Leader comment: NHS targets are not hitting the mark

In every occupation, there has to be an ability to measure achievement or progress, to ensure that business requirements are being fulfilled.

Waiting times at accident and emergency regularly miss the stated targets.

Employees might hate being judged, but without an assessment of results or productivity a company or organisation cannot operate effectively or efficiently.

There is a place for such measures in the NHS, even though the fate of a patient could be subject to factors beyond the control of medics. There has to be a way of holding to account the provision of health services, to ensure that patients receive treatment when they require it. The difficulty occurs when a rigid set of guidelines takes no account of the need to arrange timetables to ensure that doctors are able to prioritise certain patients when necessary, and have longer lead-in times for other patients requiring less urgent courses of treatment. Ticking a box which says that both patients were seen within a specified number of weeks does not ensure successful outcomes, and instead increases the likelihood of a doctor scheduling treatment which better suits government guidelines than the needs of the patient.

Today, BMA Scotland chair Dr Peter Bennie echoes the opinion of former Chief Medical Officer Sir Harry Burns by stating that targets in the NHS are not working. It is a wonder why the Scottish Government has persisted with such measurements, because targets are routinely missed, creating a rod for the administration’s own back as political rivals quickly make capital over these “failures”.

With leading figures such as Dr Bennie and Professor Burns now questioning the worth of targets, there appears to be little for the Scottish Government to gain by persisting with this strategy.

Targets – or at least the intention behind them – should not be scrapped completely. In education, for instance, the current drive to raise standards and close the attainment gap can only be achieved if attainment can be properly measured, and that is done through assessment and examination. But these measures represent outcomes rather than pledges.

Waiting list times must of course be kept to a minimum, but the efficiency of the NHS would be better monitored through outcomes rather than through promises that are no more than wishful thinking, based on arbitrary figures that may as well have been plucked out of the air.