It doesn’t seem long ago that many health professionals and managers were voicing passionate opposition to the public release of comparative information about provider performance. By and large, these voices have now gone quiet. In their place we hear more thoughtful discussions about how best to publish information in a way that engages the various audiences, maximises the benefits of disclosure, and minimises the potential for adverse consequences.

Why such a dramatic change? The argument in favour of publishing information about performance has been won in policy terms principally because of the contribution that disclosure can make to increasing the accountability of provider organisations. In more philosophical terms, many of the opponents of disclosure have been won over by arguments about the “right to know” of citizens in a democratic society.

Those who look for more instrumental reasons to justify the costly and complex task of publishing performance information have to search a little harder for supportive evidence. The original expectation in the United States, the home of so-called “report cards”, was that informed and empowered consumers would use comparative information to select high quality providers or to demand better performance from lower quality providers. In fact, …