Jeremy Hunt (Health Secretary) has helpfully summed up the problem of remote management by KPIs: You are hitting the targets but missing the point. There was a good discussion to be had there about the way in which one can measure performance and encourage improvement but sadly, he went on to use a current buzz phrase, talking about those that are coasting along and not achieving excellence.
The BBC version of the pre-speech release - why bother to have a speech at all when the main aim is to get media coverage twice: once when you issue the I am going to say and then the speech; perish the thought that something more interesting might happen and push you off the news - goes on to say:
It is commonly said about a 10th of hospital trusts are failing, although double that are actually not meeting all the essential standards set out by the Care Quality Commission. That leaves about 80% of trusts that are doing what they should. Some of these will be excellent - perhaps about 10-15% - and some will be striving to become excellent - perhaps a similar number. That leaves close to half that could be said to be stuck in the middle, coasting along.
Hitting the targets but missing the point is a well-turned phrase which must have cheered the speechwriter. It is only when you ask Who set the targets? that the reality dawns: it was, of course, Ministers. As so often - take Education as a very obvious example - if you give people boiled-down or simplified targets then they start delivering on those targets whether they make sense or not. If you set targets involving going up and down at the same time, we will find a way of doing so if that is what you say you want.
Policymakers want to set standards for Education and seem surprised when teachers teach to the test. This leads to complaints that teachers are in the wrong. Look in the mirror. Teachers may be missing the point but if you tell them that you will judge them by their ability to hit targets do not be surprised if they aim for those targets. The hint is in the word.
The interpretation of Excellence in Health is clearly following that of Mr Gove's Education department: achieving targets or being satisfactory means you are below par, coasting, not striving hard enough. Is there a statistician in the house? When will someone explain the meaning of average: the concept that there are as many in the top half as there are in the bottom; that a normal distribution includes a large bulge in the middle.
Or is it like some of our politicians and Orwell's animals where we are average, the other 95% are below average?
And just how intellectually insulting is the sentence: that leaves close to half that could be said to be stuck in the middle, coasting along. It is not even justified by the copy which appears to estimate the number that are excellent and the number striving, and then guesses at the proportion in the middle. Might this middle bunch not be actually trying their damnedest against almost impossible odds such as funding cuts and nonsensical government targets? Statistics tell us to expect them to be there. Oh no, they are coasting and missing the point.
As someone called Jo Webber says people in the Health Service come to do the best they possibly can for patients. I am sure many do. How about celebrating their efforts instead of kicking them for once?
Wielding a vague stick vaguely in the direction of the enemy never improved anything. But it makes a good line for a cocktail party and good copy for the Daily Mail.
