Hospital Performance Indicators: How and Why Neighbours Facing Similar Problems Go Different Ways — Building Explanations of Hospital Performance Indicator Systems in England and the Netherlands

1. Taking a key element within the NPM (performance indicators) to show how neighbouring countries facing broadly similar problems treat this in very different ways (that is, more divergence than convergence). 2. To compare, contrast and assess different theories that might explain the divergence. A performance orientation is generally taken to be one of the key distinguishing features of the NPM (see Chapter 1, and Pollitt, 2003). This chapter examines the operational manifestation of a performance orientation — sets of performance indicators (PIs) — in two neighbouring countries — England and the Netherlands. It examines alternative explanations for the fact that the developmental trajectory of PIs in the chosen sector — hospitals — is very different in the two countries. Thus the main aim is not to give an exhaustive account of the PI systems themselves (which will be only lightly sketched), but rather to interrogate explanations for what appear to be large differences.