An easy target

Jan 9 2008 by Rob Merrick, Liverpool Daily Post

WHITEHALL targets are normally placed just behind dirty hospitals and greedy GPs in any list of alleged evils dragging down the NHS.

Heroic doctors and nurses are prevented from using their expert, clinical judgment by the ignorant instructions of some puffed-up bureaucrat, or so the story goes.

Last week, it was reported that billions are wasted by casualty departments admitting patients they should send home, in order to meet a target that all are assessed within four hours.

It was easy, therefore, for David Cameron to win plaudits for his New Year pledge to scrap all NHS targets and “let doctors decide the right treatment for their patients”.

The Tory leader claimed the NHS was burdened with a mind-boggling 64 Treasury targets, requiring a staggering 250,000 annual data returns, at a cost of £400,000.

So, targets are, well, an easy target – and perhaps there are too many of them? But what if the evidence shows they are working?

That was the conclusion of the NHS Confederation’s study into the effect of Whitehall’s instructions to hospitals to treat all routine patients within 12, nine and then six months.

In England, hospital managers were threatened with punishments if they failed. The result? Most patients will be treated within 18 weeks – the next target – by the end of this year.

Most will be treated within seven weeks – an astonishing advance on a decade ago when waits of 18 months, or even two years, were all-too-common.

In Scotland, the Edinburgh Parliament rejected a similar target-driven regime, relying on an “expectation” that waiting times would fall.

They did not.

The conclusion was that “targets and terror work” – with little evidence that patients are treated contrary to clinical priority, or that the figures are fiddled.

But this message was buried under the headlines triggered by a related conclusion that devolution had created “NHS apartheid” – with England the poor relation.

The focus was on some benefits undoubtedly enjoyed by Scots – free prescriptions, free eye-tests, access to some life-saving drugs – and denied to the English.

Of course, targets cannot meas- ure everything that matters – and no-one likes paying prescription fees. But I think most patients would rather pay for their pills than wait months for a heart operation, or a new hip, as they do north of the border.

SOUTHPORT MP John Pugh will speak for the Liberal Democrats on the crunch issue of the economy.

A heavyweight job – but he has been in training.

As he told the House magazine, remembering his school days: “I got very interested in weightlifting and still enjoy a relaxing bout of heavy lifting.”