The government plans to send health "hit squads" into hospitals and set up health authority league tables to identify hospitals with high death rates.

They will concentrate on hospitals that are judged to be failing their patients.

The move is expected to be used as a last resort, but it is intended to motivate hospitals into attaining higher standards.

The system will be similar to that which is being used to tackle failing schools.

Ministers are concerned that hospitals have reacted slowly to mistakes in the past. These high profiles cases have included problems with the diagnosis of breast cancer in Exeter and cervical cancer in Canterbury.

High standards

"Patients have a right to expect first class service"

The government plans to set targets for the hospitals. The Health Minister Alan Milburn said: "For this government, standards in the health service are as high as standards in education."

"Patients have the right to expect that whenever they are treated they get a first-class service and in a first-class service there is no room for second-best," he said.

The squads will be supervised by a new Commission for Health Improvement.

The commission will work initially work with hospital managers but it will have the power to advise the Health Secretary to replace an NHS trust with government appointees.

The new-style league tables will compare death rates for different conditions, hospital discharge and readmission rates, and the cost of supplies and procedures. Until now league tables have been confined to waiting lists.

Consultation

The new framework for measuring and improving standards of performance is outlined in a consultation document. This is being sent to doctors and other health professionals who have until March to respond.

The measures will be opposed by some doctors, who have said that results can depend on a variety of factors, such as how ill people are on admission to hospital.

Some doctors think league tables could be misleading

The British Medical Association has said the squads should be seen as a support force rather than a threat to NHS staff.

But the BMA Consultants' Committee Chairman, James Johnson, was cautious about the new league tables, which he thought could be misleading.

"As far as league tables are concerned, the key question will be do they measure something meaningful and is the measurement valid?"

"Death rates may well tell us more about levels of deprivation and illness in a local community than about the quality of hospital care," he said.

The Conservative health spokesman, John Maples, said hit squads were not the answer.

"Labour have removed all the carrots and seem to be replacing them with big sticks and threats, hardly the way to motivate people or drive higher standards

"Perhaps they realise that their changes will lead to lower standards and that the ultimate sanctions like hit squads will be necessary," he said.

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