TERRY PRONE: Tragic results of decisions being made and turfed over the wall

Vicky Phelan

The point at which the communications people are brought in to any crisis is pivotally important, as is the brief they’re given.

Significantly, the involvement of PR people in the CervicalCheck scandal seems to have happened only at a late stage and the brief was grievously one-directional.

In other words, the expertise of the communications professionals was ignored for a long time and then pointed at the wrong task.

That, oddly, is not to criticise the HSE, not that a little extra criticism of the HSE matters, at this point, one way or the other. 

The problem of late involvement and restrictive briefing is one that happens right across the public and private sector and goes back more than 50 years. It even has a name: Over-the-Wall communication.

The example that surfaces on academic curricula is that of the car the Ford Motor Company couldn’t sell. It was called the Edsel, and it was the ultimate lemon.

It started with the best of intentions, named after Henry Ford’s son, Edsel, as a way to honour a decent bloke who died at a youngish age.

The designers of the car roughed out a shape and “threw it over the wall” to the engineers, who went to work on the transmission and electrics. Then the design got thrown over the wall to the next group, finally ending up with the communications team. 

The communications team, in this case, was the marketing department (remember, PR, in the 50s, was embryonic, so marketing handled everything).

The marketing department was told, in effect: “Make the American public like the Edsel.”

They couldn’t do it. They tried. They spent a fortune on advertising. But the American public looked at the Edsel and said: “You know something? No. You’re grand,” or words to that effect.

Pink, classic Edsel on display at the Pittsburgh Vintage Grand Prix in Schenley Park.
Pink, classic Edsel on display at the Pittsburgh Vintage Grand Prix in Schenley Park. 

As a car, it was a dud. As a communications lesson, it was stunningly good, because it hammered home the reality that you must have your communications people in at the start of the issue. 

Had the Ford marketing team been in when pencil was first put to paper, they could have pointed out that the shape, size, and general approach to the car mirrored a design they — because they were out in the field, talking to real people — knew was fading from favour. 

Not only should they have been present from the outset, but they should have been as highly regarded, as listened to, as any of the other people around the table.

All of which applies to the CervicalCheck scandal. The communications people should have been in from the start, and regarded as equals to the medical professionals involved.

Admittedly, that would have required everybody involved seeing the communications people as more than schmoozers to be sent out to influence media. 

Long before even a discussion of media happened, someone in communication should have been in a position to say “whoa”. To stop the discussion and explain the concentric circles approach to good and decent communication in a crisis.

The concentric circles model starts with the analogy of a crisis resembling a stone thrown into a tranquil pool. One circle after another ensues in the surface water. 

The key question arising is: Which is the first circle requiring communication? The second? The third?

In the case of CervicalCheck, the first circle was patients, the second their medical teams. Media would have come way down the list, and the issue of preventing any patient from going to media to publicise the failure of a smear test would have referred, not to media per se, but to the first circle: Patients themselves. 

The communications people would have been stressing the need to inform patients simultaneously, so that not one single woman would be reached first by a headline.

In that situation, two things would have happened. First of all, the system would have fought back, because that’s what systems do.

They try to protect themselves. So objections to simultaneity on the basis of cost and logistical complications would have been raised.

The job of the communications people, in that context, would have been to point out that this organisation serves the public and, given a failure of service, it ill behoves the organisation to start with issues of cost or reputation.

What is important is to do the right thing, to reach the right person with the right information, in terms they regularly use.

A matching prerequisite of good communications advice within organisations is that the expert in communication is present and contributes to the formation of crucial action plans. That doesn’t seem to have been the case, several years ago, when this cervical check issue raised its ugly head. 

According to the information released last week, the communications people were brought into the issue relatively late (no surprise there) and then given only a specific challenge related to managing the then hidden problem in media.

In Edsel terms, the key decisions were made by professionals expert in a variety of fields, not including communications, and then effectively thrown over the wall to the communications professionals, with a brief that dealt exclusively with media.

The communications experts were demoted, in real terms, to press-relations. 

The sequence will emerge through the inquiry, but it would seem that the primacy of the communications need of that first circle, patients, was not acknowledged and it would also seem that the communications people did not have an opportunity to contribute to a communications strategy that would have started and centred on patients. 

Emma Mhic Mathúna
Emma Mhic Mathúna

The objective was to protect the system from harm and the PR people accordingly worked through the scenarios which might deliver that harm to the system. They did their job as defined by their employer.

But then, if we look long and hard at this issue, interrogating the communication aspects of it, it becomes a pretty fair assumption that the communications people were not brought in early enough — not in terms of weeks or months, but in terms of decades.

Here’s the reality: HSE puts in place a screening system that works. We clear on that? It works. Has worked. Has saved the lives of countless women. Fact.

Pap or smear tests, however, are not 100% guaranteed. They have a failure rate ranging from 10% to as high as 30%. This was known when the system was put in place. 

If communications people had been consulted at that point, they would have, or at least should have, said: “We need to put a strategy in place to alert women to the fact that some slides got mis-read. Understanding that will not rob them of faith in the system. It will give them the tools to understand risk and risk management when it comes to this cancer.”

It didn’t happen. Instead, right up to the eruption of the scandal, the communications people were regarded only as media schmoozers and the priority was to protect the system. 

Decisions were made and turfed over the wall. With tragic results.

More on this topic

Taoiseach intervenes to ensure all women impacted by CervicalCheck scandal get €2,000 ex-gratia paymentTaoiseach intervenes to ensure all women impacted by CervicalCheck scandal get €2,000 ex-gratia payment

Varadkar to ensure all women impacted by CervicalCheck scandal receive €2,000 ex-gratia paymentVaradkar to ensure all women impacted by CervicalCheck scandal receive €2,000 ex-gratia payment

CervicalCheck: 'I feared legal action after letter' - Lorraine WalshCervicalCheck: 'I feared legal action after letter' - Lorraine Walsh

Department of Health blocks €2k to Cervical Check victimsDepartment of Health blocks €2k to Cervical Check victims


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