Public trust and accountability for clinical performance: lessons from the national press reportage of the Bristol hearing.

The General Medical Council hearing into events at the Bristol Royal Infirmary resulted in verdicts of serious professional misconduct against three senior doctors. After the longest-running hearing in the GMC's history the press response was fierce. This paper reviews the reporting of the Bristol case (and issues arising from it) in the main broadsheet and tabloid national newspapers (dailies and Sundays) in the 5-week period around the GMC's delivery of the verdicts and subsequent sentencing. The aim was to describe the main themes emerging from the press coverage and to assess the implications for future debates over clinical performance and accountability. Media interest in the Bristol case was intense (184 published items in 5 weeks). The reporting was emotive and largely hostile, raising doubts about not just isolated lapses of care but also the possibility of more systematic failings. Diminished trust and reduced public confidence were recurrent themes, powerfully expressed. Professional self-regulation received scathing criticism, with calls for more public access to individual performance data. Future debates about clinical governance will need to take account of the new public context in the wake of Bristol. Arguments about the relative merits of self-regulation or data-driven performance management systems now need to be played out for a knowing and openly sceptical print media.