Hospital chiefs blamed poor record keeping and employed more coders to correct a seeming anomaly in their mortality figures. In the meantime, patients were ill cared for and received inadequate or incorrect treatment. The true message was lost as people focused on the medium delivering it.
And I think there is a truth here. What "target cultures" do is not just take up valuable person to person contact time in producing figures and reports, they start to convince us that those figures and reports are the real business and that the humans behind them are incidental. Because in fact what is happening is that the measure of progress towards a target is mistaken for the target itself. In this case, the figures were the pointing finger, whilst the real target is afterall the safe and humane care of a real live person.
On a different but related topic, last night my daughter (doing her A2s this year) was complaining about the amount of work she had to produce for her Business course. I was fairly dismissive in a kind of "when I was your age, missy" kind of a way until she revealed that she was compiling a report on Motivation that was expected to reach around 30,000 words. Yes. that's right - I didn't slip an extra nought in there. THIRTY THOUSAND words for an A level course work piece.
I read through parts of it and it was really quite good. I pointed out a couple of minor confusions about Herzberg, but she assured me she wouldn't be marked down for such errors, it was writing lots of stuff that would get her an A.
I accept she may have misunderstood instructions from her teachers in this assertion, but actually I think this does reflect some key messages she is getting from school: its not what or how deeply she learns that seems to matter, but whether she produces the volume of words deemed appropriate.
Focusing on figures, volume, reports, public inquiries, grades - those things we can measure and produce as evidence - makes us feel secure. It makes us feel we are achieving something. Because how do we measure learning? How do we measure caring? How do we measure humanity or our relationship to one another? That stuff is hard....