Stafford Hospital has hit the headlines for all the wrong reasons. A report by the Healthcare Commission found that around 400 more people died at the Hospital between 2005 and 2008 than would be expected, compared to national averages.

How could such poor patient care have come about? It’s all down to the targets, apparently. Several doctors recounted occasions where managers had asked them to leave seriously ill patients to treat minor ailments so that a target could be met. There was also “pressure, pressure, pressure” on staff to meet the four-hour Accident & Emergency waiting time target. So the targets did it, right?

Wrong. That argument quickly falls flat under scrutiny. The targets in question are national ones – the same that every Hospital in the country operates under. If the targets are to blame, why were so many more patients dying at the Stafford Hospital in comparison to others? It doesn’t make sense. That’s because targets aren’t the real issue.

The use of targets to stimulate increased performance has been well evidenced. They can focus people’s attention on important tasks, provoke additional effort , and be used to measure performance – when used properly.

The act of setting targets, per se, is not the problem. How they are used (or misused) is. The Chinese philosopher Confucius said that “the superior man understands what is right; the inferior man understands what will sell”. Unfortunately, the leadership at Stafford hospital saw targets as a way of ‘selling’ themselves into Foundation status – rather than a means of promoting and monitoring patient care.

Targets, then, are desirable but not sufficient for effective performance. Really, this is a tragic case of poor leadership and management leading to unnecessary deaths. Ignore the cries of ‘target culture’ because poorly used targets are the symptom not the cause. A poor manager is a poor manager – with or without targets.