In its report on health board budgets, the Scottish Parliament’s health and sport committee finds that no systematic measurement is made of the cost – or benefits – of avoiding relatively trivial target failures. It urges ministers to consider a more flexible approach to the targets regime, which is set annually to cover matters like delays at Accident & Emergency and cancer treatment times.
The committee says that health boards complain of having to divert substantial resources where one of the government’s more politically high-profile targets is in danger of not being met, sometimes to the disadvantage of clinical priorities elsewhere.
No clear assessment was made of the cost to boards of upping performance where outcomes threaten to fall just short of target. “This is especially relevant where a board’s performance may only be 1-2% below the target and the money may be able to achieve much greater gains elsewhere,” the report says.
Committee convener Duncan McNeil said: “While there clearly needs to be some measurement of output and delivery, our committee has questioned if meeting that final percentage of performance targets is really the best use of public money.
“Given that there is no way to measure the amount of investment that goes into this, we are calling for the Government to consider whether there should be flexibility in the targets to ensure any investment goes towards actual improvements in the quality of care.”
Cabinet health secretary Shona Robison said that ministers had reduced the number of targets operating in the NHS in Scotland from more than 200 to around 20, but she insisted that the so-called HEAT targets (Health improvement, Efficiency and governance, Access and Treatment) were an important tool in driving up NHS performance.
“We know that rigorous targets can deliver improved services for patients, as our health service is now delivering some of the lowest waiting times on record,” Robison said.
“However, we do need to ensure we have the right targets for the right things and set at the right levels.”
