Where is the evidence?

Posted by: Witch Doctor | November 7, 2008

Where is the evidence?

ANOTHER EXPENSIVE GOVERNMENT EXPERIMENT

You’ve found the document, My Black Cat?

DOES PUBLIC RELEASE OF PERFORMANCE RESULTS IMPROVE QUALITY OF CARE?”

Well, does it?

What does it say?

They studied the evidence from a literature search and found 50 papers world wide. Only 4 of these papers were from the UK?

Only four?

What were the conclusions form these 4 UK papers, My Black Cat

SCOTLAND 2001

“Data were rarely cited as informing quality improvement activities; concerns raised about validity, timeliness and lack of external incentives.” Mannion and Goddard

SCOTLAND 2003

“Little use of data to stimulate quality improvement in hospitals, most doctors were aware of data but rarely used it, most Health Councils were unaware of the data.” Mannion and Goddard

SCOTLAND 2004

“78 per cent of GPs were aware of the data, but these were discussed only rarely with patients or others.” Mannion and Goddard

ENGLAND 2005

“Ratings transmitted important priorities from central government and helped direct and concentrate front-line resources. Public reporting led to tunnel vision, distortion of clinical priorities and disincentive to improve performance among high-rated organisations.” (Mannion, Davies and Marshall)

So, four studies in the UK, three of them in Scotland, all by the same group of researchers, and there is no evidence that any of this benefits patients?

What other countries were studied?

Apart from one in Canada, only the USA.

Findings from the USA cannot be extrapolated to the UK. Comparing the privately funded USA healthcare system with the NHS is like comparing turnips and mangos, My Black Cat.

So, we are using evidence from the USA to justify spending money from the public purse in this way.

The USA evidence isn’t so hot either….. Sometime it drives improvement in a hospital at other times it leads to surgeons avoiding high risk patients and consequently worse cardiac outcomes amongst sicker patients.

Eh?

My Black Cat, do you suppose that since there is no evidence base that any of this is valuable, that there is a massive UK experiment going on just now at the taxpayers expense?

Just like the MTAS experiment?

How many private companies are benefiting from this exercise?

Did the taxpayers give their consent for the use of their money in this way?

While medical treatment for seriously ill patients is rationed?

Surely not, My Black Cat!

a red apple ……………………