Targetless Standards

The Home Secretary, Theresa May, made great virtue of her plans to scrap policing targets yesterday. No longer would the police have to answer 999 calls quickly, or bother themselves with such trivia as patrolling on the beat or their public reputation. Instead, they should just focus on bringing down the crime rate. Her colleague, Andrew Lansley had a similar outlook a few weeks ago as he consigned an already long limit on A&E waits of no more than four hours to history, and abandoned one of the most successful public sector reforms of Labour's years, the 18 week waiting time target. Instead consultants and trusts could pretty much decide for themselves whether to be bothered about patients suffering on trolleys or facing extra months in agony awaiting treatment.

Both moves will lead to a serious decline not only in the quality of the police or health services, but particularly in the rights of victims of crime and patients. A shared insight of the Thatcher/Major and Blair/Brown years was in the importance of customers of public services and their rights, and a recognition that producer or professional interests did not always know best. The most important change Labour introduced was in delivering minimum standards (in schools, expectations of minimum GCSE or test results delivered huge improvements in the most disadvantaged areas). Now the Coalition in a zealous attack on an admittedly excessively target-driven culture has thrown the baby out with the bathwater.

In one sense, this could be said to be understandable, at least in the police. By removing public expectations, the police can be 'freed' to concentrate on other matters. Yet in saying this, May seems profoundly to misunderstand the nature of the relationship between police and public. Most crime has fallen significantly in recent years (though some violent crimes are up) so the expectation that the police treat victims and the public better has not been at the expense of this core task. But it is also the case that the police are more than crime-fighters: their presence and that of community support officers makes people feel safer, particularly at night; their willingness to respond reassuringly to victims is as important in some crimes, like burglary, as the knowledge that the criminals will be caught. This has particularly been true in community policing. What these targets said is that the police recognise that they are funded by taxpayers, and are not a law unto themselves. Gene Hunt was being consigned to the past.

Andrew Lansley seems equally in thrall to professional interests. Despite polling clearly showing that waiting times are very important to patients, he is abandoning the maximum waits and allowing consultants to adopt a 'doctor knows best' attitude that was beginning to be challenged by the success of the targets. The point is not that most medical professionals don't believe they put patients interests first; it is that the default position of too many in the medical profession is to ignore what patients say they want. Without minimum standards, patients' concerns can too often be ignored. And the frustration and anger that follows will not be good for their health - or the NHS.

So, why is Labour not making more of such profoundly regressive steps? One reason is the preference of too many leadership contenders for attacking a record they should celebrate more - or at least offer a balanced assessment. Having failed to defend our record over the last few years, it is also harder to revive it now. But the bigger reason is the failure of the party to level with voters about where it would cut and what it would protect before the election (of course the other parties blatantly lied to voters but they are now in government and getting away with their dodgy reinvention of history). Had Labour followed Alistair Darling's advice, it would be in a stronger position to challenge those policies that will harm patients, parents or victims. But even those weaknesses should not prevent the party from trying harder: unless it does so now, history will have been rewritten by the coalition. And when the 8 hour trolley waits return, and the delayed 999 responses soar, the reasons will be lost in the mists of time.

Hopi Sen has a valuable follow-up to this post here.