A&E crisis - Treating the ill or massaging the statistics?

The deliberate manipulation of statistics can lead to enormous confusion.

“There are three kinds of lies: lies, damned lies, and statistics,” according to a famous quote, attributed most often to nineteenth century British Prime Minister Benjamin Disraeli, but also ascribed to several other thinkers, politicians and even a famous naval commander.

Equally confusing is the growing discrepancy in the figures produced by the Health Service Executive (HSE) and the Irish Nurses Organisation (INO) in relation to the number of patients languishing on trolleys in Accident and Emergency departments around the country.

Whether one takes HSE figures or the INO’s statistics, there were more than 170 people waiting for A&E care, on trolleys, on any given day in 2005.

This can reliably be contrasted with 2001/2002, when the number of patients of trolleys broke the 100 mark for the first time. The ongoing situation is an indictment of the HSE, the Government, which has repeatedly promised to make more beds available in order to end the A&E crisis, the Department of Health and the Tánaiste.

This time last year, when a record 422 people were waiting on trolleys in A&E departments, Health Minister Mary Harney promised that a 10-point plan would rectify the situation - by transferring those patients who belong in nursing homes, and by providing extra clinics to deal with acute medical problems and to treat minor injuries.

During the year, 470 patients were discharged from acute hospital beds in Dublin, according to a spokesman for the HSE, and these people were supported by a combination of home-care packages and enhanced nursing home subventions.

In addition, 50 public long-stay beds were reopened in nursing facilities and a further 477 people were transferred from hospital to intermediate care beds. Yet the trolley problem remains.

The INO contends that there was a daily average of 141 patients waiting for care on trolleys in Dublin A&E departments last year, while the HSE says that the daily average was 104.

Regardless of what figure people accept, it would seem that there has been no real progress on the issue in the lifetime of the current government.

There were fluctuations over the course of last year in the number of people waiting for emergency care.

The decline in the figures for July, August and December, however, has been attributed by hospital medical staff to a reduction in the volume of surgery planned during the holiday periods - when the lower level of surgery releases hospital beds and thus reduces demand for trolleys.

Whatever about the trend in the trolley figures, there is no doubt that the disparity between the figures trotted out by the HSE and INO is growing.

In December, the HSE contended that there was a daily average of 98 people on trolleys in Dublin, while 79 people waited on trolleys in the regions.

The INO, on the other hand, said the respective figures were 158 and 119 - a 61% discrepancy in the respective figures for Dublin and a 50.6% difference in the figures for the rest of the country.

Either the HSE, the INO or both have been exaggerating, embellishing or otherwise ‘massaging’ the numbers for their own purposes.

Under present circumstances, people could not be blamed for concluding that each side is playing games. This is as reprehensible as any ‘damned lie’ when what is at stake in this debate is not just the credibility of numerical data, but the health and wellbeing of people.