To: Don Wise, chief executive

From: Paul Servant, assistant chief executive

Re: Outcomes, schmoutcomes

Dear Don

It's been such an exciting couple of weeks, what with the NHS60 celebrations and the Darzi report. Your speech at our NHS60 civic reception will probably be remembered at NHS120. The passage where you talked about what we can do now compared with 1948 certainly grabbed the audience's attention. I'm sure I caught the mayor's eyes watering when you mentioned how her fistula repair could never have been done back then.

With all this excitement, the Conservatives' contributions to the celebrations seem to have been overlooked. It is probably worth noting that for each of the last major anniversaries the Tory policy was to ensure there would never be another one.

But now they've come up with a new policy. So as we celebrate the NHS's unique position in world healthcare and look forward to achieving its world class ambitions the title of the Tory policy is Delivering Some of the Best Health in Europe.

The Tories can't stand Europe, yet now they want an NHS based on bits of it. The document is one long whinge that the NHS hasn't improved enough.

But improved from what? The way they left it? They keep calling it our NHS but didn't they vote against it for even longer than the British Medical Association? And they object to targets which were invented by John Major with the Patients' Charter.

The slogan for the report is "outcomes not targets", which I can't quite see being adopted as fondly as the NHS demo chants of yesteryear... "Maggie, Maggie, Maggie! Out! Out! Out!" or that old crowd pleaser, "Cecil, Cecil, Cecil! In, Out, In, Out, In, Out!"

So out go the four-hour and 18-week targets and in come the quatre heures and achtzehn wochen outcomes. Outcome data will drive performance pay for doctors and apparently "the best person to report on a treatment episode is the clinician responsible".

That's almost as sensible as allowing MPs to vote on their own pay!

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