The government's work in reforming the NHS is being applied to psychiatry and four key principles have been identified: transparency, accessibility, accountability and protection. These principles are considered in relation to the problem of measurement and outcomes in one NHS psychotherapy context. Goodhart's ‘Law’ (what is counted, counts) is used to analyse how outcome measurements can impede the delivery of good services. The idea is proposed that what gets counted can become what is delivered in an area, such as psychoanalytic psychotherapy, where risk is essential to the process and the state of knowledge; and research is incomplete and uncertain.