Lies, damned lies, and waitlist statistics


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The Government of Ontario is rightly in the soup for having justified (if not designed) its utter disruption of the province’s services for children with an Autism Spectrum Disorder on the basis of a single, apparently known-to-be-inflated statistic (23,000 kids sitting on a waitlist). The sad irony is that service providers have long been exaggerating the size of their waitlists as part of developing their “business case” for additional funding. When push has come to shove, the (government) funder’s usual response has been threefold:

  1. Question the reliability and/or validity of service providers’ reports of “waitlists-as-proxies-of-unmet-need”.
  2. Define and ask providers to begin reporting “more meaningful” waitlist statistics.
  3. Require providers to initiate “evidence-based strategies” to reduce these newly-minted waitlists.

During this traditional dance-of-the-public-servants – held largely outside the view of the general public and, certaintly, outside the view of people-in-need – service providers and government bureaucrats alike have tacitly acknowledged that all these waitlist statistics are nearly meaningless – or are, at least, so unfounded as to form no rational basis for (re)allocating resources.

In a surprising development, this time around the government has grabbed hold of these waitlist statistics and accepted them and announced – not increased funding for providers to increase their delivery of services-as-usual – but that insiders (government bureaucrats and service providers alike) have had long enough to fix a broken system – and have failed miserably (by their own miserable admissions). Now, the system is clearly in need of reform by outsiders (new ministers, new government bureaucrats, and undoubtedly, some new service providers).

It has not been a thing of beauty.

In a prior life, I worked as a senior executive of a substantial children’s mental health service in Ontario. All of the elements we see being played out today with services for children with Autism Spectrum Disorder have long been evident here, too. For many months, Children’s Mental Health Ontario’s #kidscantwait campaign has used stale, flimsy data to lobby for increased funding for its membership, while multiple ministries (including children and youth, health, education, and auditor-general) have bemoaned the apparent intractibility of “the waitlist problem”.

Unless my former colleagues move to clean up their version of this mess – quickly and soon – I predict that the government will move to put things right with them, too.

It will not be a thing of beauty.