24 May 2002
It warns that targets that are linked to funding and set without taking account of their knock-on effects can have damaging consequences. For example, an A&E department that is meeting its trolley-waits target has a disincentive to help out a neighbouring casualty department that is struggling. Taking its neighbour's patients would make its own figures look worse.
The problem is highlighted in a Demos report, Systems failure, published this week. Author Jake Chapman, who has acted as a consultant to the Cabinet Office's Performance and Innovation Unit, said: 'Policy-makers make a basic error when they treat any public service as a machine whose parts can be tinkered with separately.'
Demos was due to explain its findings at a seminar on May 24, to be attended by government policy advisers, including Geoff Mulgan, director of the PIU.
NHS Confederation policy director Nigel Edwards said the strategy to achieve government policy should come from within the NHS and should not be imposed through central plans linked to penalties for failure.
For example, the proposed fines for social services that contribute to bed-blocking could hinder good relationships between the NHS and local authorities. 'This is a classic example of well-intentioned policies that need to consider the impact on the whole system,' he said.
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