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Sunday, June 7, 1998 Published at 16:33 GMT 17:33 UK


Special Report

Hospitals to publish death rates

As the patient goes under the knife, the surgeon will be under scrutiny


Health Secretary Frank Dobson explains why the statistics will be made public
Hospitals in England are to be forced to collect and publish controversial league tables showing patient death rates. The information has already been available in Scotland since 1994.

The move to publicise information on surgical death rates comes in the wake of the Bristol heart babies scandal related to the deaths of 29 babies in care.


Professor Norman Browse of the British Medical Association on the need for accurate figures
Three doctors - cardiac surgeons James Wisheart and Janardhan Dhasmana and their manager Dr John Roylance - could be struck off after the General Medical Council's initial inquiry ruled there was enough evidence to proceed against them.


[ image: Sian Collyer: One of the babies who died in Bristol]
Sian Collyer: One of the babies who died in Bristol
Health Secretary Frank Dobson will announce the comparative tables in a meeting with Labour backbench MPs on Tuesday.

Patients will be able to compare how hospitals perform after figures have been weighted to take into account relevant medical information on any deaths.

Patients will not be given the right to switch their hospital, nor will the programme include information on the UK's private hospitals.

Drive for standards

Mr Dobson will introduce the annual tables covering surgery for major diseases or conditions in October.

Ministers believe the system will become a powerful tool to raise standards and share information on the National Health Service.


[ image: Dobson: Launching tables in October]
Dobson: Launching tables in October
It could also work as an early warning system to prevent cases similar to that of Bristol.

An independent commission for health improvement is also being planned to complement the tables. It will scrutinise service and standards at NHS trusts.

Mr Dobson said: "Patients have a right to expect the best possible treatment in the NHS. In the vast majority of cases they get it.

"The appalling tragedy of Bristol cannot be allowed to happen again.

"These tables will allow us to identify problems at an early stage and act if necessary."

Top doctors want tables

Leading NHS consultants have already called for league tables following the Bristol scandal.


[ image: Janardan Dhasmana: Not subjected to peer scrutiny]
Janardan Dhasmana: Not subjected to peer scrutiny
The two surgeons, Janardan Dhasmana and James Wisheart, are alleged to have continued to carry out heart operations on babies despite high death rates.

The scandal remained hidden for years. One colleague who suspected the high death rate, carried out his own painstaking research into the pair's performance in order to tip off officials.


Opposition health spokesman Alan Duncan criticises the plan
James Johnson, chair of the British Medical Association's consultants committee, said that it is currently almost impossible for doctors to know if their work is up to scratch.

He called for tables to be coupled with a peer appraisal system.

Mr Johnson said: "We need proper risk management strategies in hospitals for recording things that go wrong or near-misses so that hospitals can analyse this in a systematic way and make sure they don't happen again."

But Stephen Thornton, chief executive of the NHS Confederation, said care should be taken to ensure the league tables took into account variations in population and other factors.

He said, for example, that mortality rates would be higher in areas with more elderly people.

The Welsh Office and the Northern Ireland Office will consider the issue further before implementing similar policies.



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The BMA: Response to the Bristol case

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