Mortality rates report just meaningless figures

There are three kinds of lies: lies, damn lies, and statistics. British Prime Minister Disraeli said that in the 19th century, but the aphorism is still applicable today.

I'm referring to the report issued by the Ministry of Health rating the various DHBs in terms of mortality rates, and that purports to show that our DHB has the fifth-highest mortality rate in the country in 2010-11 (Chronicle, October 11, 2012).

In response, DHB Director of Nursing, Sandy Blake, who otherwise does a commendable job in terms of patient safety, got roped in, I suspect, to provide a defence of the DHB record that was entirely unnecessary, while it exposed another of her boss's, CEO Julie Patterson's, deficiencies. Ms Blake does point to our ageing population, which is one - but only one - factor that needed explication.

What was needed from the DHB CEO was leadership which in this case means an effort on Mrs Patterson's part to educate the public as to the meaning of this hodgepodge of meaningless numbers.

Why is this data meaningless? The quick answer is that it tells us nothing about the success or failure of care at Wanganui Hospital, nor even elucidates in any way the serious issues implicit in mortality data.

A comparison of mortality figures among the country's DHBs neglects the significant variables in each region as to population density, age of population, levels of poverty, degree of education, ethnic character, acuity of presenting illness, and diverse environmental influence.

I haven't done Chi-Squares, but looking at the numbers I'd bet there isn't much significance in the variation of each DHB from the simple (and meaningless) derived average of 1.48 per cent.

To illustrate, take only one DHB, West Coast. It had a very few deaths - 64 - but a mortality rate that is second-highest at 1.77 per cent, just behind Waikato's 1.78 per cent with 775 deaths. Whose population is greater? And where are mine accidents and environmental issues more likely?

We also need to understand that these mortality data involve what is called "standardised death rates". Statistics New Zealand defines that term this way:

"Standardised death rates: the overall death rate that would have prevailed in a standard population if it had experienced the age-specific (usually age-and-sex-specific) death rates of the population or area being studied."

Confused enough yet? I can understand that gobbledygook enough to see the usefulness of standardised death rates when comparing mortality statistics for different ethnic populations of specified age and gender, but no use at all for comparing DHBs.

Debunking this stuff ought to be the task of Julie Patterson and not your hard-working correspondent. It's not that she's incapable of the task (or of assigning it to someone with math skills) but her failure to do so reflects on her inherent compromised position. She is the handmaiden of central government, chosen by it to lead the hospital in directions prescribed by Wellington. Julie is a non-resident representative sent by our hospital's absentee landlord.

Inherently, the MOH is a political body which exists mainly to keep the Minister of Health from looking foolish. What is needed in the country is a non-political body independent from party or government to promote the health of the citizens. These phony statistics about mortality are, I fear, a way to down our own DHB.

What's needed from our DHB leaders is courage and commitment. But we have little hope for commitment when Julie Patterson, CEO, doesn't even live here. Residency ought to be a minimal requirement of the position.

If it's a requirement for management at Pacific Helmets, a great company, which, after all, manufactures inanimate objects, how much more is it needed for leadership of the city's hospital where care is a matter of life and death.

Once more I'm obliged to do the work that Julie Patterson should be doing. Maybe I ought to ask for some of her $269,000 salary. One thing's sure. The money would be spent in Wanganui.