Friday, October 27, 2006

The Trouble With Performance Targets

Good people work hard and care about what they do. They also understand what they do and why it is important. When some authority comes crashing down from above with performance targets, it invariably cocks things up.

1. Targets measure the wrong thing. In the old Soviet days there was a directive to produce so-many shoes. So the manufacturers produced that many shoes. They may have been hideously uncomfortable and all of them brown, but the targets were met.

2. Targets prioritise the management of the task above the task. In Britain the New Labour government introduced targets to cut hospital waiting lists. So the hospitals treated all the easy cases first - this reduced the waiting lists, but it increased the waiting time for anything non-routine! Think about it... the length of the waiting list doesn't matter a bit! It's how long you have to wait that counts.

So now our beloved leaders have introduced targets to cut waiting times. And now the quick treatments are prioritised to lower the average waiting time. The result - patents needing slower treatments need to wait even longer!

All along, the targets are there to get the government re-elected, not improve health care. In the health service, targets pervert clinical priorities. Good practitioners don't need targets. Government does.

3. Targets make the right thing damned inconvenient. Yesterday we heard the report that a Welsh police force had reached its targets on tackling violent crime. Good news? Only if you're a violent criminal. In response, the police have stopped collecting intelligence in the field because it would lead to a higher target the following year. So the target becomes an incentive to do a worse job.

1 comment:

Anonymous said...

AKA Body Counts of the Vietnam war...