Exercise 4. When targets were imposed on British GPs, the effect at my practice was that only a few appointments were available. I had to sit by the phone from 8.30am when the practice opened, phoning, getting the engaged tone, repeatedly pressing the redial button. Then I got the appointment time I wanted. Phone later in the day and there were no appointments available.

A GP may decide that his amour propre (signalling?) is more important than conforming to targets.

Experience on targets appears to indicate that people find ways of meeting the target, which may or may not be by achieving what the target-setter wished to achieve.