September 8th, 2019

Lies, damned lies and health statistics: the patient’s guide to pathological politics

杭州桑拿, by admin.

So the doctor says: “I’ve got good news and bad news.”
Shanghai night field

And the patient goes: “Can I have the good news first?”

“Sure,” says the doctor. “You’ll only have to wait 49 days for your surgery.”

“That’s the good news?” The patient is aghast. “It sounds like a long wait.”

“Well, I was getting to that: the bad news. Here in NSW we have the longest waiting times in Australia.”

“Oh, so remind me. What was the good news?”

“Well,” says the doctor, “the waiting times haven’t got any longer for the past three years. Your government has slashed the health budget – and so saved you $725 million and made a total of $3 billion in efficiency savings – and you’re none the worse for it. You’d have to be happy about that.”

“Er, I suppose, Doc, now you put it like that.”

The Australian Institute of Health and Welfare has released the latest of its annual reports, Australian Hospital Statistics 2013-14: Elective Surgery Waiting Times.

It is understood the same report was delivered to NSW’s Baird Government and the Labor opposition. What cannot be understood is their wildly differing diagnoses based on the same evidence.

We are in the incubation period of an election campaign, when the first casualty is typically truth. But we’ll require an MRI to detect which of the following press releases is bull:

“Health Minister Jillian Skinner today congratulated the state’s public hospitals following the release of a report showing NSW was the best performing state for the total combined percentage of surgeries performed on time.”

Versus this from Opposition Leader John Robertson: “[The] statistics show that NSW has the longest elective surgery waiting times in the country.”

The statistics, in fact, do show that … sort of.

NSW tops the pops for the average waiting time for elective surgery – 49 days against 28 for Queensland, 29 for Western Australia, 35 for South Australia and Victoria, and 45 for Tasmania. It gets worse in NSW if you need a knee replacement (290 days against the national average of 194 days); your tonsils removed (233 days plays 99); cataract removal (218 v 79); or hip replacement 191 v 106.

And yet Skinnerreckons: “Today’s report shows NSW is leading the nation when it comes to elective surgery procedures being performed on-time.”

We’re sending that one off to pathology, just to be sure, but it presents as so much bull that there’s steam coming off it. It has to be pathological.

Skinner might resort to the three-kinds-of-lies defence. That is, there are “lies, damned lies and statistics”.

It is true, for instance, that the proportion of people who waited for more than a year for surgery in NSW fell from 2.8 per cent in 2012-13 to 1.8 per cent last year. And it is true that the 49-day average has been sustained for three years while the number of people in surgery has risen.

Skinner: “In 2013-14 there were 216,675 admissions for elective surgery – an increase of 2876 procedures on the previous year. We’re treating more patients than ever before.”

And the Australian Medical Association points out that NSW has the lowest rate of readmission. Better surgery, better care, fewer mistakes.

So we haven’t quite descended to the farce of Yes, Minister, in which patients – per se – were a burden on the efficient running of hospitals; in which a hospital with 500 administrators, but not a single patient, was nominated for the Florence Nightingale award. For hygiene.

But these are early, pre-cancerous days in the toxic election cycle. We’ll need to be vigilant, to subject the press releases to regular scans. If the budget won’t stretch to MRIs, perhaps we could wheel out that trusty old workhorse from Monty Python’s hospital adventures: the “machine that goes bing”.

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