Monday, January 09, 2006

"We don't need more statisticians."

I'm watching the Canadian leaders debate, and just heard Bloc Québécois leader Gilles Duceppe say "We don't need more statisticians." Of course I can't let that pass without comment!

First, the context. The debate was focusing on healthcare. Healthcare in Canada is governed by the Canada Health Act, through which the federal government ensures that the provinces and territories meet certain requirements, such as free and universal access to insured health care. (That description of the Act is taken from this helpful overview.)

Duceppe noted that under Liberal governments, the number of federal government employees in healthcare-related areas (presumably in Health Canada and the Public Health Agency of Canada) has increased considerably. But delivery of healthcare (including paying for nurses and doctors) is a provincial responsibility. Duceppe argued that what is needed is more nurses and doctors, not more federal employees such as ... statisticians (among other examples he mentioned).

Now, it is widely accepted that more doctors and nurses are needed, and I agree. But I am dismayed that Duceppe should so casually dismiss the value of federal health employees. The recently-established Public Health Agency of Canada seems particularly relevant given the current concerns about avian flu.

Duceppe's disparaging mention of statisticians is, of course, particularly galling to me. Sure, if you go to hospital you won't be treated by a statistician. But that doesn't mean you're nobenefitingng from the work statisticians do. For example, statisticians play a key role in the Cochrane Collaboration, which is an important part of the movement towards evidence-based healthcare. For a stimulating account of statistics in medicine, see Stephen Senn's book "Dicing with Death: Chance, Risk and Health" (which I reviewed for CMAJ).

I often find Gilles Duceppe's comments to be quite insightful, but he was way off the mark this time.

Update 14Jan2006: According to the transcript of the debate, I didn't get the quote quite right. Here's the relevant excerpt (the italics are mine):
Moderator: "In the area of social policy, let's go to health care, which, of course, many Canadians want to know a lot about, and Mr. Duceppe, this question is for you. Provinces including Quebec have increased the role of the private sector in the delivery of health care. Would you support a federal ban on private for-profit health clinics?"

Gilles Duceppe: "I mean, I don't want people to have to use their credit card to go to hospital, but the thing is, it is a provincial jurisdiction. It is a Quebec jurisdiction, and a main problem is the fact that the federal government cut in the payment transfers for health since 1994. Recently, they put more money, but not at the level it was in 1994. Just consider that in Ottawa, in the health department, there's 10,000 civil servants, and they're not managing a single hospital. Five years ago, there were 506 employees for promotion, like against cancer or smoking, thing like that. Today nowadays, we have 4,561. We don't need inspectors. We don't need statisticians, we need doctors and nurses. I'm confident the province of Quebec will be able to settle that problem and make sure you go with your health card and not your credit card."
But here's something very interesting I stumbled on. The snappy line actually dates back about 7 years! Here's an excerpt from Hansard 171 of the 36th parliament, 1st session, February 1st, 1999 (again, the italics are mine):
Mrs. Pauline Picard (Drummond, BQ): "Mr. Speaker, the intentions of the federal Minister of Health are clear. He wants to control the provinces' exercise of their constitutional rights with respect to health. Will this federal interference in health matters not mean more public servants, statisticians and inspectors, rather than more doctors, nurses and clinical staff, which is what the public really wants?"

Hon. Stéphane Dion (President of the Queen's Privy Council for Canada and Minister of Intergovernmental Affairs, Lib.): "Mr. Speaker, as always, the Government of Canada intends to respect the Constitution fully."

Some hon. members: Oh, oh.

Hon. Stéphane Dion: We intend to work with the provinces in a spirit of respect for the Constitution as it applies to the health sector, just as a certain federal minister wanted to work with the provinces in the education sector 10 years ago.
I only happened to find this because I did a Google search on duceppe statisticians. And why am I bothering to point this out? Well, it clearly shows that Duceppe's words were pre-planned. Not exactly a shocker: we all know these things are carefully scripted. But the original statement by Pauline Picard was pretty ignorant and I don't think serving it up a second time makes the Bloc Québécois look too good!

I'd also like to note Mrs. Picard's words "... rather than more doctors, nurses and clinical staff, which is what the public really wants". Well even if that is true, it sounds like we're pandering just a little, doesn't it? Allow me to suggest an analogy: suppose you walk into your doctor's office and demand a prescription for an antibiotic. Does that mean you should automatically get it? Could it be that what you want isn't necessarily what you need?
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8 Comments:

Anonymous Mike Anderson said...

I'm reminded of a story told back in the late 70's in the headquarters of the Strategic Air Command. SAC had a huge data systems directorate at the time to do intelligence analysis and strategic targeting, and programming talent was always scarce. At a senior staff meeting, the director said, in a snit, "Computer programmers are a dime a dozen." One of his division chiefs calmly stood up, opened his wallet, tossed a bill on the conference table and responded "Great. Gimme a dollar's worth."

12:27 PM, January 10, 2006  
Blogger Nick Barrowman said...

That's a great story!

I wonder if Giles Duceppe actually knows what a statistician is. He may just think it's someone who tabulates figures. Of course tabulating figures is still important.

4:53 PM, January 10, 2006  
Blogger Raywat Deonandan said...

I still can't get over this:


"I often find Giles Duceppe's comments to be quite insightful"

Examples, please!

3:14 PM, January 11, 2006  
Blogger Nick Barrowman said...

Well, off the top of my head ... I can't think of any, but thanks to the wonders of Google, check out this report from the Nunatsiaq News.

The Bloc tends to be fairly progressive on a number of issues, and Duceppe can often give more straightforward answers on important issues because he doesn't care about his popularity outside of Quebec.

4:49 PM, January 11, 2006  
Blogger Raywat Deonandan said...

"Insightful" Duceppe quotes like...


"The difference between 1000 and 1 is exactly 999"

?

;-)

5:44 PM, January 11, 2006  
Blogger Nick Barrowman said...

I'm just glad no one keeps track of all the stupid things I've ever said!

5:53 PM, January 11, 2006  
Anonymous Mike Wendt said...

To the second comment above: aren't statisticians those guys who count the number of RBIs in baseball?

9:57 AM, January 16, 2006  
Anonymous Colorado Health Insurance said...

Duceppe is right people should not have to use their credit card when going to a hospital. It's not about private health care it will be about more doctors and nurses to help the many in need.

1:52 PM, January 30, 2006  

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