Health League Tables

March 16th, 2010 at 9:13 am by David Farrar

The Herald reports:

showing which primary health organisations (PHOs) are doing best – and worst – at meeting community health needs have been released by the Ministry of Health for the first time.

The tables, to June 2009, ranked how well general practices are doing at immunising 2-year-olds, detecting and following up diabetes patients, assessing the risk of heart disease, breast and cervical cancer screening, flu vaccinations and other key health indicators.

Information ranking the top and bottom five PHOs for meeting targets across the health indicators were released to Radio New Zealand under the Official Information Act.

One league table showed PHOs in the Hutt Valley, Wairarapa, Wellington and Hawke’s Bay at the top for immunisation, exceeding the target of an 85 per cent immunisation rate with rates of up to 93 per cent.

The bottom of the table were PHOs in Counties-Manukau, Northland, Bay of Plenty and Waikato with rates as low as 32 per cent.

This got me thinking that if the health sector unions had the same ethics as the education unions, they would be out there encouraging doctors and nurses to refuse to immunise children, unless the Government promised not to collate the data on immunisation rates.

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10 Responses to “Health League Tables”

  1. MikeNZ (3,234 comments) says:

    David
    sometimes you are wicked, are you saying that the health unions aren’t as strong ethically?.

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  2. Graeme Edgeler (3,289 comments) says:

    if the health sector unions had the same ethics as the education unions, they would be out there encouraging doctors and nurses to refuse to immunise children, unless the Government promised not to collate the data on immunisation rates.

    And if the Ministry of Health had similar goals to the Ministry of Education, the government would collate data on one or two immunisations, which hadn’t been tested, and ignore high immunisation rates for other diseases.

    [which isn't to say your observation wasn't quite witty, but it's not like the NZEI is encouraging teachers not to teach]

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  3. drgonzo (2 comments) says:

    The difference is that immunisation offers proven benefits to children (seen any smallpox/polio/Haemophilus meningitis recently? me neither) – can the same be said for league tables of exam results?

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  4. Jeff83 (745 comments) says:

    This got me thinking that if the health sector unions …

    That got me thinking that the report shows surprise surprise the poorest areas (Counties-Manukau, Northland) have the worst statistics. Wow who would of thought? Waiting for the same with league tables for schools which will likely show equal amounts of ‘great informative’ bits of information.

    IF the information is then used in a positive way to try and rectify it, then it will be useful. However I get the feeling with budget cuts its just going to be used to point fingers.

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  5. toad (3,674 comments) says:

    Bad analogy DPF. There is strong evidence that immunisation improves health outcomes. There is no evidence that National Standards improves educational outcomes.

    The various vaccines now available were not introduced without extensive clinical trials. Why should Tolley’s National Standards be introduced without being trialed, especially when many educationalists (academics, not primary teachers) have expressed severe reservations?

    [DPF: Red Herring. National Standards are about identiying students and schools not achieving the minimum level of literacy and numeracy. This is not a solution in itself, but a necessary first step]

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  6. Graeme Edgeler (3,289 comments) says:

    can the same be said for league tables of exam results?

    What benefit do children get from immunisation tables?

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  7. andrei (2,652 comments) says:

    The tables, to June 2009, ranked how well general practices are doing at immunising 2-year-olds, detecting and following up diabetes patients, assessing the risk of heart disease, breast and cervical cancer screening, flu vaccinations and other key health indicators.

    Information ranking the top and bottom five PHOs for meeting targets across the health indicators were released to Radio New Zealand under the Official Information Act.

    Color me cynical but aren’t the “key health indicators” just things that beltway bureaucrats deem important – take cervical cancer screening as an example of an identified “key health indicator” 177 cases registered in New Zealand in 2003 meanwhile Prostate Cancer registrations for the same year were 2696 screening for which does not appear to be.

    And given that diagnosis is devastating for the diagnosti in either case and where “key health indicators” would be of little consequence and compassionate, humane and hopefully effective treatment would be the primary focus and would be that individuals “key health indicator” .

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  8. Inventory2 (10,340 comments) says:

    Health League Tables are nothing new. When the Upton health reforms of the early 1990’s led to the formation of Crown Health Enterprises, there was a suite of measures which CHE’s reported monthly to CCMAU. The comparative performance of each CHE on each measure was then publicly available. I don’t recall protests from Labour at that time.

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  9. Graeme Edgeler (3,289 comments) says:

    Health League Tables are nothing new … The comparative performance of each CHE on each measure was then publicly available. I don’t recall protests from Labour at that time.

    And I haven’t heard any now.

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  10. mpledger (425 comments) says:

    Immunisation rates are fairly easy to measure, there is no debate (although possibly deception), either a child has been immunised or not.

    If there were league tables about “how healthy are children in each PHO” with the implied intention for poorly performing Doctors that they will lose their jobs and not be able to practise if it’s not good enough then I suspect the Doctors would be up in arms. The doctors have a bit stick that they can wallop the govt with – they can bugger off and get excessively better pay elsewhere. The health system would collapse.

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