Mangin and Toop1 provide an interesting overview of QOF, reflecting the many useful papers on aspects of QOF in the June issue of BJGP. Their criticisms of QOF make sense from a deontological (duty based) ethical perspective. It is far from clear that medicine is a deontological enterprise any longer.
There is a strong utilitarian perspective on QOF that sees the greatest good of the greatest number of patients as being a worthwhile objective. If this good can be measured then so much the better. (The felicific calculus is achieved.) Outcome measures would be ideal but intermediate …