... is that in any system or organisation where success is measured by abstract criteria like these "targets" the people in hte organisation get really good at manipulating the system to produce a "target result" and rather less good at whatever the organisation was set up to do -- in this case traeting sick people.

Some examples:-

the "Large Anonymous IT Company" has a problem tracking system in place for some years now whereby the support staff lose bonus if they don't resolve problems within 14 days. However all the support staff know that "resolve" includes asking the customer for more data. Its not unheard of for customers to receive pointless requests for single parameter settings at thirteen day intervals thereby ensureing that the support bod "has resolved all problems within 14 days" even though the call has been outstanding for 12 weeks and nothing constructive has been done. He probably gets a much better bonus than the poor suckers who waste there time trying to solve the customers problems.

Another more historical example would be the classic Soviet 5 year plans. The consequences of failing a target were rather drastic under Stalins leadership therfore all targets were met. Tractor production was always up althought some tractors did not have wheels, towns and villages were electrified on time (though the lightbulbs were rather dim from the 90 volts supplied).

I suppose its rally our own fault for electing lawyers, PR persons, advertising execs and phone cleaners to run the country.

Around here they appear to have found the secret to hitting hospital waiting list targets. Instead of putting you on a waiting list they put you on their calendar to inform you that they are putting you on the waiting list at some time in the future.

They get round waiting times to see your GP by getting you to call first thing in the morning to see if your GP has a slot that he/she can see you in. If there isn't a slot for your GP they tell you to telephone the next day to see if there is one then. They will not put you on a waiting list. You can take pot luck and see a GP or locum that same day but that is no use if you have complicated health issues that only your normal GP knows about.

The squeaky wheel gets the oil, and the patients getting close to waiting for 18 weeks will get the priority. Two observations:

What if there are a lot of patients close to the deadline?

Will this mean that all (or most) patients will have to wait for the full 18 weeks? Even in critical cases?

At least they can track their patients.

Try tracking them in the Southern Cluster across the CRS and RIS products supplied by the LSP. It seems it can only be done using 3rd party software!