In the private sector, quality of a product is reflected in the price. But what about the quality of a public sector? How can we assess the quality of a public service given it is distributed for free? Some governments opted to adopt performance indicators that aimed at specifying the pursued quality of the service. In the English health care sector, shorter waiting times are one of the key performance indicators of the quality of health care.
The waiting time target was not just a output measure but a management performance tool used to address the chronic long waiting times of the English hospitals. The UK government created a system of strict penalties or rewards based on meeting shorter waiting time targets. Some call this system “targets and terror” as it subjected top leadership to possible public humiliation and reputational damage whilst granting highly scoring hospitals a greater autonomy and access to finance.