25 February 2010

An extreme example of the failure of targets culture?

I have blogged about the effect that 'targets culture' can have on public services. The extremely distressing news from Mid Staffs Hospital, see here on this BBC article should help those who run and are accountable for public services to stop and think again whether the 'targets approach' is the right one.

The BBC article states:

"The trust had been climbing the NHS ratings ladder during the period in question and was even given elite foundation trust status."

The Guardian refers to :

"Staff were equally critical about the hospital's management, and described bosses who bred "an atmosphere of fear of adverse repercussions", stressed NHS targets were the top priority and were secretive when things went wrong.

The trust's board, which was meant to hold managers to account and ensure high clinical standards were maintained, were aware of the weaknesses but failed to ensure improvements were made, the report says."

Health Secretary Andy Burnham said there could be "no excuses" for the failings.
But he added: "This was ultimately a local failure, but it is vital that we learn the lessons nationally to ensure that it won't happen again - we expect everyone in the NHS to read the report and act on it."

I am not so sure that the human failings and above all the desire to hit targets based on not clinical and medical demands of running a modern hospital but instead by distant managers and others can have a corrosive impact on the actual service itself. Appropriate targets set locally as part of the range of management tools fine - centrally driven targets which can erode the professional judgement of managers and clinicians, lead to false reporting (Baby P) and undermine the proper functioning of the services not fine.

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