Tories confused over whether Peter should rob Paul or not

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Last week, you may remember David Cameron defending his plans to fine hospitals for superbug infections on their turf:

“We have got to make sure every hospital, every service, is prioritising this and the best way to do that is to make it part of the payment by results system.

“That will mean that every doctor, every nurse, every ward sister, the management of the hospital will be absolutely thinking of infection control first and foremost.”

As I’ve already suggested, replacing targets with incentives is to fundamentally miss the point about what is wrong with targets which is that they can game the system and are subject to the law of unintended consequences. Both problems also apply to incentives. Now it emerges that Cameron has another critic on his front bench.

Speaking in an Opposition Day debate on the New Year Network Rail debacle, Theresa Villainous said:

As my hon. Friend the Member for Macclesfield (Sir Nicholas Winterton) noted earlier, merely imposing fines on Network Rail would not be an adequate response, as the taxpayer would pick up the bill for them anyway.

Good point, well made. But, um, doesn’t that apply to hospitals as well?

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