Mr. Philip Crowley:

I agree with Senator Crown in so far as one must set a series of targets. Targets, as one will be aware, and as we have seen their impact on other jurisdictions, can lead to game-playing - somebody referred to a possible example of that this evening already - and can lead to tunnel vision.

What is important about the service plan is, first, that it has a clear emphasis on quality and patient safety, not only when services go wrong. It is about improving the quality of care and, really, in the end of the day, is measured by patient experience. The committee will note in the appendix that there is an increasing number of measures of quality being assessed during the year. We also will be working with the system to develop what we are calling a "quality profile", which is a set of validated measures of quality, but also incorporating matters such as what incidents have occurred in the setting for which one is responsible, what has one learned from them and what has one done about those incidents. It will include validated measures of patient experience and, hopefully, with time, also staff experience because we believe that front-line staff have much to tell us about the quality of care that we provide. We believe we should be listening to front-line staff more and that we would have a much higher quality service if we do that more effectively than we currently do.

To reiterate the point about the Mid-Staffordshire report and the Keogh report that followed it, it is imperative that we learn from other jurisdictions. We share our learning with other jurisdictions as well. There are lessons from those reports for us. I have brought that report on two occasions to the management team for us to reflect on those reports and to ensure that we put in place safeguards to ensure that such level of care does not happen in our system.