By Jim McVeagh 26/10/2009

Have you noticed recently how every headline in the media is slanted to make whatever is happening in ACC look bad? ACC is clearly the current whipping boy and Nick Smith appears to be the Minister designated for denigration. This headline is a particularly egregious sample:

ACC pulls fall plan support

While superficially true, it obscures the fact that ACC is attempting to be careful with taxpayers money.

ACC is pulling the plug on a world-leading falls prevention programme for older adults in favour of getting more people to modified tai chi classes that it says are cheaper and more effective.

Can you hear the slanted criticism? ACC are destroying a world-leading programme because of some crackpot idea that Tai Chi classes are more effective. Silly ACC. What are they thinking?

Here is the real story:

General manager for injury prevention Katie Sadleir said the classes cut the chances of falls by two-thirds at a cost of about $100 per person, while the Otago Exercise Programme cost up to $600 per person to reduce falls by one-third.

That’s right. The expensive, world-leading, well-researched Otago falls program is only half as effective at preventing falls and cost six times as much. In dollar terms Tai Chi classes are twelve times as effective.


That is an extremely adequate reason for moving the funding out of the Otago Exercise Program.

Make no mistake. The OEP is a fine program that does quite a bit more than help old folk with their balance. But in the end it prevents half the number of falls as a simple Tai Chi class. MacDoctor can confirm that this is not some hare-brained idea from ACC. The research on the effectiveness of Tai Chi is well-established; this is not based on a couple of shonky studies in an obscure medical journal. The comparison is being done with excellent data.

The protestations of the physiotherapists are therefore somewhat hollow. Though their program is indeed excellent, the use of Tai Chi actually achieves the end-point (less falls) twelve times more efficiently. It is therefore time to let go of the Otago program. The physiotherapists can rabbit on about the cost of falls and the cost-effectiveness of their program, but the simple reality is that, for the same amount of money, ACC can prevent twelve times as many falls and prevent twelve times as many fractured hips.

And twelve is a very, very large number in medical inteventions…