Since it used to come up in secondary school debates, I've always automatically agreed with the comment: "There are lies, damned lies, and statistics."
This week I abandoned it, because statistics presented a sickening reality to me. I was reflecting on The Irish Times report on the health board, somewhere in the country, where they have had considerably over the average number of Caesarean hysterectomies in the last decade.
On a follow-up TV report, well-known gynaecologists commented on the reasons why this operation might be (rarely) performed. But what had most impact was a graphic showing the statistics involved. The top half, representing the number of Caesarean hysterectomies performed during a particular period in a leading Dublin hospital by all the many consultants operating within that hospital, showed a single line of little badges.
The bottom half, representing the number of Caesarean hysterectomies performed during the same period by the small number of consultants in the hospital outside Dublin, showed row after row of little badges.
There was nothing emotional or sensational about it. It was a simple, graphic statistic: pure information. Admittedly, it was information not up to that point freely available, the way, for example, figures for that kind of procedure are freely available on the Websites of some of the large maternity hospitals.
But "Freedom of Information" should not be thought of simply as data we drag out of institutions by quoting the Act at them. The information represented on screen by the rows of badges was freely available to lots of people down the years.
What sort of people? Anaesthetists, for a start. The Bristol scandal has reminded us of the necessary constant presence of anaesthetists when surgery is going on. In that case, a surgeon continued to do heart operations on young children when his mortality rate should have warned everybody his skills were not up to it.
An anaesthetist blew the whistle and in the process, blew himself out of a job and ultimately out of Britain, because of the tendency of consultants to cluster protectively around one of their own (in this case, the heart surgeon). The whistle-blower was accused of less-than-perfect performance.
In mentioning the Bristol case, I must of course make the point that in the case of the consultant with the high level of hysterectomies, no judicial process has been gone through to establish whether there was anything improper about any of them.
However, it takes no judicial process to make it clear to several people that over many years, a statistical abnormality was happening. The information was freely available. But not only did no one shout stop. No one called for an examination of the implications.
Now if you assume that this area had clusters of very difficult gynaecological cases, necessitating the high level of Caesarean hysterectomies, many of them among very young women, this would surely be of scientific interest. Any consultant noticing it might have studied it and presented papers on it.
BUT the information sat inert until two nurses, earlier this year, decided it meant something worth examining.
"All hospitals should have to put their figures on the Internet," one friend said to me this week. "That's all there is to it."
Not true. Built into that statement is a startling assumption: consultants can't be trusted to keep an eye on each other in the interests of patients, even to the extent of noticing and questioning a pattern so out of kilter with practice throughout the State. This week, the view was repeatedly expressed that consultants are more protective of each other than of patients.
Nobody I talked to found it at all strange that the health board involved had gone to England to get expert second opinion: there was a general view that Irish peers would not be able to take the detached view of the information an overseas expert might take.
In that context, it will be interesting, in due course, when the Institute of Obstetricians and Gynaecologists' examination of the cases has been completed, to compare the view obtained from three eminent Dublin obstetricians with the view (on the same cases) obtained from the British expert.
That presupposes, of course, that the health board involved will be open and transparent with the records it has.
Earlier this week, I would have had serious doubts about the health board in question, in terms of openness, since it was refusing to answer any questions about any aspect of the issue. By such refusal, it seemed to me, it was ensuring women all around the State would be worried they might have been operated on by the consultant involved.
It took a while for it to sink in that the operation is so statistically rare (except in this area) that there could not be large numbers of women anywhere in the country other than in the area governed by the remit of this health board - and all of those women were to be reached through their GPs.
The health board, one assumes, was setting out to give its own consultant as much protection as possible, on the principle that he is, of course, innocent in advance of whatever process of investigation is now under way, and is co-operating with that process. If that was the objective, RTE blew a hole in it on Tuesday night, with Miriam O'Callaghan in hold-the-front-page mode, announcing that "for the first time" her reporter was going to name the man and the health board.
"No wonder that health board wants to keep its head down," was a comment this week. "That hysterectomy issue isn't on its own. Several consultants there are having their work examined at the moment."
FUNNY old world. Every airline worth travelling with puts its pilots into the simulator regularly and examines records of near-misses and other problems to identify any correction, upskilling or retraining needed, and we admire the airline for it. Yet, when a health board does the same thing, we think "Oh, bad stuff afoot there." Maybe it's time we realised that a health board that moves quickly on a complaint and is not afraid to examine its consultants' performance is probably more committed to high standards than a health board where no questions are asked.
Which loops back to freedom of information. Having thought lengthily about it, I am reluctantly coming to conclude that the health board's absolute silence this week was probably appropriate. There was no gain to the public in the health board arguing the toss on any of the case histories, or doing off-the-record briefings, although the temptation to underline its relatively recent takeover of the hospital must have been enormous.
The objective now must have three elements: to ensure rigorous examination of the practice in the hospital and do justice to the individual involved; to provide information and support to any affected patients and - in due course - to share the information publicly, so that health care throughout the State thus benefits.
One of the most problematic factors for me in this case is that key information had been sitting, waiting to be discovered/exposed, for at least five and perhaps as long as eight years.
To adapt Edmund Burke's famous observation: To render free information valueless, all that is required is that good people do nothing with it . . .