A crass attempt at transparency

Targets and indicators are essential if we're looking at improving well-being in our large, complex societies. Currently, though, our targets are chosen unsystematically and incoherently. So we see results like this:

One in three heart surgeons refuse difficult operations to avoid poor mortality ratings, survey shows.... [S]urgeons would look at a patient and think, 'I know what’s best for you’, it’s this operation. Now a surgeon looks at a patient and says, ‘I know what’s best for you but is this going to be good for my figures?' ...Since 2014 the [UK's national Health Service] has published the individual mortality rates for consultant surgeons on the publicly available website ‘MyNHS’, which was supposed to represent a milestone in transparency. 'Daily Telegraph', accessed 22 April

It's pitiful. A national health service will always need numerical indicators, but we should be making sure that achieving them is inextricably linked to improvements in people's health and well-being. Mickey Mouse micro-targets, like an heart surgeons' 'success' rates are, as we see, worse than useless. They are as crassly thought out as certain other targets, such as:

A notorious example was that some hospitals kept patients waiting in ambulances outside the hospital until the hospital could be confident that the patient could be seen in its accident and emergency department within the 4-hour target. Source

I suggest that instead of these idiotic micro-targets or idiotic attempts at 'transparency', we look at we target measures that are important to ordinary people: the users of health care services. My suggestion is that we issue Health Bonds, which would explicitly and impartially target improvements in longevity, Quality Adjusted Life Years, infant mortality rates and other general population health indicators. Resources are always going to be limited but decisions our healthcare goals and - and the basis on which they are made - should be made clear to ordinary people, so that we can participate, if we want, in their formulation.