencing the mass media, and dedicate the considerable resources at their disposal to “managing” media content and agendas by methods, popularly known as the art of “spin”. Ministries have sprouted new roles and departments that exist solely for this purpose: platoons of media consultants and public relations officers have become an established feature of the political landscape.

Good journalism matters because it is a bulwark against both industry and state influence over media content and agendas. While the meaning of “good journalism” is open to interpretation, three values are crucial for maintaining a healthy media in the context of powerful influences: accuracy, independence and a critical outlook.

Accurate health journalism helps Australian consumers make informed choices by exposing fraudulent or exaggerated claims about health products and services, by informing them about effective products and services, and by countering disease mongering.9 A well informed public is also vital to the proper functioning of a modern democracy; and in democratic countries like Australia where the state is a major funder of health services, it is particularly important that the public have accurate information, as they can have a significant influence on the public health system through the ballot box and through direct participation in deliberative processes.

While some health reporting in the mainstream media undeniably fails the test of accuracy, it has also been shown that reports about health interventions in the less sensationalist newspapers are more accurate and complete than reports in other media, including online news outlets.5 Given that the loss of journalism jobs affected some of the highest quality newspapers, there is clearly cause for concern about their effect on the future quality of health reporting in this country.

An independent media draws attention to issues that powerful interests might prefer hidden. We can and should question what “independence” means when most journalists in Australia are employed by a few large corporations. Most journalists would claim they are independent no matter who employs them. While this claim is open to challenge, at least readers know who is “paying the piper”, and that media corporations have some investment in the notion of good, independent journalism. (As the News of the World scandal shows,10 when journalism fails to meet basic ethical and legal standards, media proprietors will go so far as to shut down a media outlet to control the damage to their brand.) If media content is increasingly produced by sources other than journalists, in future it will be more difficult for readers to know what commercial interests lie behind the reportage.

A critical media serves as a watchdog on behalf of the public interest. Public interest journalism is a longstanding topic of discourse and debate among Australian journalists, and acting in the public interest is a principle that is widely upheld by experienced members of the profession.11

We need journalism as a profession to uphold these values. Journalists are trained to be accurate, independent and critical. They acquire investigative skills through training and experience and build extensive networks of contacts. Specialist health journalists and editors gain an extensive understanding of the complexities of our health system; but since the health of the Australian public is affected by policy decisions and developments in sectors other than health, the quality of Australian journalism more generally is also a potential concern. In short, the experience, knowledge and skills of professional journalists are vital for exposing conflicts of interest created by industry influence and holding governments accountable for policy decisions across all sectors that affect the health and wellbeing of Australians.

We should not assume that we are witnessing the end of good-quality journalism in this country. The effect of the recent job losses on the quality of journalism in the longer term in Australia will depend on several factors. One is the degree to which the emerging online media environment provides opportunities for accurate, independent and critical journalism. Recent initiatives in Australia such as The Conversation (http://theconversation.edu.au) and Croakey (http://blogs.crikey.com.au/croakey) are notable in this respect. In effect, they provide opportunities for health experts to collaborate with professional journalists in the production of media content, with journalists playing a curatorial role.

The ongoing involvement of professional journalists in emerging digital platforms is important because, while there is much to be said in favour of citizen journalists and public intellectuals, most health experts lack the investigative skills and extensive networks of the professional journalist, and they have not necessarily developed the important ability to both engage powerful interests and manage the influence that inevitably attaches to doing so. An important question for emerging models of online journalism is, therefore, how can journalistic know-how be transferred to a new generation of content providers who are not organised into a profession? Such providers would not have developed an ethos that supports the values of accuracy, independence and criticism, and would not have — and might not even value — access to the education, training and mentoring through which practical skills and professional values are passed on by experienced practitioners.

It seems likely that some of the existing journalistic expertise and experience that has been shed by the Australian print media will be redeployed in emerging online platforms that provide opportunities for good journalism. It seems equally likely, however, that some of it will be redeployed in industry and government public relations jobs that provide a more reliable source of income. At this point we can only speculate about where the balance lies, and what the long-term effect will be on the quality of Australian journalism. Either way, the quality of journalism is an important issue within the health sector. The health professions should take an interest in the emerging media landscape, and take an active interest in ongoing debates about the goals and values of journalism — that is, what good journalism means, how it is produced, and how it can remain independent from powerful commercial and state interests.