Praise where it’s due – the UK government have today announced that a limited range of centrally-imposed targets for the English NHS [non-UK readers = National Health Service] are being scrapped or amended.

To those who’ve grasped the point about “how work works” this is good news.  Targets are counter-productive and have adverse unintended consequences.  People can always achieve them – at best by distorting other priorities, at worst by sleight of hand.

It would be nice to think the health secretary Andrew Lansley had been reading the “bad effects of targets” file on my PC but I’m not paranoid enough to think he’s had time to dip into it.  However, his decisions uncannily provide direct answers to some of the examples I’ve collected over the years.

The Government now say – Patients in England will no longer be guaranteed a GP appointment within 48 hours under a scaling back of NHS targets.  Instead, doctors will be allowed to prioritise patients.

The BBC News said (on 23 September 2004) – GPs’ patients are not receiving the best care they could be because of a new government target, a report [by the NHS Alliance and Royal College of GPs] says.   Patients should only have to wait 48 hours for an appointment under a target which must be met this year.  The report said it was “too simplistic” and should be scrapped.  A professor of general practice said “In my experience it’s very easy to massage the figures.”  Messages posted on the BBC News web site added:

  • Is mine the only GP practice that achieves the target by refusing to make an appointment if there are no doctors free within 48 hours?
  • Having chronic conditions – heart and lungs – I have been assigned TWO doctors. I can see either one whenever necessary. And guess what? I cannot see either within 48 hours.  I need to ‘predict ‘ my illness and make appointments accordingly
  • My doctors’ surgery won’t see anyone unless you phone at 8 in the morning.  If you phone at some other time they tell you to call back tomorrow.

The Government now say – changes will be made to the 18-week hospital treatment waiting time target.

The Financial Times said (on 16 September 2006) – a hospital trust apologised yesterday after it emerged that its waiting lists had been “mismanaged” to meet government targets.  An investigation found patients of the United Lincolnshire Hospitals NHS Trust were given appointments even when medics could not honour them.  The appointments were subsequently recorded as if patients had cancelled.

Sadly both these examples show how long it can take to fix something that was plainly wrong so long ago.

New governments always promise a bonfire of the quangoes.  Can we now expect a bonfire of the targets?

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