Does the rorting of health statistics mean anything to you? [With poll]

Considering the Rhodium thieves barely got a wrist-slap for their crimes, I doubt much will come of this one.

johnboy said :

5% of the records is a huge amount when you consider they’d only alter the adverse entries.

And indeed for serious cases my understanding is the altered records was closer to 20%

You need to go and read the report,
“Audit estimates that in the latest twelve months for which records have been examined (April 2011 to April 2012), the Canberra Hospital’s ATS Category 3 results (i.e. achievements against the target) were overstated by at least 19 percent, and ATS Category 4 results were overstated by at least 10 percent. This involved changes to at least 5,800 patients records out of total of 43,000 records in one year for these two triage categories.”

The 11700 figure comes from all categories, over 3 years (with over 300k entries per year). And note there is a difference between “overstated” and “altered”.

Anyway, my point was that regardless of the extent of the changes made, the lack of security is a bigger worry. When the auditor can’t identify who has logged in when (or even if they were authorised to do so), what faith can we have that confidential records are secure. If there is a culture of using generic logins then what faith can we have that people who are not accountable don’t have a bit of a poke around in the records just because they can.
If the “executive director of critical care” thinks it is okay to have a security system like this, and it is okay to fiddle with the records, does her attitude infect all the staff working there. How can we believe any assurances from others within the same system that it doesn’t.

The fudging of the numbers worries me a whole lot less than the lack of security identified in the report. When a department in charge of private medical records sees it as normal that they use a generic login (with no limits on who has access through that login) then there are much deeper problems than an alteration to treatment times on less than 5% of the records.

http://www.canberratimes.com.au/act-news/data-scandal-threatens-funds-20120704-21hvg.html

Hospital funding should not be linked to how fast emergency patients are seen. Surely if a hospital is struggling to meet patient demand stripping funding from that hospital is a ridiculous response to its struggles.

VP@#11

Love it!!!

The fact remains that the system rewards good performance, with hard to earn cash, whilst poor performing systems are denied financial assistance.

Way to go!! 🙁

Those that need the dollars are denied it, and the reverse applies.

Our political overlords have decreed that this should be the way it works. Cannot someone with both a brain and some political clout point out the stupidity of this system?

We have a system which certainly does wonders in the ED. But any additional funding, which would reduce waiting times, depends on the medical personnel performing miracles with the resources given them. I can appreciate the pressure subtly applied to all levels of the ED medical workforce to display dollar earning performance.

Given the leakiness of the ACTPS, I’m sure we will soon be privy to a note from on high to the medical team to ‘give us some good figures’.

Having said that, the whole debacle comes down to a scheme dictated by the Feds, and Govco doing their best to maximise income for health.

davo101 said :

eh_steve said :

Investigations need to be made nation wide I reckon, as by many accounts this sort of practice happens everywhere.

No kidding. Does anyone think this is not happening in every other jurisdiction? Once you tie pay, funding, career progression, etc to a performance metric you create an incentive to game the metric. You can just change the numbers, as done here, or change the way you operate. Giving each patient an aspirin and sending them home would get the average wait time way down (and the throughput would go up because when they come back they’re another patient).

Exactly the same thing is happening with NAPLAN: give the kids the answers, drill them for the test and ignore the rest of the syllabus, tell the dumb kids to stay home on the day of the test, etc.

The Freakonomics guys have dozens of examples where this sort of thing has been tried and the outcomes have not been what the originators had hoped.

+1 – I made a similar point on the other thread.

This fraud is an appalling action and the person/people responsible should be punished.

However, it would be doing little but treating the symptoms of a much wider disease if we stopped there without considering why people feel forced to do things like this. We have such high expectations about the service government service providers will give us, but unless these service providers are funded and staffed appropriately it is not particularly fair on them to impose negative consequences when those expectations aren’t met.

Talk to any nurse who works in ER. They are absolutely run off their feet. They are understaffed and over-worked. Is it any surprise they aren’t meeting unreasonable performance expectations?

It’s pretty well inevitable in the contemporary political management environment. Add a ten minute news cycle to a nervous government and throw in upper managers who are conditioned to provide (possibly through performance agreements) whatever result a panicky Minister or his/her protective phalanx of shortsighted staffers wants. Then factor in that the management’s priorities will percolate down to where actual work is done. The surprise for me is simply that this stuff gets found out so rarely.
The cures would mostly require the insertion of a spine into the relevant Minister and senior managers. The treatment would take effect a great deal quicker if about three-quarters of the Ministerial staffers were directed to work more appropriate to their abilities. Selling used cars, perhaps. Prostitution, maybe. Telemarketing?
Repeat in all portfolios in the ACT and every other jurisdiction.

Deref said :

Few, if any, of us trust politicians, and with damn good reason.

But we badly need to be able to trust our public servants. The reason that this is such a big honkin’ deal is not the figures themselves – it’s the erosion of public trust in what has to be a trustworthy organisation. Take that away and you’re one of a kind with Indonesia and India. The gods help us all in that case.

String ’em up and dispose of the stinking dead skunk that’s current senior executive structure.

The scary thing is the number of people who think it is ok to be dishonest as long as they were well treated by A&E.

eh_steve said :

Investigations need to be made nation wide I reckon, as by many accounts this sort of practice happens everywhere.

The TCH “audit” should now be extended to the Walk In Clinic and the surgery waiting lists.

The reason that this is such a big honkin’ deal is not the figures themselves – it’s the erosion of public trust in what has to be a trustworthy organisation.

+11

This should come as no surprise to anyone. We have politicians that don’t know how to administrate and although they make the laws are unable or unwilling to interfere to make sure the law and policies are adhered to by those who really seem to be in charge.
This is not restricted to Health but many areas where the those at the top of the heap have a personal agenda.

This is not an isolated case in government. It is a big honking deal because it is figures which back up policy decisions and if incorrect give gravitas for decisions around reforms (or need for extra staffing). The pressures in some areas of government to do this are understandable especially with pressure from Ministerial offices but in the long term it distorts the truth and should be revealed at all times wherever possible and in safety (if a whistleblower).

There is no excuse for politicians placing these sorts of pressures on staff already under pressure within a traditionally underfunded sector but I wish more public servants would show some mettle in pushing back on politicians with some hard truths.

While it is in everyone’s interests to encourage emergency patients away from the service to the GP, fudging statistics doesn’t help the problem. It is nothing but window dressing, while seemingly insignificant, may inadvertently lead to a death.

In a further update, sources suggest that Becket may, in fact, have tripped and repeatedly fallen (nearly twelve thousand times, apparently) on the rogue knights’ generic swords and daggers. The matter has been referred to the Sheriff.

eh_steve said :

Investigations need to be made nation wide I reckon, as by many accounts this sort of practice happens everywhere.

No kidding. Does anyone think this is not happening in every other jurisdiction? Once you tie pay, funding, career progression, etc to a performance metric you create an incentive to game the metric. You can just change the numbers, as done here, or change the way you operate. Giving each patient an aspirin and sending them home would get the average wait time way down (and the throughput would go up because when they come back they’re another patient).

Exactly the same thing is happening with NAPLAN: give the kids the answers, drill them for the test and ignore the rest of the syllabus, tell the dumb kids to stay home on the day of the test, etc.

The Freakonomics guys have dozens of examples where this sort of thing has been tried and the outcomes have not been what the originators had hoped.

Few, if any, of us trust politicians, and with damn good reason.

But we badly need to be able to trust our public servants. The reason that this is such a big honkin’ deal is not the figures themselves – it’s the erosion of public trust in what has to be a trustworthy organisation. Take that away and you’re one of a kind with Indonesia and India. The gods help us all in that case.

String ’em up and dispose of the stinking dead skunk that’s current senior executive structure.

Investigations need to be made nation wide I reckon, as by many accounts this sort of practice happens everywhere.

In news just in, an exhaustive, independent inquiry has concluded that the murder of Thomas Becket was the work of four unidentified rogue knights, acting alone. King Henry II was oft heard to say “will no one rid me of this turbulent priest”, or words to that effect, but, as the independent inquiry found “although managerial pressure was placed on the four unidentified rogue knights, this was not manifested in direct or indirect instruction or guidance to deliberately butcher the (late) Archbishop of Canterbury”.

Nearly ten years ago, in a particularly acerbic piece about Kate Carnell, Alan Ramsey wrote of “the bumpkin circus that is local government in our national capital” – as the saying goes, the more things change, the more they stay the same.

In answer to your question JB – HONK, HONK, BLOODY HONK!!! – well done for your coverage of this, and likewise to last night’s ABC TV news.