"Rather than focusing on treating their charges thoughtfully and professionally, doctors will instead be pushed to simply hit targets."

All it takes is one misstep and a hospital's reputation will be ruined -- league table or no league table. Nor is patient care the only concern here. Between understaffing and burnout, healthcare professionals are operating under immense strain. The prospect of having their workplace "named and shamed" as a "failing" hospital will only compound these pressures, inevitably leading to an exodus of talent from the health service. There are other second-order dangers here too. Consider, for instance, what will happen to the desirability of places with "high-performing" hospitals, a gap that'll inevitably widen preexisting societal divisions yet further. Think I'm being paranoid? Just look at how school league tables are now hooked to property prices.

Just as important, Streeting's initiative risks creating opportunities for private healthcare vultures. The precedent of the private prison industry, where for-profit companies have seized on the shortcomings of the public jails, is a cautionary tale here. Should the Government's league table policy create the perception of a "two-tier" NHS, with "successful" hospitals thriving and "failing" ones crumbling, it could provide the perfect justification for an expansion of private healthcare. It goes without saying that such a move would undermine the very foundations the NHS is built on, and condemn millions to the permanent gruel of underfunding. Then there's the question of how you'd even build a league table worth the name. As the Royal College of Emergency Medicine (RCEM) has rightly noted, simplistic comparisons are particularly challenging given hospitals are now merged into multi-site trusts.

To be clear, I'm not claiming that league tables are never appropriate -- either in healthcare or elsewhere. Universities, after all, have long been ranked. But the point is that these decisions are based on a limited range of factors. Hospitals and healthcare trusts, to say nothing of the communities they're located in, are clearly far more complex. Just look at the numbers: 45,500 people a day visit major hospital A&E departments in England. And while Alan Milburn did see success in reducing the NHS waiting lists during his tenure as Health Secretary during the New Labour years, the current waiting list hovers at around 7.7 million.

This immense scale speaks to the fundamental issue with Streeting's proposals. Ultimately, the problems facing the health service can't be solved by superficial performance management tools. Significant, sustainable improvements will instead require a comprehensive, evidence-based approach, one that empowers frontline staff; invests in infrastructure and training; and addresses the social determinants of health. Rather than this misguided initiative, the Government should focus its efforts on policies that put staff first. Any reforms that fail to recognise their expertise, and empower their leadership, are doomed to fail.

Beyond that broad principle, what could the Health Secretary do specifically? Improving social care is a start. But to do this, Streeting needs to understand what NHS trusts have in the way of social care provision -- then dovetail that with strategies for getting patients out of oversubscribed wards, notably around boosting preventative measures around obesity and other social ills. The point, at any rate, is to understand hospitals as the local organisations they undoubtedly are: a hospital in Surrey clearly can't be compared to one in Rochdale.

Streeting also needs to do away with the primary care rush for 8am GP slots, a phenomenon ultimately driven by sluggish telephone and online appointment systems. We equally need creative thinking around how to prod people away from A&E in all but the most critical cases. Why don't trusts and local authorities think about health as a genuine priority, particularly in poorer areas where hospitals are dealing with a wellbeing crisis that goes far beyond emergencies? Do all this, it goes without saying, and the Department of Health may finally stop staff from leaving, along the way bolstering both care and the morale of workers.

In the short-term, though, the best the NHS can probably manage is merely to keep its head above water. Of course, that's not the kind of vote-winning transformation Streeting is hoping for. But the challenges facing the health service are just too entrenched to be fixed through quick political fixes -- let alone arbitrary league tables. As my wretched mental health patient so vividly proves, the system is just too far gone for that.