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Monday, 23rd January, 2006

The first paper in our Discussion Paper Series, What’s Measured is What Matters: Targets and Gaming in the English Public Health Care System, jointly authored by Gwyn Bevan and Christopher Hood can be found in our library section and is now available to download.

In the 2000s, governments in the UK, particularly in England, developed a system of governance of public services that combined targets with an element of terror. This has obvious parallels with the Soviet regime, which was initially successful but then collapsed. Assumptions underlying governance by targets are synecdoche (taking a part to stand for a whole) and that problems of measurement and gaming do not matter. We examine the robustness of the regime of targets and terror to these assumptions using evidence from the English public health service on reported successes, problems of measurement and gaming. Given this account we consider the adequacy of current audit arrangements and ways of developing governance by targets to counter the problems we have identified.

Our Discussion Paper Series aims to disseminate innovative and, as yet, unpublished research findings to generate discussion and debate. This is only the first in what will become a substantial set of research-based discussion papers, so keep checking our website for new additions.