Defending his government’s use of targets to drive UK public-sector reform through the practice of “deliverology,” Tony Blair declared that he couldn’t imagine running any business without them. Leave aside the fact that he had never run a business, Blair’s need to mount a defence was driven by the volume of protests, objections and evidence of the dysfunctional consequences of his targets regime. Blair was visibly shocked when publicly confronted about the absurdity of a patient being unable to make an appointment to see her GP the following week – according to Whitehall-imposed targets the appointment had to be given within two days. The perverse consequence was that if she wanted to be seen next week she would have to come back and make the appointment later.
There is a systemic relationship between purpose, measures and method. To describe it as systemic is to say it exists in any organisation for good or ill.
When targets are imposed onto any system two consequences ensue: they create a de facto purpose (be seen to make the targets) and they constrain method (organise the work around meeting targets). For example, in care services workers worry about meeting targets for carrying out assessments. In fact, it might take anything from days to months to gain a good understanding of a person’s real needs, so the constraint of completing the work in an arbitrary time leads to inaccurate assessments and, often, denial of services. To avoid failing the target cases are ‘closed’ or passed on to other services. The focus is meeting the target, not assessing people’s needs.
The architect of Blair’s “Delivery Unit,” Sir Michael Barber, acknowledged that the results of the first few years of his target-setting “Deliverology” – what he described as the “science of delivery” – weren’t good. If you read his books you will see his admission that one year in, Deliverology wasn’t working; three years in, still not working but then, as if by magic, the numbers started getting better…(does Canada’s federal government have three years?)
The reality was that the recipients of the targets had become competent at sending up the hierarchy the figures that central government wanted to see. Their ingenuity was engaged in survival and avoiding punishment, not, sadly, in improving performance. People cheated. The more they learned to cheat the more disillusioned they became. It was an illusion of control; while Whitehall fondly imagined that performance was improving, public servants were becoming demotivated and the services were being made worse. Being seen to meet targets had become the de facto purpose.
It is a simple truth: sending any arbitrary measure down a hierarchy will sub-optimise the system, driving it away from meeting its purpose.
Reflecting their unthinking adherence to convention, managers often imagine that ‘no targets’ must mean ‘no measures’. Not so. To establish measures that will always drive improvement, we have to think about the purpose of a service in citizen terms. In care services the purpose would be ‘understand me, my context and what a good life means to me’. Clarity of purpose in citizen terms enables measures to be established that help people who deliver the service to understand and improve what they are doing; their ingenuity is engaged constructively rather than defensively; it is the positive expression of the systemic relationship.
Conventional managers would believe that using real measures, related to the purpose, at the point where the work is done, could only lead to anarchy. Counterintuitively, the consequence is genuine control and improvement. It is foolish to try to persuade them they are wrong. The best way to help managers realise the counterintuitive truth is to enable them to see it for themselves. When they study their own system and see how targets create dysfunction, driving up costs and worsening service, they cannot escape the realisation that it is indeed their current ideas about measurement that are flawed – they are not, in fact, controlling anything but, instead, are steering the system out of control.
Using measures derived from the purpose of a service from the citizens’ point of view liberates method – and how, if not by changing method, can anything at all be improved? Furthermore, and vitally, putting these measures in the hands of the people who perform the work in turn changes management’s focus from “monitoring” dysfunctional measures to acting on the system – dealing with all the things that impede the service deliverers from giving citizens what they need. This is what management should be doing – and as managers learn to work this way the culture switches from one of fear and misplaced ingenuity to one of collaboration and constancy of purpose. Culture change comes free. Moreover, as services become more effective, costs fall – and by amounts that would never have been thought possible. If only Blair had known that.
John Seddon is the leader of the Vanguard organisations, now active in eleven countries. His latest book The Whitehall Effect: How Whitehall Became the Enemy of Great Public Services and What We Can Do About it (Triarchy Press).