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Naming & Shaming: The impacts of different regimes on hospital waiting times in England and Wales


  • Besley, Timothy J.
  • Bevan, Gwyn
  • Burchardi, Konrad B.


Improving accountability in public services has been a central objective of many public sector reforms in recent years. Chief among these have been efforts to generate observable performance measures as a basis for monitoring performance. This paper examines a natural experiment in regimes applied to waiting list targets for hospital admissions in England and Wales. Prior to 2001, each country had similar policies, organisational structures for hospital care, and levels of resources. After 2001, the principal difference between the countries were the consequences for hospitals that failed to meet targets for waiting times: in England, failure resulted in sanctions in a process of `naming and shaming', but in Wales, failure was perceived to result in extra resources. We use hospitals in Wales as a 'control group', to examine the effect of `naming and shaming' in England. We found that this policy did indeed reduce waiting times in England as compared with Wales. However, there is some evidence there was in England, initially, some shuffling of prospective patients to meet specific targets which increased mean waiting times.

Suggested Citation

  • Besley, Timothy J. & Bevan, Gwyn & Burchardi, Konrad B., 2009. "Naming & Shaming: The impacts of different regimes on hospital waiting times in England and Wales," CEPR Discussion Papers 7306, C.E.P.R. Discussion Papers.
  • Handle: RePEc:cpr:ceprdp:7306

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    References listed on IDEAS

    1. James J. Heckman & Carolyn Heinrich & Jeffrey Smith, 2002. "The Performance of Performance Standards," Journal of Human Resources, University of Wisconsin Press, vol. 37(4), pages 778-811.
    2. Propper Carol & Sutton Matt & Whitnall Carolyn & Windmeijer Frank, 2008. "Did 'Targets and Terror' Reduce Waiting Times in England for Hospital Care?," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 8(2), pages 1-27, January.
    3. Katharina Hauck & Andrew Street, 2007. "Do targets matter? A comparison of English and Welsh National Health priorities," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 275-290.
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    Cited by:

    1. Cabus, Sofie J. & De Witte, Kristof, 2012. "Naming and shaming in a ‘fair’ way. On disentangling the influence of policy in observed outcomes," Journal of Policy Modeling, Elsevier, vol. 34(5), pages 767-787.
    2. Samuel Bowles & Sandra Polania-Reyes, 2011. "Economic incentives and social preferences: substitutes or complements?," Department of Economics University of Siena 617, Department of Economics, University of Siena.
    3. Cooper, Zack & Gibbons, Stephen & Skellern, Matthew, 2016. "Does competition from private surgical centres improve public hospitals’ performance? Evidence from the English National Health Service," LSE Research Online Documents on Economics 67662, London School of Economics and Political Science, LSE Library.
    4. S. Bowles & S. Polania-Reyes., 2013. "Economic Incentives and Social Preferences: Substitutes or Complements?," VOPROSY ECONOMIKI, N.P. Redaktsiya zhurnala "Voprosy Economiki", vol. 4.
    5. Ben Lockwood & Francesco Porcelli, 2013. "Incentive Schemes for Local Government: Theory and Evidence from Comprehensive Performance Assessment in England," American Economic Journal: Economic Policy, American Economic Association, vol. 5(3), pages 254-286, August.
    6. Gerdes, Christer, 2015. "Does Performance Information Affect Job Seekers in Selecting Private Providers in Voucher-Based ALMP Programs?," IZA Discussion Papers 8992, Institute for the Study of Labor (IZA).
    7. Prasenjit Banerjee & Rupayan Pal, 2016. "Honor and Stigma in Mechanisms for Environmental Protection," Working Papers id:10883, eSocialSciences.

    More about this item


    hospital waiting times; targets;

    JEL classification:

    • H11 - Public Economics - - Structure and Scope of Government - - - Structure and Scope of Government
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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