Gordon Brown, the former British Prime Minister was obsessed with setting targets and his obsession helped remove humanity from public life and in particular to destroy the health service.
It is because of Brown that public services have been afflicted by an absurd and dangerous ‘target culture’.
Brown seemed to believe that if you give public servants targets they will work harder and provide a better service. Indeed, like any good soviet dictator, Brown seems to believe that he only had to announce a target for it to become an achievement.
Brown set spending review targets (known as public service agreements or PSAs) which cover the performance of all the major government departments and which set highly complex and specific criteria for the way in which public servants are assessed. The PSAs cover everything from exam results to crime figures and cancer rates.
What Brown didn't realise (possibly because of a lack of much genuine work experience – he's been an MP since the age of 32) is that when you give public servants targets they will concentrate on satisfying those targets to the exclusion of everything else. Self-preservation takes over, the target becomes the aim and the focus, and the welfare and indeed the existence of the public, the individual, the person, the end user, the patient, the client, the poor taxpayer hoping to get some service for their money, goes out of the window, never to be seen again. The end result is a massive fraud. Public servants are encouraged to cheat the public in order to get promoted and to receive bonus payments.
Performance indicators on a scale that would have impressed Stalin have been forced on councils, schools, hospitals, the police and institutions throughout the nation, and Brown helped create a mad bad world in which every public employee is more concerned with meeting ‘targets’ than in satisfying the public's needs.
It was Gordon Brown who created the entirely mad world in which public services can claim that they are providing the public with wonderful service even though everyone with half a brain knows that they are not. It was Gordon's target culture which encouraged administrators in every branch of public service to cheat and to concentrate not on providing a good service but on satisfying Gordon's utterly absurd targets.
Gordon Brown's endless series of targets gave him control over other Government Departments and the way they worked. By controlling the purse strings at the Treasury, and making other departments obey his targets, Gordon interfered with other departments in a way never seen before in Britain. Brownism meant that a bunch of people who knew nothing about vital services such as health, education and crime fighting were effectively in control of health, education and crime fighting. Incompetent professionals were able to behave ever more incompetently. Unimaginative, uncaring jobs-worth bureaucrats who worked by the rule book were able to rise through the ranks and take control. For them Brown’s targets were a dream come true. Politically correct nurses, policemen and teachers now all had excuses for ignoring the needs of their patients, citizens and pupils. Millions of public servants who were being paid to serve the public now had just one master: Gordon. Instead of pleasing the public all they had to do was meet their artificial targets and success and glory would be theirs. It is to their eternal shame that so many professionals should submit so meekly to such nonsense.
Some of the targets introduced were nothing short of mad. So, for example, the Atomic Energy Authority was told that it must increase its favourable media coverage by 43.9%. Kew Gardens was told that it must receive 30,000 herbarium specimens a year.
Hospitals were told that patients who visited casualty departments had to be seen within four hours. (I confess that I always found this woefully unambitious. Can you imagine Gordon Brown sitting in a casualty department waiting four hours to have a member of his family seen by a nurse? No, nor can I.)
Hospitals got round these woefully unambitious casualty waiting time targets by employing a ‘hello’ nurse. The nurse just says ‘hello’ but doesn't offer any treatment. But she is officially the end of the waiting time.
Struggle into a Brownian casualty department with a leg hanging off and a nurse will totter over and say ‘hello’. That's it. Hello. You can sit there and bleed to death. No one cares. You've been seen within four hours. It is deceitful and dishonest and so it fits the Government's style like a rubber glove.
In other hospitals the result of Brownian targets is that patients wait for seven hours because they are placed in ‘medical assessment units’ where, although they still haven't been treated, they don't officially count as still waiting.
Patients are given an appointment for 8 o’clock in the morning. They arrive on time, often at great inconvenience, and find that dozens of other patients also have appointments for the same time. They wait all day to be treated – only to be told that their blood pressure readings are too high and they must go home and come back another day.
Nothing much changes, does it?
Adapted from They Want Your Money and Your Life by Vernon Coleman