I shiver to the thought that hundreds of millions of dollars have been mis-allocated in health care just for implementing policies supported by statistical research, such as the blowing up of acute care beds, and the un-coordinated expansion of the so called home care(2). Statistics has been brought to the forefront of our management practices by the Total Quality Management (TQM) movement preached first in Japan by Edwards Deming(3).

TQM has certainly provided improvements in our workplace by removing the fragmentary and functional division of work among employees and making them directly responsible as a team for the produced services and goods. However, when TQM is practised within a rigid environmental system it fails to identify the structural deficiencies of the working environment(4). In Saskatchewan, for example, we have the ongoing breaking of the Districts Health Act, we have the development of ongoing obsolete health system architectures, and we have districts operating as puppets of the Government and of the Saskatchewan Association of Health Organizations (SAHO). You reader, you must tell me how in the world we can use Statistics to find remedies to our failing health care system when the law is broken, when the health system architectures are obsolete, and when there is confusion and mistrust in every corner of the health care system(5)(6).

The current operating deficit of our districts is in the order of some $47-million(7). This means that the health care system is continuing to fail in providing services in accordance to needs, it means that the budgeting processes are out of whack, it means there is no sharing of information or knowledge among employees(8). We have a health care system which is unable to carry forward a coordinated approach to the elementary double entry bookkeeping(9), and now we have Minister of Health Pat Atkinson telling the districts on how to evaluate their performance by the use of additional Statistics called "Health Indicators(10)(11)."

Pat Atkinson doesn't know yet that we already have Health Indicators showing that we are first in having the highest infant mortality rate of any other province, that we are first in having the highest juvenile crime rate, and that we are first in having the largest proportion of children at risk of getting an education because they are so poor. Do we really need additional Statistics or Health Indicators, or it is a matter of telling the Minister of Health Pat Atkinson that she cannot recognize a tree from a forest?

Endnotes

Quote by Mark Twain "There are lies, damned lies, and statistics"

Quote by Albert Einstein "Problems cannot be solved at the same level of awareness that created them"

Quote by Donella Meadows "challenging a paradigm is not a part-time job. It is not sufficient to make your point once and then blame the world for not getting it. The world has a vested interest in, a commitment to, not getting it. The point has to be made patiently and repeatedly, day after day after day" ftp://sysdyn.mit.edu/ftp/sdep/Roadmaps/RM1/D-4143-1.pdf http://iisd1.iisd.ca/pcdf/meadows/default.htm

General reference: Articles by Mario deSantis published by North Central Internet News

1. Dr. Steven Lewis: Preaching the Gospel of Statistics at SAHO Convention, by Mario deSantis, March 22, 2000

2. Dr. Steven Lewis and HSURC Commission of Saskatchewan: Contributing sources to the decline of health care in Saskatchewan, by Mario deSantis, March 12, 2000

3. The W. Edwards Deming Institute, W. Edwards Deming: "Lack of knowledge...that is the problem," The Deming System of Profound Knowledgehttp://www.deming.org/deminghtml/wedi.html

4. Comments on the present management philosophy of centralization of health reform with specific reference to information technology services, by Mario deSantis, June 21, 1995 http://www3.sk.sympatico.ca/desam/paper-HealthRefCentrSystArchA-Jn21-95.htm

5. North East Health District: the Closure of Carrot River Hospital and Telehealth, by Mario deSantis, March 9, 2000

6. ATKINSON CONFIRMS COMMITMENT TO CARROT RIVER HEALTH PROJECT, Government News Release, March 23, 2000. Health - 146 http://www.gov.sk.ca/newsrel/2000/03/23-146.html

7. Health District Deficits & Surpluses, Based on Third Quarter Projections. Source: Saskatchewan Health As at March 14, 2000 http://www.skcaucus.com/news/2000/mar/summary_of_health_district_deficits.htm

8. Immediate Need of New Budgeting Processes for Saskatchewan Health and District Health Boards, by Mario deSantis, March 9, 1995 http://www3.sk.sympatico.ca/desam/paper-NeedBudgProc-mar09-95.htm

9. An Extract from PACIOLI 2000 for Windows: An Accounting Software Solution to Address the Problems of Accountability of Saskatchewan District Health Boards, by Mario deSantis, June 1996 http://www3.sk.sympatico.ca/desam/paper-pacioli.htm

10. HEALTH INDICATORS WILL HELP DISTRICTS PLAN, Government News Release, March 22, 2000. Health - 145 http://www.gov.sk.ca/newsrel/2000/03/22-145.html

11. Health Indicators are macroscopic statistics trying to measure our health status and have no significance for the short term or for smaller and mobile populations.