News

Hospital death rates to be published for England

John Warden, parliamentary correspondent, BMJ

Comparative mortality rates for NHS hospitals in England are to be published in October, the health secretary Frank Dobson announced this week. The move has been contemplated for over a year but has been accelerated by the case in Bristol, where death rates of children after heart surgery were unacceptably high (6 June, p 1691).

Mr Dobson has decided that reassurance to patients should have priority over the reservations of doctors. He told MPs at a Commons meeting: "The appalling tragedy in Bristol cannot be allowed to happen ever again. These [mortality] tables will enable us to identify potential problems at an early stage and to act if necessary."

The tables will show the death rate per operation in each hospital after different procedures, including cardiac surgery, surgery for cancer, and routine operations such as hip replacements. Mortality tables for Scottish hospitals have been published since 1994.

The Department of Health said that the figures will be adjusted to take account of variables such as the age of patients and the difficulty of the case. A spokesman said: "Some hospitals may, because of their expertise, be sent the worst cases. It would be unfair to compare their performance with a trust doing relatively straightforward surgery. We want the public to be able to make meaningful comparisons."

But Mike Goodman, deputy chairman of the BMA consultants committee, said: "Our fear is that the weighting of the statistics will not be sophisticated enough. Consultants will be tempted not to choose high risk patients because they could affect their position in the tables. Good tables are better than no tables, but no tables are better than bad tables."

The government also announced that in future participation by surgeons and anaesthetists in the four confidential enquiries into deaths after surgery and other causes will be compulsory and not voluntary. (See p 1759.)