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What's measured is what matters: targets and gaming in the English public health care system

Bevan, Gwyn and Hood, Christopher (2006) What's measured is what matters: targets and gaming in the English public health care system. Public Administration, 84 (3). pp. 517-538. ISSN 0033-3298

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Identification Number: 10.1111/j.1467-9299.2006.00600.x


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 represent 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 in order to counter the problems we have identified.

Item Type: Article
Official URL:
Additional Information: © 2006 Blackwell Publishing Ltd
Divisions: LSE Health
Centre for Analysis of Risk & Regulation
Subjects: J Political Science > JN Political institutions (Europe) > JN101 Great Britain
Sets: Research centres and groups > Management Science Group
Research centres and groups > LSE Health
Research centres and groups > Centre for Analysis of Risk and Regulation (CARR)
Date Deposited: 28 Jul 2008 16:18
Last Modified: 20 Apr 2021 02:03

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