Friday, November 25, 2016

Utterly predictable

One of the first things National did after being elected was implement targets for A&E waiting times. Seven years later, and it turns out that hospitals have been faking their waiting-time data:

Health Minister Jonathan Coleman has ordered an investigation into alleged "manipulation" of data at district health boards to comply with the six-hour emergency department target.

The first study on this since the six-hour target was introduced in 2009 was presented at a Queenstown conference today by Dr Peter Jones, an emergency medicine specialist and Auckland University researcher.

He said he had found evidence that the data had been manipulated to meet the target.

Opposition politicians have long suspected this, especially after widespread manipulation was uncovered in the UK to comply with its tighter, four-hour target. The UK's policy, unlike in New Zealand, came with incentives and penalties.

This is utterly predictable, and we've seen it everywhere such targets have been tried. When the incentives are strong enough, and its easier to fake data than meet the target, then that's exactly what institutions will do (see also: Serco). We're fortunate here that it doesn't seem to have negatively affected people's care, but that's all it is: good fortune. In reality, what this has done is shifted resources from elsewhere in the health sector to meeting National's targets - and who knows what else is being neglected as a result?

The key problem in the health system isn't slack doctors letting A&E patients suffer because they're on their tea-break - it is under-resourcing. Maybe we should fix that? But I forget: to National, having enough doctors and nurses to deal with actual demand (let alone letting them work sane hours rather than endangering patient safety with endless 14-hour days) is "waste". Better to have mickey mouse targets that everybody lies about instead.