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de Vries, Frans

The B.E. Journal of Economic Analysis & Policy

Editor-in-Chief: Jürges, Hendrik / Ludwig, Sandra

Ed. by Auriol , Emmanuelle / Brunner, Johann / Fleck, Robert / Mendola, Mariapia / Requate, Till / Zulehner, Christine / Schirle, Tammy

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Did 'Targets and Terror' Reduce Waiting Times in England for Hospital Care?

Carol Propper1 / Matt Sutton2 / Carolyn Whitnall3 / Frank Windmeijer4

1University of Bristol and Imperial College,

2University of Aberdeen,

3University of Bristol,

4University of Bristol,

Citation Information: The B.E. Journal of Economic Analysis & Policy. Volume 8, Issue 2, ISSN (Online) 1935-1682, DOI: 10.2202/1935-1682.1863, January 2008

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Waiting times have been a central concern in the English NHS, where care is provided free at the point of delivery and is rationed by waiting time. Pro-market reforms introduced in the NHS in the 1990s were not accompanied by large drops in waiting times. As a result, the English government in 2000 adopted the use of an aggressive policy of targets coupled with the publication of waiting times data at the hospital level and strong sanctions for poor performing hospital managers. This regime has been dubbed ‘targets and terror’. We estimate the effect of the English target regime for waiting times for hospital care after 2001 by a comparative analysis with Scotland, a neighbouring country with the same healthcare system that did not adopt the target regime. We estimate difference-in-differences models of the proportion of people on the waiting list who waited over 6, 9 and 12 months. Comparisons between England and Scotland are sensitive to whether published or unpublished data are used but, regardless of the data source, the ‘targets and terror’ regime in England lowered the proportion of people waiting for elective treatment relative to Scotland.

Keywords: health care; waiting times; targets

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