Targets not realistic during axe-swinging COMMENT

• Published date: 18 April 2024
• Author: Arena Williams is an MP for the Labour Party Arena Williams
• Publication title: Whanganui Chronicle

None of the things people would visit to talk about have a natural end point. They were about child poverty, the degradation of the environment, or the need for better healthcare — and the complex interactions between these issues. I got into politics to work through those issues for people too, because whatever progress we have made in the last two decades, the job isn’t done

These points are worth bearing in mind following the Government’s recent announcement of nine public service targets.

Targets in themselves are not a bad thing. In Government, Labour set a range of targets to ensure that progress towards long-term measures was being tracked. The Public Finance Act was reformed to require government to set wellbeing objectives and state how Budget decisions have been driven by these objectives.

But when are targets a useful tool for accountability and when are they counter-productive? The British economist Charles Goodhart coined what is known as Goodhart’s law: “When a measure becomes a target, it ceases to be a good measure.” When we put too much weight on a single indicator, that becomes a less reliable measure of the outcomes that we care about.

Take the targets National has set for the health system.

Targets have a long history in the United Kingdom’s national health service as a way of trying to change behaviours within a system.

Ideally this works through directing energy towards things that matter. But poorly implemented targets can result in gaming of the system or neglect of aspects that aren’t measured.

As Labour’s health spokeswoman Ayesha Verrall said, effective targets need to be focused on the relevant part of the system, with a clear timeframe for achieving them.

National has set a target for patients to receive cancer management within 31 days of the decision to treat. However, if the barriers to treatment are actually the long wait before patients can get the biopsies and scans that would lead to that decision, then the targets are focused on the wrong part of the system.

National’s targets also completely ignore primary care doctors, GPs, like my mum. One of the biggest problems in health is that people can’t see a GP, but National has no target that would see GPs remunerated fairly, supported to do their work or to support training of the workforce. There are no targets for other primary health outcomes, like kids’ teeth, that would support early...