Soft Targets

There are times when I think that Labour really deserve a fourth term in government. They are so good at feeding the public misleading information (and the MSM just lap it up too). Take, for example, yesterday’s release by David Cunnliffe of the results of the first annual National Health Targets report (The PDF is here). The Herald gushily reports:

“A nationwide survey of 10 critical areas of the country’s public health system has shown big gains in most areas since last year.”

Oh, puleeeeeease! 1800 more adolescents accessing dental services is a critical area? What is critical about the percentage of babies who are breast fed?  Important, yes – critical, no (unless, of course, you live in China).

As far as I can see, the reporter has taken the media release from the ministry of health and unquestioningly regurgitated it without understanding any of the contents or checking the freely available source document. If he had bothered to read the document, he would have realised that it is a tool for monitoring the bits of health that interest the Labour government. It does not described the state of the nation’s health system in any meaningful way.

For instance, the mental health target is “At least 90 percent of long-term clients have up-to-date relapse prevention plans.” Yes, you read that right. Up to date plans. NOT the relapse rate of mental health patients, which would tell you if the plans were working, just whether they have a plan in place at all. And the current figure is 76% (16% improvement from last year but still short of target – and the target is not even 100% which would be a logical target). Sadly, we don’t know if this target is a useful one because we don’t know the relapse rate of mental health patients.

My personal favorite target is the nutrition one of: “Increase the proportion of adults (15+ years) eating three or more servings of vegetables per day to 70 percent or greater.” Yes, Nanny, I am eating my vegetables, I promise!

The point is that these are very soft targets. They represent little in the way of real-world improvements in the health of our nation. I have no problem with following these types of feel-good targets, but they should be placed against hard targets to see if they are actually achieving anything (like plans placed against actual readmissions and vegetable consumption placed against rates of colon cancer). Secondly, these types of statistics should not be misrepresented as being some sort of snap-shot of our health system. 

The benchmarking report for DHBs April-June quarter (PDF here) was released last month. Although this is a performance report (rather than a health status report), it does tell us something of the real level of function in the public health system. It is nowhere near as pretty as the health target report. For example, 75% of Triage 3 patients (Broken arm, broken leg level of priority) should be seen by a doctor within 30 minutes. The average is 53%. 90% of Triage 2 (Heart attack level of priority) should be seen by a doctor within 10 minutes. The average is 71%. This tells us that the staffing levels in emergency departments are hopelessly inadequate.

Bet you didn’t see that in the news last month did you?

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