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Home » Research Projects » Performance Indicators in Health Care: A Comparative Anglo-Dutch Study

Indicators of progress

How do performance indicators develop, what conditions lead to their introduction and what is the response to their introduction?

Quantitative performance indicators (PIs) are often said to be a general feature of modern public management today, yet they have developed rather differently even in neighbouring wealthy democracies. In England, PIs have had a central place in the assessment of health care performance since the first phase of the Thatcher Government in the early 1980s and managers whose organizations fail to perform adequately on centrally-prescribed PIs face dismissal. In the Netherlands, however, PIs only began to develop in health care in the early 2000s and appear to be used in a less centrally-directed way to monitor the links between public and private provision of health care. How is it that PIs can develop so differently in neighbouring countries, even in a supposedly ‘global’ age, and how much difference does it make to performance?

This study aims to trace out how and why PIs developed in healthcare in England and the Netherlands, what changes they entailed and what their impact was.

What the research means for policy-makers and the wider community

Research Methods

The study will use a combination of three qualitative methods (‘triangulation’ in methodological jargon) to examine how PIs develop and are used:

Project Outputs and Related Webpages

Christopher Pollitt, Stephen Harrison, George Dowswell, Sonja Jerak-Zuiderent, and Roland Bal (2010) ‘Performance Regimes in Health Care: Institutions, Critical Junctures and the Logic of Escalation in England and the Netherlands’ Evaluation  16: 13-29

Project Poster 2009

Visit the project web page at the National Primary Care Research and Development Centre.

Pollit C (2007) ‘Hospital performance indicators : how and why neighbours facing similar problems go different ways : building explanations of hospital performance indicator systems in England and the Netherlands’ in New public management in Europe : adaptation and alternatives, (eds: Pollitt, C; Van Thiel, S; Homburg, V.) Palgrave Macmillan, Basingstoke

Research Team

Stephen Harrison

Stephen Harrison

Stephen Harrison is Professor of Social Policy at the University of Manchester. He worked in the Ministry of Labour / Department of Employment, and held various posts as Personnel Manager in the steel industry and the UK National Health Service before becoming an academic.


Christopher Pollitt

Christopher Pollitt

Christopher Pollitt is currently Professor
of Public Management, University of Leuven, and Scientific Director,
Netherlands Institute of Government. He
was previously Professor of Government
and Dean of Social Sciences, Brunel
University and and Professor of Public Management at Erasmus Universiteit Rotterdam