Commentary: Lack of Transparency at DHHS is a Public Health Problem
When communication breaks down, it’s more than just a political problem.
This commentary is also published in the News & Observer
By Rose Hoban
Recent media reports have highlighted large salaries and raises given to young Department of Health and Human Services staffers who worked on Gov. Pat MCCrory’s campaign. But what’s been less noticeable to the public has been a shutdown of the lines of communication between DHHS and reporters.
Reporters and press liaisons – in both government and industry – are often at odds with one another. Press officers want their message out, while reporters may be looking for something less flattering lurking behind the press release.
In close to a decade of reporting on health care in North Carolina, I can recount many times when DHHS press officers were reluctant to release unpleasant information – such as the federal government’s decision to withhold Medicaid payments to several state psychiatric hospitals in 2008. The joke around the office was that we needed to look for bad news about the Division of Mental Health at 6 p.m. on Fridays, a time that would ensure the news would be lost in the weekend news cycle.
I also can tell stories of seasoned press officers helping me pull paper files on abusive adult care homes at the Division of Health Services Regulation, supplying me access to former secretaries in order to ask pointed questions about policies and arranging for me to tour the new Central Regional Hospital to see conditions there, inviting me to follow and question the former HHS secretary as he toured a clinic. My list goes on.
Inherently, the relationship between reporter and press liaison includes tension – but the important thing is that relationships do get built.
But the closing of the lines of communication between DHHS and reporters in the past six months has been troubling. Ricky Diaz, the lead press officer at DHHS, has been quoted in many stories about issues in his department. But many reporters have voiced concern about the extended time it takes them to get responses to requests for information – if they get a response at all. And while Diaz may be quoted, there have been few opportunities for exchanges between Secretary of DHHS Aldona Wos and other leaders in the department.
Recently, The News and Observer reported that one of its employees was blocked by a “bodyguard” while attempting to ask Sec. Wos a question. <http://projects.newsobserver.com/under_the_dome/dhhs_secretary_wos_speaks_on_freedom_not_health_care_at_womens_club> And departmental employees were told to call the police if activists who were bringing petitions to DHHS’s Dorothea Dix campus stopped any employees or entered any of the department’s public buildings.
At NCHN, we have had most media requests denied or unanswered since we ran a story in May that painted Sec. Wos in an unflattering light. We have resorted to making many requests in the form of open records requests with legal language that essentially compels the department to answer or face the prospect of litigation.
While this might just sound like a reporter grousing, the lack of transparency, the increasing suspicion on both sides and the frayed relationships could have deep ramifications – especially in the unfortunate event of a disease outbreak.
Gene Matthews, who was the lead counsel at the Centers for Disease Control and Prevention for more than two decades, said he believes public officials stonewall the media at their peril. “If you want the public to trust you in an emergency, you have got to be transparent on the normal days, build your credibility when the sun is shining,” he said.
“People get much more suspicious in an emergency, when the dark clouds are around,” Matthews said. “The communication is more difficult. So you’ve got to demonstrate integrity and transparency ahead of time.”
Several years ago, DHHS press officers worked with me during a joint effort by the Association of State and Territorial Health Officers and the Association of Health Care Journalists to create guidance for state health departments for reporting deaths during an outbreak. Last year, when a baby in Forsyth County died from pertussis, DHHS press officers overcame prior reluctance and reported the age, gender and town of residence of the baby.
The result? No reporters tracked down a grieving family, because they had the information they needed. Instead, numerous outlets cooperated with DHHS to disseminate a strong prevention message. It was a win for everyone.
Matthews said he learned the hard way at CDC that when those relationships are frayed, the public health message can easily get lost, “and the blame game is accentuated.”
The governor has the right to appoint people loyal to him: “Elections have consequences,” they say.
But if, God forbid, there were to be some kind of outbreak of disease in North Carolina, the profound lack of trust that has been created between DHHS and members of the media could have the kinds of consequences that none of us would like to see.
Telephone image courtesy Zigazou76, flickr creative commons