Planned hospital rankings based on patient surveys will
inevitably become league tables and could be detrimental to
services, retiring Southern District Health Board member Dr
Malcolm Macpherson says.
Association of Salaried Medical Specialists executive
director Ian Powell also has concerns, urging the Government
to rethink the proposal, which he fears could demotivate
health workers by stigmatising hospitals.
Health Minister Tony Ryall has announced a national patient
survey will be introduced to public hospitals from next year.
In a statement, he said the regularly published results would
inform health boards about what they did well and what they
needed to improve.
''It will be the first time this information has been
collected and measured in the same way across the whole
University of Otago health systems authority Prof Robin Gauld
said patient scores, properly collated, were a low-risk way
of improving services.
''It's something we should have been doing a long time ago''
and was in line with developments happening overseas.
However, Dr Macpherson, who is also a systems consultant,
said a patient rating system could motivate hospitals to seek
as high a rating as possible to the detriment of some aspects
''If you introduce perverse incentives, people respond
perversely, and you get outcomes you don't want. And I think
it's quite likely that a Trip Advisor-type approach to
provision of health services would precipitate significant
gaming of the system.''
A ranking system risked masking systemic problems, giving a
false sense of transparency.
''These approaches measure and report on the wrong things -
and the superficial is exactly what you don't want in
Dr Macpherson did not stand for re-election to the board, and
retires at the end of the three-year term in December.
Mr Powell, head of the senior doctors' union, said the most
satisfied and most unsatisfied patients were most likely to
complete the surveys, giving a skewed picture.
''It won't actually tell you that much about the quality of
public hospitals as a whole.''
They would reveal individual things that should not have
happened, but would not show why they happened, he said.
Patient feedback was a great way to improve the system, but
should not be used for any kind of ranking system, he said.