In hospitals in the UK, there are certain diseases that are caused by an overuse of antibiotics, which allow bacteria to invade your gut when previously your normal ‘good’ bacteria keep at bay. The best example of this is Clostridium Difficile
If a ward has too many incidences of C. Diff it has its funding cut/pays a fine to punish the doctors for making this mistake and to provide more money for the other hospitals. This system is ubiquitous, from GPs having to check the blood pressure of x many patients/month to ambulance drivers and the 8 minute arrival time.
Miss the target, lose money.
Let’s imagine I’m a doctor on the wards and I see somebody has C. Diff. Should I report this information to the government, knowing full well they’ll take money away from my ward?
I have a duty of care to the patient in front of me. I will save the life of a murderer or a pedophile or somebody who is a super-spreader of HIV, even if they will harm the community.
In the same way, although reporting it might help the community as a whole to become more efficient or map the spread of the infection, I have to be selfish on my patient’s behalf, and lie on the sheet to secure my department as much money as possible so I can treat the patients in front of me as much as possible.
If lying gets more money to my ward, and with more money we can treat more patients, I should do everything I can to get that money, because that money could be the difference between life and death.
So, if any doctors end up reading this, the same oath that makes you treat your patients and look after them is the same one that means you should lie on the target forms.
Doctors lie on these forms all the time already. The government either knows this but continues to use the statistics or doesn’t realise that paying somebody to lie is going to make people lie.
This is why having targets tied to funding makes no sense.