Spot the difference: when is an outcome not a target?

Well according to the Tories outcomes and targets are two very different beasts. If you are striving to reach a certain outcome does that not become a target? Apparently not.
I have been taking looking at the Conservative's Green Paper on health - 'Delivering some of the best health in Europe. Outcomes not targets. Responsibility Agenda. Policy Green Paper No. 6.

They suggest:

Focusing the NHS on results instead of targets will not simply replace one set of government diktats with another. Results are clearly different from targets because they are not produced by specifying, in a top-down way, the procedures, processes or approaches taken by care professionals to achieve a good result for patients. What matters is the result itself, not how it is achieved. That must be left to the discretion of the professionals.

The system which links GPs’ pay to performance (which we support in principle measures their performance more on administrative processes than clinical ones.

So performance related pay stays. Kind of makes outcomes look a lot like targets.

Patient choice has been a depressingly over-used term in the recent NHS past. Everyone I speak to would prefer to have a good quality service at their local clinic or hospital and not have to have the additional stress about finding a decent 'provider' when ill. This is the Tory viewpoint:

Combined with our plans to give every patient an open choice of provider, and our plans to introduce payment-by-results within the system, this focus on outcomes will provide a tough incentive to raise quality all the time.

Instead of these 'orrible bureacratic time-wasting targets we will have PROMs. What are PROMs you may ask?

Patient Reported Outcome Measures, or PROMs, are used to help measure the benefits patients receive as a result of treatment. They are collected directly from patients through very simple questionnaires that ask for details about their particular condition, how long it has affected them, and how well they think the treatment they receive is working. Patients can complete this at home in their own time, or with their GP.

Finally they suggest:

We are consulting on the outcome measures which we propose to introduce as soon as practicable. Over time, we will seek to roll out information about outcomes in further areas, including dentistry,maternity services and palliative care.

Great, more targets. Sorry, outcomes. Plus ça change...