Saturday, June 26, 2010

Missing targets

Last week I heard the new Tory health minister defending the abolition of a raft of health targets as heralding the dawn of a new age of local accountability over the preceding era of national control. Not for the first time, I'm scratching my head to understand the logic behind the typically grandiose statement.

Three of the key national indicators to be scrapped are the 48 hour wait to see your GP, the 4 hour wait in A&E and the promise of treatment within 18 weeks. None of these seem to be controversial matters and are consistent with the sort of targets common in the private sector.

The Tories promise that citizens will be able to hold public services to account, but how will they judge performance? Every business operation has some method of performance measurement, because it has been accepted for years in management that if you can't measure it, you can't manage it.

And within this lies the truth about the future of the public health system in this brave new Conservative world, although it applies just as much to the rest if the public sector, who are being freed from the restraining hand of targets - or being let loose to run unmonitored and unaccountable, depending on your view.

The targets are going not because they hold healthcare back - the evidence is the reverse - but because they reveal performance and the Conservatives know that despite Cameron's supportive rhetoric, the NHS is going to be subject to ideological roll back as well.

Tune to dust off the Major government's Patients' Charter? That 18 month treatment promise might start to look attractive if Lansley gets his way.

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