The Trap: What Happened to Our Dream of Freedom

Narrator:
The original idea behind the mathematical system was that it would liberate public servants from old forms of bureaucratic control. Once they were given the targets, they were free to achieve them any way they wanted. But almost immediately, New Labour began to discover that people were more complex and devious than the simple model allowed. Public servants began to find the most ingenious ways of hitting their targets.

James Strachan:
It's the fact that the pressure to meet these targets is causing some NHS managers to game the system.

Narrator:
Hospital managers proved to be particularly devious. When they were set targets to cut waiting lists, they ordered consultants to do the easiest operations first. Like bunions and vasectomies. Complicated ones like cancers were no longer prioritised.

Voice Over:
When the managers were set a target to reduce the waiting time in Casualty, they came up with more clever strategies. A new job was invented, called the Hello Nurse. Who did nothing to treat the patient, but simply greeting them meant they had been seen and were off the list. When the government then tried to set a target to reduce the number of patients waiting on trolleys, the managers took the wheels off the trolleys and reclassified them as beds. And they redefined the corridors as wards and yet again the patients were off the lists.

Narrator:
When the government then tried to set a target to reduce the number of patients waiting on trolleys, the managers took the wheels off the trolleys and reclassified them as beds. And they redefined the corridors as wards and yet again the patients were off the lists. The Police were also under pressure to meet their targets. One of the main ones was to reduce the rate of recorded crime. Again, inventive strategies were found. Lothian Police announced the most successful crime figures in 25 years. But it was later found that they had reclassified hundreds of crimes, including assault, robbery and fire-raising, as simply Suspicious Occurrences.

Voice Over:
When the government then tried to set a target to reduce the number of patients waiting on trolleys, the managers took the wheels off the trolleys and reclassified them as beds. And they redefined the corridors as wards and yet again the patients were off the lists. The Police were also under pressure to meet their targets. One of the main ones was to reduce the rate of recorded crime. Again, inventive strategies were found. Lothian Police announced the most successful crime figures in 25 years. But it was later found that they had reclassified hundreds of crimes, including assault, robbery and fire-raising, as simply Suspicious Occurrences.