Abstract

This review of the literature examines how political ideologies have converged around English health policy and why command and control management techniques using performance indicators and targets are used to achieve policy and judge its efficacy. Performance indicators and their role in an enterprise culture, which health policy has introduced to replicate the efficiency successes from the private sector, is evaluated in this article. The article concludes that although performance indicators are valuable for efficiency improvement, the way they are implemented and managed in the English NHS does not assure the successes seen in the private sector but can lead to damaging defensive management actions.