Scottish health targets are meaningless and useless

Health Ministers are pursuing “meaningless and unambitious” health targets that will fail to rid Scotland of its reputation as the sick man of Europe, one of the country’s leading economists has warned. Dr Andrew Walker, a health economist at Glasgow University and a former NHS manager, has condemned as “useless” eight of the Scottish executive’s 14 key health targets.

Walker has claimed that the targets, set in 2001, are meaningless, either because performance can’t be measured or any improvement has nothing to do with executive policy.

Most of the remaining six targets have already been missed, are unambitious, cannot be verified or are unlikely to be achieved, he added.

Walker’s intervention will cause embarrassment to Andy Kerr, the health minister, who was accused last week of short-termism in a report by Audit Scotland which criticised the vast amount of money being spent to cut waiting lists. It said money had gone into short-term bursts of activity to clear the backlog of patients without addressing their underlying health problems.

According to Walker, the money would have been better spent tackling obesity and alcoholism as well as providing nicotine patches and cholesterol-lowering medicines.

In 2001, the executive pledged to cut the proportion of adults exceeding safe weekly drinking limits from 33% to 31% among men and from 13% to 12% among women within four years. Following indications that the target for women wasn’t going to be achieved, the executive dropped it and issued a vague commitment to cut death rates among under-75s by encouraging people to drink and smoke less, improve their diet and take more exercise.

Currently, around 44% of men and 27% of women drink more than the recommended safe level.

“I would call for a specific target to be restored and for it to be an ambitious one,” said Walker, who added that the executive had watered down its commitment because it didn’t want to be seen as a “killjoy”.

Although the target of reducing the proportion of smokers from 35% to 33% between 1995 and 2005 was achieved, Walker said it was “profoundly unambitious”. He believes making nicotine patches and cessation counselling more widely available would have led to a much bigger fall.

While the executive was on course to meet targets to reduce deaths from coronary heart disease, cancer and stroke in the under-75s by 2010, he said the reductions were being achieved by people changing their lifestyles rather than improvements in care.

A target that no patient should wait more than two months for urgent cancer treatment by the end of last year was also missed. More than half of cancer patients requiring an urgent referral are having to wait longer than two months.

“Targets have to be quantifiable and have a time limit. There are too many targets where outcomes cannot be changed by policy or that are so badly worded that progress won’t show up even if the health service is doing a terrific job,” said Walker.

Stewart Maxwell, the SNP shadow deputy health minister, accused the executive of dishonesty. “The executive drops inconvenient targets that they aren’t going to meet — even though most are so utterly simple they could be achieved by any government. The ones they achieve make little or no difference,” he said.

The Scottish executive said the 2001 targets had been “superseded by more recent ones which better reflect the needs of patients and the wider public”.

http://www.timesonline.co.uk/article/0,,2090-2047804,00.html