Talking-up Scotland

Nearly all of the NHS Scotland targets are for treatment within a period of time for between 90% and 95% of patients. Anything below that is described as a failure to meet the targets and is the trigger for ministerial apologies, opposition attacks and miserable patient interviews, but I think I’ve noticed something interesting and vulnerable in these reports.

I haven’t done the research. I’ve just got an emerging wee thesis. The typical waiting time for removal of wee theses in 18 weeks. Here it is:

Reporting Scotland tell us about every failed target on the day it is released by ISD. They always tell you that the target was failed and that it has now been failed for whatever period of time it has been failed.  They sometimes tell you what the actual target percentage is but not always. They rarely if ever tell you what the actual percentage seen on time was.

I’ve noticed this pattern recently and will be watching from now on to see if it repeats to suggest a propaganda tactic. I’ll have a look back at some earlier reports for evidence too. Why? Well, is it possible that the omission of the actual performance percentage and of the target percentage is because both, when presented that way, seem very high and may trigger an unpredictable response in many viewers?

Targets are almost always 90% or 95%. Performance commonly ranges from around 70% to over 90%.

Now, imagine your base assumptions about whether or not a percentage score is good or not derives mainly from your own experience in educational assessments, in school or in college or at university, or in some craft or professional programme. Isn’t 70% really pretty good, an A? In all my time on the way to a BA Hons (2.1), even as a mature student, I only once reached 82% and commonly scored in the 65% to 75% range. Isn’t 70% for most of us, evidence of greatness and 95% evidence of freakish unworldliness?

So, is there a danger that viewers will think performance by NHS Scotland is actually pretty damn good across the board and that the targets are a bit OTT?

There is evidence that in Scotland and in the UK ,we have come to treat what should be longer term aspirational targets as opposed to everyday minimal targets.

A bit of context from an international study in 2014, is illuminating:

‘Most countries are following the UK 4-hour target as it is recognised that there is a benefit to adding in a time constraint. Victoria and Ontario [Canada] both have set the achievement target lower, at 75% and 90% respectively, compared to 95% in England [and Scotland]. Moreover, neither system actually meets their target, and especially in Victoria there are few consequences to this. In Stockholm [Sweden] the county monitors performance on the 4-hour target but this is not nationally mandated.’

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/382847/Annex_5_AandE.pdf