The New Zealand Herald

Targets not realistic during axe-swinging

National has no target for paying GPs fairly or to support their work

- Arena Williams comment

Igrew up in a South Auckland house that was always full of visitors. My mum was the local GP and my dad a local councillor. On Sunday afternoons, our neighbours would sit at the kitchen counter working through problems for their kids, their health and local parks and streams.

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.

National’s public sector targets are coming as it takes an axe to the public sector.

But when are targets a useful tool for accountabi­lity and when are they counterpro­ductive? 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

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