Monday, 18 February 2008

Target practice

So the government decided it would add some new rules to the game and gave hospitals some targets. They decided that every patient arriving at A&E should be seen within 4 hours. That sounds like a good idea for the game you might say. And it would be a great idea, if hospitals (and A&E in particular) weren't already stretched to snapping point. So, what did hospitals do? They played the game.

The targets given by the government suggested a 4-hour limit for treating patients entering A&E. Many hospitals quickly realised they had no hope in hell of reaching this target if they continued to play the way they always had. To get around this obstacle, hospitals prevented ambulance patients from entering the hospital until they were sure they could treat them within the target time. We cannot blame the hospitals for this; whose budgets live and die in the reaching of these government targets. Rather it is another example of the government failing to see the woods for the targets.

In true Labour style, the government have not been careful in what they measure. Prior to the introduction of these taregets, the statistics may have revealed something about the ability of hospitals to deal with A&E patients in an efficient manner. However, once the statistics became part of the game, they lost all meaning. The goal is not to get patients in and out in 4 hours; the goal is to treat patients successfully. Much like targets in primary education, the goal is not to have children abeing able to do X,Y or Z at key stage 3; the goal should be to reach 100% literacy and give our children the tools to be able to think for themselves.

When New Labour moved to the centre, they abandoned much of their socialist rhetoric. Somehow, they managed to forget how counter-productive targets were in the old Soviet Union. Yes, targets will be reached, but what will be achieved and at what cost?

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