One star for trying

News (p 236)

The self proclaimed aim of Health Secretary Alan Milburn's star awarding exercise, rating the performance of trusts, is simple. It is “to provide patients and the general public with comprehensive, easily understandable information on the performance of their local health services.”1 No one could argue with that. But execution is another matter. Two dilemmas arise when constructing a summary measure of performance in an organisation as complex and heterogeneous as the NHS. On the one hand, how “comprehensive” can it be while remaining “easily understandable?” Sophistication can all too easily turn into mystification. On the other hand, can the same sort of exercise meet the requirements of the multiple audiences involved? The general public apart, these include ministers and their officials, the boards of trusts as well as the doctors, nurses, and others working in them, and the commissioners of services. Attempting to meet everybody's expectations may mean frustration all round.

The Department of Health's performance …