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Performance 99 Wednesday, 16 June, 1999, 10:03 GMT 11:03 UK
How performance tables started
Frank Dobson announced expanded tables last year
Performance indicators were introduced by the Conservatives in 1993 to monitor services in schools, local authorities, the police and National Health Service.

NHS Performance 99
Labour continued and expanded the policy when it took office.

Last year's tables included a number of new performance indicators - breast cancer mortality, waiting times for accident and emergency departments, cancelled operations, hospital admissions and outpatient appointments.

Complaints against hospitals were another addition to last year's tables, along with indicators on care of the elderly, and delayed discharges of patients.

But the big addition in 1999 is the publication of six key indicators looking at death rates and re-admissions at hospitals, as well as how long it takes for patients to return home after admission with a serious condition.

New tables, old criticism

In 1995 the tables were criticised by professional associations as pointless and misleading after ranking some of the country's leading hospitals among the worst performers.

The new tables are likely to be criticised for much the same reasons, although the indicators were developed with the help of doctors.

It was in June 1998 that Health Secretary Frank Dobson announced the introduction of mortality figures to be published annually, although the NHS Executive had been looking at introducing new indicators since 1997.

Mr Dobson made the plans public following the scandal at Bristol Royal Infirmary where 29 babies died and four more were brain damaged during heart operations between 1988 and 1995.

However, the figures published in June 1999 would not expose problems such as those at Bristol - there are too many ifs and buts to any interpretation of the data.

Instead, they give a general indication of where there might be problems.

A tool kit for health professionals

While Mr Dobson gave the impression that the publication of death rates would reassure the public, they are obviously designed for health professionals.

For the general public, the figures can appear a little bewildering.

But Mr Dobson appears undeterred, and suggests the public can take comfort from the use health professionals will make of the information.

"The indicators are not intended to get patients to shop around and travel for better treatment," he said in his introduction to the 1999 tables.

"They will help NHS organisations to spread best practice, nip problems in the bud, and to devote resources which clearly need attention ahead of time, rather than too late."

Similar mortality tables introduced in Scotland in 1994 by the last Government caused an outcry, with doctors warning that the tables were misleading and would deter patients from getting treatment.

Similar warnings have emerged with reference to England's tables, but the British Medical Association and the Department of Health remain upbeat about the usefulness of the figures.

See also:

08 Jun 98 | The Bristol heart babies
09 Dec 98 | Health
09 Apr 99 | Health
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