Schools' experience of league tables should make doctors think again

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Abstract
EDITOR—The BMA discussion paper Clinical Indicators (League Tables) touches on the issue of how performance indicator systems can have dysfunctional behavioural and managerial implications.1 Winston shows how this applies to the Human Fertilisation and Embryology Authority's league tables of in vitro fertilisation clinics.2 Our research looks at the dysfunctional effects of league tables in education and may be relevant to some of the issues surrounding league tables in the health sector. We have recently reported a comparison between two systems, one with league tables (English primary schools) and one …