Original

Commentary

[1] Hello,

[2] Thank you for getting in touch again about the Panorama programme Private ADHD Clinics Exposed and please accept our apologies for the delay in our response.

[3] Due to the number of comments we have received from people contacting us a second time, we are again providing a single response which will address the key issues.

[4] Many of those who contacted us a second time continue to believe that the programme was damaging to the ADHD community, including those who have received a private diagnosis of ADHD or anyone who might be considering seeking a private assessment.

[5] This is something the Panorama team considered very carefully before and during their investigation, engaging with colleagues across the BBC as we would any story about public health which concerns alleged wrongdoing on the part of healthcare providers. They also consulted experts in the field, including clinicians running specialist adult ADHD services.

[6] The closing credits of the programme advise that “If you are affected by any of the issues in this story you can visit BBC Action Line” and two online stories also link to the action line, taking readers to support services.

[7] Moreover, the programme made clear that many of those who are diagnosed with ADHD by private clinic will have the condition. The issue the programme highlighted was that unreliable diagnoses can cause problems for both the individuals that receive them and the clinicians seeking to treat them in the NHS. This is particularly the case when people are prescribed medication as a result.

Summary: BBC claim that they have applied sufficient effort to balance out the potential harm from the output by consulting within the BBC and externally with ADHD clinicians as well as by providing closing credits advisory. They also provided statements that private diagnoses are valid [4-7]

BBC Guideline(s): BBCG Section 1.2 - Editorial Values BBCG Section 1.3 - Public interest

Argument(s): A02. Direct Harm / Lack of Careful Consideration A16. Justification of Public Interest

Notes: “We consulted some people, added a few bits of text at the very end that barely anyone reads and online stories that don't have nearly the same reach, made clear that many private diagnoses will be correct so we're good”

[8] It has been suggested that the programme should have highlighted the positive experiences that others, including a small number who spoke to our reporters, say they had when they approached private clinics, or that there was insufficient exploration of what life is like for those living with the condition.

[9] Our programme does not gainsay these experiences, or the important role that these clinics play in diagnosis given the considerable problems getting an NHS assessment and the length of those waiting lists.

[10] However as we said in our previous response, that does not deny the importance and validity of what was a focused investigation.

Summary: BBC claims that whilst it’s not dismissing the positive experiences of others and doesn’t gainsay the difficulties people with ADHD face but it felt that mere presence of those issues doesn’t deny the importance of the output investigation [8-10], [24-26]

BBC Guideline(s): BBCG Section 4.3.2 - 4.3.8 - Due Weight, Impartiality, Controversial Subjects BBCG Section 3.1, 3.3.1, 3.3.8 - Accuracy, Gathering Material, Statistics and Risk (3.3.5, 3.3.6 Supporting)

Argument(s): A03. Lack of positive representation / ADHD voice + omitting testimonies

Notes: “We focused on the investigation, don't deny positive experience" and "Why speak of your problems and struggles when we can spew sensational crap with no care of how it'll affect you, let us focus on dismantling THE ONE thing that is a viable option for you to get out of it. Tough luck. Oh and we also linked to it online, which is totally comparable and absolves us of everything" respectively.

[11] Indeed it is the scale of involvement of private clinics in this process, and our findings when we came to investigate these serious and specific allegations, which go to the heart of why there was a clear public interest in reporting our findings.

[12] We then did so in accordance with the BBC’s Editorial Guidelines, including those on due accuracy https://www.bbc.co.uk/editorialguidelines/guidelines/accuracy and due impartiality, rather than balance, which say the journalism must be adequate and appropriate to the output and that we give due weight to events. https://www.bbc.co.uk/editorialguidelines/guidelines/impartiality

Summary: TODO ****[11-12]

BBC Guideline(s):

Argument(s): Breach of BBC’s Editorial Guidelines

Notes: "We chose accuracy and impartiality foregoing balance”

[13] Some of those contacting us again have also suggested that the programme presented the NHS assessment our reporter underwent as a typical NHS assessment, alleging that it is not, or suggesting that Dr Mike Smith had prior knowledge of the details of our investigation and so this compromised the comparison between the approach of the NHS service and the three private clinics.

[14] For the avoidance of doubt, Dr Smith was not aware of the programme team’s plan to film undercover when carrying out his assessment of Panorama’s reporter and had no contact with the reporter in advance of the assessment.

Summary: “Dr Smith was not aware of the programme team’s plan to film undercover when carrying out his assessment of Panorama’s reporter and had no contact with the reporter in advance of the assessment” [13-14]

BBC Guideline(s):

Argument(s): A04. NHS Clinician Dr. Smith Bias and Inadequacy of comparison

Notes: This one is very sinister, look at the wording. They say "was not aware of the plan to film undercover” - referring to private clinics, not the NHS filming. They also specify that only the reporter didn't have contact, omitting the rest of the team which might have (AND MUST have as per @section

[15] Dr Smith has been working in the area of developmental disorder for over a decade, including as the current lead clinician at a specialist NHS service for adult ADHD. Dr Smith has conducted - as well as supervised - numerous ADHD assessments in adults. There are no grounds to suggest that Dr Smith was not an independent evaluator. He conducted a thorough, impartial and objective assessment, with the programme making clear that they had engaged an NHS specialist to demonstrate how these assessments should be carried out. We did not say this was a typical NHS assessment, as assessments can vary across the health service. However, it was typical of the assessments Dr Smith conducts at his clinic and provided the audience with an example of how a quality assessment is carried out.

[16] As the programme and online articles made clear, this process is governed by the guidelines issued by the National Institute for Health and Care Excellence (NICE). We found strong evidence that while the NHS assessment had followed these guidelines, the private clinics had not.

Summary: “Dr Mike Smith does the assessments this way and it's NICE-compliant. We also didn't say it's a typical assessment and it can vary across the NHS but it's impartial either way” [15-16]

BBC Guideline(s):

Argument(s): Presented NHS assessment not being a typical representation of such

Notes:

[17] There are also no grounds for suggesting that Panorama’s reporter faked his symptoms, or used false Facebook profiles to pretend to be a woman during his research. As our previous response pointed out to those who raised these allegations, the reporter gave honest answers to all of the questions about symptoms during his assessments at the three private clinics, while a female member of the production team joined some groups using her real name and Facebook profile. The programme team always made it clear when they were approaching people – whether on Facebook or elsewhere – that they were working for the BBC on a programme about ADHD.

Summary: TODO ****[17]

BBC Guideline(s): BBCG Section 7.3.7 - Vulnerable Contributors BBCG Section 1.2 - Editorial Values BBCG Section 6.3.1 - Contributors and Informed Consent

Argument(s): A13. Panorama reporter lying / misrepresenting the condition A18: Undercover work in closed Facebook groups

Notes: "You can't prove anything lol, trust us”

[18] Some of those contacting us have taken issue with the programme’s use of the description “powerful drugs,” or say that the issue of medication was not sufficiently explored.

[19] Our wording reflects the fact that each of the clinics featured in the programme offered Panorama’s reporter stimulant medication, a controlled substance under law which has a number of serious side effects, particularly in relation to the weakening of the heart, which can increase the chance of seizure, stroke and heart attack.

[20] In addition to those with a history of heart problems, ADHD medication is particularly dangerous for those with complex mental health problems including bi-polar and certain personality disorders. These conditions often present very similarly to ADHD, and can involve some of the same symptoms. According to the experts Panorama spoke to, this heightens the need for thorough and reliable assessments, which minimise the risk that other conditions will be missed.

[21] Although Dr Smith summed up these concerns in the programme, we nevertheless sought to present a nuanced picture in order not to cause unnecessary alarm, setting out that these drugs are the standard treatment for adults with ADHD and would be safe for the majority of people if properly prescribed.

Summary: “Stimulants are controlled substances and can be dangerous to people with heart conditions and other ADHD-adjacent mental disorders”

BBC Guideline(s):

Argument(s): Fear-mongering around stimulant medication and "powerful drugs" term usage [18-21]

Notes: Another sinister one. They word it so well here in their written response, but the episode is riddled with provocative uses of the term and the term itself is far from best for describing controlled substances

[27] We believe most viewers would understand what is an established approach from a long-running current affairs programme, although the various points which you and others have raised have been discussed in detail with the team, and circulated internally on our audience log.

[28] We hope this reply addresses your concerns and thanks again for taking the time to contact us.

[29] This concludes Stage 1 of our complaints process. That means we can’t correspond with you further here. If you remain unhappy, you can now contact the BBC’s Executive Complaints Unit (ECU). The ECU is Stage 2 of the BBC’s complaints process. You’ll need to explain why you think there’s a potential breach of standards, or if the issue is significant and should still be investigated.

[30] How to contact the ECU:

[31] We’ve provided a unique link for you in this email. This will open up further information about how to submit your complaint. You’ll be asked for the case reference number we’ve provided in this reply. Once you’ve used the link and submitted your complaint, the link will no longer work.

[32] This is your link to contact the ECU if you wish: