Smoking Targets

Labour’s Iain Lees-Galloway has said:

The Government is deliberately ignoring health data that doesn’t tell the story it wants the public to hear, Labour’s Associate Health spokesperson Iain Lees-Galloway says.

“Statistics collected by the Ministry of Health reveal that every district health board (DHB) except one is failing to get close to acceptable rates for early smoking cessation intervention.

“The Government wants us to believe it has made smoking cessation a priority. These figures highlight the reality – it hasn’t, “Iain Lees-Galloway.

“The Ministry of Health expects 90 per cent of smokers who see a GP to be provided with advice and help to quit, yet only one DHB is reaching that target.

“No other DHB is even close. In fact, on average they are underperforming by 57%.

“Tony Ryall, of course, is allergic to bad news, so these figures never get reported.

 “Interestingly he talks up statistics around smokers who end up in hospital* and the advice they get there.

“But only reporting smoking cessation activities in hospitals is ludicrous. Far more people see their GP than go to hospital.

This is an interesting issue. Lees-Galloway is taking about two seperate things – the proportion of smokers who see their GP who get advice and help to quit, and the proportion of smokers in a hospital who get advice and help to quit.

The hospital figure is the official national health target. It was 90% and has just gone up to 95%. The DHB average was 95% in the first quarter of 2011/12 and slipped back to 89% in the second quarter. Six DHBS made 95% and 12 made 90%, while eight did not.

Now hospitals are actually run by DHBs. DHBs control hospitals. A DHB has the ability to put in place policies around offering quit smoking services to patients. Also be aware that the average person spends hours or days in hospital, so it is easier to do something additional to the reason they are in hospital.

GPs are not employed by DHBs. They are private entities, that only get a portion of their income from the Government. The ability of a Government to get GPs to do something is very limited, and frankly it is silly of Lees-Galloway to think they can.

Now from what I can tell, the DHBs only started funding GPs to even code their patients as to whom are smokers and non-smokers. Sure it is recorded in notes in long-hand, but it is a big job to go through every file and mark them in the database as a smoker.

The new target for GPs only started this year, and they noted:

Unlike the other health targets, this measure started from scratch as provision of advice and help to smokers was not recorded previously nor even offered routinely.

So imagine what is involved to get every GP in NZ recording the status, and then also recording if they offered quit smoking assistance. I’ve worked in a medical centre. The average visit is around 15 minutes, and covering anything apart from the immediate problem slows things down a lot. Now this is not to say it is not a good idea – it is. But expecting 90% achievement in the first year is silly.