We need to get things right because we are accountable directly to the human being in front of us. We deal with the individual on a personal level.

Aspire: To hope to do or be

Target: goal; aim; end; objective

The former is a moving line, a journey; the latter an end point, a destination.

The former is a desire, an intent to be good at something, say for example, golf. The latter is the hole on the green. Every golfer tries to get the ball down the hole in the least number of strokes as possible. They try their best to do so. They endeavour to improve over time with practice. Marginal improvements brings a sense of achievement and hope. So the aspiring professional golfer keeps on practicing; keeps on improving; keeps on enjoying; and keeps on playing the game. Now what would happen if that novice golfer was told that he had to get round the course in level par. He tries and tries but he just can't do it. He becomes disenchanted and disillusioned with the game. He feels a failure. The target becomes an insurmountable object. So what does he do? He gives up.

The news over the past two weeks has been full of stories of, on the one hand, government's failure to hit its target on immigration, house building and the 'deficit/debt' and on the other A&E departments missing their targets on waiting times, ironically set by who? Well, governments of course!

So why are governments, of any hue, so keen on setting targets for others when they are so palpably inept at meeting the ones they set for themselves? Why do they get carried away with making election promises in their party manifestos only to find that once in power things tend to be more complex than they envisaged and that unforeseen events tend to conspire to derail their well-meaning intentions? In short because they know that targets are meaningless. They are just a cynical ploy to buy votes and if that does not work then they don't get voted in. They move off to other jobs. The utility of a jobbing MP is limited.

MPs have a superficial, self-promoting mindset. Professionals tend to be more committed and outward-looking in their thinking and actions. Medicine is often spoken of as a vocation (an occupation that someone feels called to do). Doctors (and allied health staff) are drawn to an ethos to help others. We get a warm feeling inside when something goes right; when we see that our actions have improved the lot, even in some small way, of some poor soul. Believe it or not, we thrive on helping people and are upset when we can't. We are devastated when something doesn't go the way we hoped or planned. These may sound like hyperbolic verbs of emotion but I assure you they are not misplaced. We need to get things right because we are accountable directly to the human being in front of us. We deal with the individual on a personal level. Politicians? Well, they don't. They deal with amorphous populations, large numbers and statistics. It is those discordant perspectives that contribute in some measure to some of the dysfunctional elements within the NHS.

Setting doctors and other healthcare professions, targets, has no meaning. It is pointless. They are all aspiring to do the best they can anyway. They don't need to be set goals because they have already set those themselves. They want to make sick people well and they want to do so quickly, efficiently and unencumbered by any distracting influences.

Targets are irrelevant and counter-productive. Any sense of achievement in hitting a target is transient and illusory. However missing a target is far more destructive. The consequences are feelings of frustration, demoralisation and failure. And what do people do when that happens? They walk away. They leave. They find something else to do where they might be better appreciated. They emigrate to Australia!

The NHS does not need targets. It needs to be left alone to aspire to be better. Otherwise it will just expire.


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