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Last Updated: Monday, 6 February 2006, 15:57 GMT
First surgery death rates issued
Individual surgical statistics have been made public in Scotland
The death rates for all Scottish surgeons have been published for the first time.

Health administrators have been forced to reveal the totals under the Freedom of Information Act after requests by two journalists.

Until now, NHS Scotland has kept the information confidential.

Chief Medical Officer Harry Burns said that publishing crude surgical mortality rates did not reflect varying difficulties of procedure.

Scotland is believed to be the first part of the UK to publish the death rates of all its surgeons in all specialities.

NHS Scotland refused the journalists' requests last year, but Information Commissioner Kevin Dunion upheld their request.

'Pretty meaningless'

He said the public had a right to know and was perfectly capable of understanding the figures which, he insisted, were not technical.

He told BBC Radio Scotland: "I don't think that if all the information for all surgeons is being released, and is being released in the kind of context that the health service can provide, that surgeons should have any fear that someone would be the subject of a kind of witch-hunt."

Many of those surgeons with the highest mortality rates are the heroes of the health service
Dr Harry Burns
Chief Medical Officer

The rates vary between 0% and 100% mortality, said to be because the statistics are often skewed by a surgeon who has taken on only a small number of cases.

The NHS has also warned that high death rates may indicate a skilled surgeon who tends to take on high-risk cases.

One surgeon had a death rate of 100% for emergency heart surgery - but he only saw one emergency patient, and that patient died

However, his death rate for complicated heart and lung surgery was very low. Out of 113 patients, only one died.

Some surgeons have welcomed the move, and said it could pave the way for more reliable information in the future.

But Dr Burns said there was already an existing verified audit scheme for surgical mortality in place across NHS Scotland, and that lessons were learned from that.

Comprehensive table

"The figures are pretty meaningless unless you know much more about the individual cases taken on by each surgeon," he said.

He said the outcome of surgery was strongly influenced by severity of illness and by the presence of other conditions unrelated to the surgical problem.

"Many of those surgeons with the highest mortality rates are the heroes of the health service," he said.

We do have concerns about how this information is presented and interpreted by the general public
Clive Davis
BMA Scotland

"They are the last hope of very sick patients. Some of our best, most experienced surgeons take on the very hardest cases.

"They make the difference between life and death. But inevitably, the hardest cases, the sickest patients, have the least chance of survival."

Dr Burns pointed out that it was more risky to operate on blood vessels in the brain than on varicose veins.

Clive Davis, chairman of the BMA's Scottish consultants committee, said: "While we support the publication of surgical mortality rates in principle, we do have concerns about how this information is presented and interpreted by the general public."

He pointed out that the data on the outcomes of one surgeon would not take into account the role of the anaesthetist or other members of the theatre team.

John Smith, president of the Royal College of Surgeons of Edinburgh, said it was right to inform the public, but any league table had to be comprehensive.

See the concerns over the figures

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12 Dec 02 |  Scotland
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02 Sep 02 |  Scotland


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