Abstract
On 22nd September 1983 the Department of Health and Social Security issued the first national package of ‘performance indicators’ to the 14 Regional Health Authorities (RHAs) and 192 District Health Authorities (DHAs) which make up the National Health Service in England. Introducing this central government initiative, the junior minister said that it gave ‘local managers, for the first time, the facility to compare local performance with what is happening elsewhere in the NHS’ (Department of Health and Social Security 1983). The DHSS also set up a DHSS/NHS Joint Working Party on Performance Indicators, which at the time of writing has still to produce its recommendations for developing the present indicator set. After only one year’s experience of the new system, any judgements must of necessity be tentative. This paper is based on correspondence with more than 100 of the 207 Regional and District Health Authorities (hereafter RHAs and DHAs), supplemented by a literature search and a dozen lengthy interviews with District Administrators and other officials with significant roles in the 1983 initiative.