The
Campbell government has not explained why it has deleted
infant mortality as a performance measure from both the
overall government strategic plan and from the service plan
for the Ministry of Health. Nevertheless, health professionals
everywhere will continue to use infant mortality as a key
indicator and will sound the alarm should it rise as the
result of changes in the New Era.
The
Campbell government has chosen to make the health status
report available via the new website that was developed
as part of the government television ad campaign on health
care. That campaign was recently extended although no one
in government has been willing to provide information on
how much more is being spent to broadcast the ads. 
You
won't find a link to the health status report on the top
level government website, nor on the websites for the Ministries
of Health but if you are at the TV ad website and you click
on a graphic with the words "Latest Health Info",
you will find the page with the report. To save time you
can get the same result by clicking on that graphic reproduced
here for the 417 Kb pdf file.
The
health status report provides information on 64 of 67 indicators
defined by the Conference of Deputy Health Ministers. BC
does not yet have data for three indicators: Utilization
of home care services, 30-day acute myocardial infarction
mortality rate and 30-day stroke mortality rate.
The
full health status report will not be published again for
two years; however, some of the indicators are published
on an annual basis by Vital Statistics or by other branches
of the Ministries of Health.
Improvements
in health information systems that allow for the consistent
measurement of health outcomes will not only help in holding
governments accountable, but they will also help in the
development of evidence based protocols for service delivery.
For
Alberta's report see http://www.gov.ab.ca/home/news/dsp_feature.cfm?lkFid=241
For
Ontario's report see http://www.gov.on.ca/health/english/pub/ministry/pirc/pirc_mn.html
August
28, 2002
Infant
Mortality - Measured and Ignored
Statistics
on infant mortality are more than the canary in the coalmine.
They are used as a key measure of the health of populations.
On Wednesday, August 28th, Health Planning Minister Sindi
Hawkins appeared for a few brief moments on CKNW's Rafe
Mair show with guest host Peter Warren in order to "explain"
why her government no longer considers infant mortality
as a measure of its performance. 
She
claimed that deleting infant mortality as an measure of
government's progress isn't important since Vital Statistics
will still measure it.
The
graph shown here is from page 51 of the annual report for
the Ministry of Health Services that Collin Hansen released
last month. It shows that the infant mortality rate declined
throughout the period of NDP government. It reached record
lows for both the general population and for the aboriginal
population in 2000 (the last year reported). The Campbell
government has said that it will use infant mortality for
the aboriginal population as an important measure in its
service plan for the Ministry of Health Services but it
will not use infant mortality for the overall population
as a measure of performance for any aspect of government.
The
public will be free to draw its own conclusions on whether
infant mortality says anything about the performance of
government. We should be concerned if it rises for any reason.
At a time when child protection services are being cut,
when welfare policy is being criticized, when health care
is being reorganized and when tax burdens are being shifted
downwards, any rise in infant mortality could indicate problems
with government policy.
Also
see: Canadian
Perinatal Surveillance System
August
23, 2002
Infant
Mortality Ignored by Minister
Speaking
with Peter Warren on CKNW's Rafe Mair show Health Minister
Collin Hansen admitted that he didn't know whether infant
mortality is one of the criteria used to measure whether
his ministry is achieving its goals. Government is likely
to ignore those things that aren't used to measure its performance.
Worse, it is likely to ignore those things that it has intentionally
dropped from its performance measurements! Hansen knows
that his pay will be cut if he doesn't live within his budget.
His pay will not be cut if infant mortality increases under
his watch.
The
current government uses the term "service plan"
to describe its goals and the criteria used to measure whether
those goals have been achieved. Under the former government
this was called a "performance plan".
The
last performance plan for the Ministry of Health under the
NDP government can be found at http://www.healthservices.gov.bc.ca/cpa/publications/performance01.pdf
In it you will find that infant mortality was not only a
key measure for the Ministry of Health but it was also one
of the key measures for the overall strategic plan for all
of government. (see pages 7 and 43)
The
service plan for Collin Hansen's Ministry is found at http://www.gov.bc.ca/prem/popt/corereview/srv_pln/hlthser/hs.pdf
On page 14 it says that the goal of improved health and
wellness for British Columbians will be measured by "7.
Improved health status for Aboriginal peoples measured by
infant mortality and life expectancy." There is
no other reference to infant mortality in the Ministry's
service plan. In other words, infant mortality for over
95% of the province's population had been dropped by the
Campbell government as a measure of performance for the
Ministry of Health.
The
former government also introduced BC's first Strategic Plan
(pdf).
The overall Strategic Plan for the Campbell government can
be found at http://www.gov.bc.ca/prem/popt/corereview/StrategicPlan/Strategic_Plan_02.pdf
Unlike the NDP government's Strategic Plan, there is no
reference to infant mortality in Campbell's document but
that is not surprising since they also removed it from the
service plan for the Ministry of Health.
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