The tyranny of targets
Has the government set a target for reducing targets? Scarcely a day now passes without news of more central controls being loosened. John Reid, the Secretary of State for Health, announces that more than 700 targets for the NHS are to be dropped and replaced by a mere 24 "core standards" and ten "developmental standards" (clearly, Whitehall is meeting whatever targets it sets itself for inventing gobbledegook). Meantime, over at the Department for Education, the target for reducing truancy in schools is to be abandoned. Elsewhere, a target for all council tenants to live in decent homes by 2010 has also gone down the pan. But does Whitehall move as one? Days before Mr Reid announced his bonfire of targets, it was revealed that hospitals which hit targets for accident and emergency treatment would get performance bonuses, as would ambulance services that hit a target of getting to 999 calls within eight minutes.
It may in any case be too late to rescue public services from the tyranny of targets. New Labour is often accused of failing to change the national culture in the way that Margaret Thatcher did, but it has changed the culture of the public sector profoundly (albeit after the foundations had been laid by the Tories). Ministers can afford to relax central controls, because local managers have learnt to generate their own targets, tick-sheets, action plans and vision statements. Chop off the head of the bureaucratic monster in Whitehall and it will reappear, fearfully multiplied, in a thousand other locations. The days when teachers were left to do what they thought best for their pupils, and doctors for their patients, have long gone. Ministers now need a target for reducing the time spent on paperwork at all levels of the public services.
Targets have not been all bad. They deflated the arrogance of public sector professionals, and particularly of their associations and unions, which too readily confused self-interest with the public good. But to use targets as the main tool for service improvement was an error. As Professor David Marquand puts it in his new book, Decline of the Public: "Audit is an iron cage." Professionals "had to adapt their practices to the demands of the audit process, just as managers in the old Soviet Union had to adapt theirs to the demands of Gosplan. Little by little, they began to lose the autonomy that is fundamental to professionalism . . . The more professionals were audited, the less professional they were able to be."
This had two results. First, in striving to meet targets, which were inevitably quantitative in nature, public services created new problems for themselves and their users. Targets for literacy and numeracy led, as the chief schools inspector stated in his annual report this month, to a "wide gap" in pupil achievement between English and maths on the one hand and such subjects as geography and history on the other. Targets for waiting lists led hospitals to push through easier - and often less urgent - operations. Targets for research publication led academics to publish a growing number of impenetrable, badly written papers in small-circulation journals. Targets for convicting persistent offenders led the police to ignore more serious criminals, who are too smart to get caught easily. Across the land, targets threw up such unintended consequences, which themselves prompted more targets. Ever greater armies of bureaucrats were required to monitor employees' work more finely and to guard against sharp practice. Hence the widespread perception that public services are drowning in paper and that teachers, doctors, nurses and police spend more time on form-filling than on dealing with pupils, patients or criminals.
The second result was that the public sector's biggest weakness was made worse. It is in the nature of state employees that they play things by the book, referring decisions upwards, protecting their backs, sticking to established procedures. The penalties for unauthorised error are greater than the rewards of inspired success. Targets and central controls make public servants more risk-averse, less inclined towards the sort of bold innovation that new Labour ministers have said they wish to encourage.
Targets are not wrong in principle. But, under this government, they have grown like weeds and have often been used not after careful thought about whether they can effectively raise performance, but merely to provide another "ministers act" headline for the next day's papers. Professor Marquand compares audit to an unstoppable train: "If auditees perform properly only when they are audited, repeated audits are the only way to ensure that proper performance continues." But somehow the government must find the brakes.
An inquiry, it is said, offers "closure", a condition now sought after as much as a state of grace once was. Increasingly, however, only more inquiries will do. Tony Blair is compelled to set up an inquiry into matters excluded by the Hutton inquiry. But since Lord Butler's terms of reference are, in their way, just as narrow, another inquiry may be needed after that, even though MPs have also held inquiries. Meanwhile (see David Cox, page 24), the BBC has an inquiry into why it got criticised by Lord Hutton. Mr Cox fears that Mark Byford, the acting director general, has made an error in setting it up and that it may rebound upon him. We shall then surely want an inquiry into Mr Byford. At some stage, just possibly, one or more people will put their hands up and say: "Terribly sorry. Save your money. I was wrong. My fault." But we would then need an inquiry into who had bribed or bullied them to say it.