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Missing in action: the key KPI for government

By Dave Bath - posted Thursday, 3 December 2009


The reason for the lack of collection and publication of these statistics is not the difficulty in collecting them, not the difficulty of interpreting the results, even if you do break them down by age, geographic region, and the frequencies of different score ranges. The more likely reason is that the politicians know that collection and publication of such statistics, the KEY Key Performance Indicator of government action, would leave the politicians red-faced.

If a government was competent, especially after a change of government, we'd have ministers proudly showing graphs and trending figures about how much they were lowering misery, in as many press conferences as they could muster, pushing the sound bites into the news. We don't see that.

Instead, on the key business of government, the happiness of citizens, we get spin on indirect indicators, announcements claiming a deep concern, with the only real figures put before the public that amount of money politicians are spending, however uselessly, on the problem of misery.

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A recent report from the Victorian Auditor General on the handling of Mental Health Crises, crises being defined as times the individual is a risk to themselves or others, had the following in the summary of findings, each paragraph separated from the others in the report:

There is a lack of information showing the effectiveness of triage and CAT services, and police and ambulance responses to mental health crises. This prevents quantitative analysis and robust performance monitoring, allowing service gaps to go unaddressed.

DOH lacks useful data about triage and CAT service responses to mental health crises. CAT services have run for 15 years, but DOH does not know the number of urgent referrals received, how services respond, their timeliness or the outcomes.

Until agencies have access to robust information about response effectiveness, they cannot identify successes or areas to improve in their own crisis response operations, nor can they review their joint performance to identify system-wide issues.

Thus, even for crises that have a huge impact on not only the individual in the crisis, and if not handled correctly, contribute to further crises, but also affect the families and friends of those unfortunate people, perhaps pushing others into misery and possibly crises, almost no useful data is available to assess performance and effectiveness.

There is a truism in management and performance improvement: "If it isn't measured, it can't be managed." Our politicians must understand this, but use the corollary: "If it isn't measured, we can weasel our way out of accountability."

The auditor mentions 15 years. For a system to be in place that long, and yet there to be no useful data to demonstrate effectiveness, is not mere incompetence, which would probably have taken five to 10 years to produce decent data collection systems. It seems likely that this lack of information is the product of deliberate inaction by politicians, or perhaps the intentional sabotage of the efforts of the competent and well-meaning public servants across a range of departments who would be wanting to get the data, assess the effectiveness of measures, and institute improvements where so often necessary.

While depression is not the only mental health issue, depression and associated stress are major contributing factors to other mental health disorders becoming visible in an individual, changing from a subclinical condition to something more obvious, touching the lives of all around them.

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With the Victorian Auditor-General noting that "nearly one in five Victorians experience mental illness each year", the domino effect upon families and friends, the consequent impact on budgets for health and policing, as well as the consequences for workforce productivity, it is fairly obvious that prominent quarterly depression incidence statistics would be useful indicators of government performance as a whole, could force governments to be accountable and take action.

If a political party seeking office has the courage to promise frequent publication of such indicators, to ask voters to use these to assess government performance, then we might not be able to judge ability to make a difference, but we can at least conclude that they think they can govern well, manage perhaps the most important duty of a government, the happiness of the citizenry.

Until we get such promises, we can be assured that no major political party has the intent to govern in the public interest or the confidence that they can perform their core duty.

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About the Author

Dave Bath is a former single custodial dad (and grandfather since early 2007), has developed software for nearly 30 years (both open source and commercial), has an academic background in biomedical sciences, and has spent much of his commercial IT work in the fields of health, risk management, resourcing and finance. He blogs at Balneus.

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