Campbell's law revisited

Toby Lowe writing for the Guardian:

Payment by results is a simple idea: people and organisations should only get paid for what they deliver. Who could argue with that? If your job is to get people back to work, then find them a job dammit.

Plenty of people working in local government and public services are already starting to realise this is nonsense, and a pernicious, damaging nonsense at that. The evidence is very clear: if you pay (or otherwise manage performance) based on a set of pre-defined results, it creates poorer services for those most in need. It is the vulnerable, the marginalised, the disadvantaged who suffer most from payment by results.

Here's why: payment by results does not reward organisations for supporting people to achieve what they need; it rewards organisations for producing data about targets; it rewards organisations for the fictions their staff are able to invent about what they have achieved; it pays people for porkies.

We know that common things happen when people use payment by results, and other outcomes-based performance management systems. There have been numerous studies that show that such systems distort organisational priorities and make organisations focus on doing the wrong things – and they make people lie.

This lying takes all sorts of different forms. Some of them are subtle forms of deception: teachers who teach to the test or who only enter pupils for exams they know they are going to pass; employment support that helps only those likely to get a job and ignores those most in need; or hospitals that reclassify trolleys as beds, and keep people waiting in ambulances on the hospital doorstep until they know they can be seen within a target time. In the literature, this is known as gaming the system.

Some of the lying is less subtle. People just make up results. Last year's scandal with A4e provision of employment programmes is just one in a long line of haphazard outcome measurement.

Gwyn Bevan and Christopher Hood, professors of management at theLondon School of Economics and the University of Oxford respectively,looked at the impact of results targets on the NHS. They concluded that "target based performance management always creates 'gaming' ". Not sometimes. Not frequently. Always.