Was Rodney Ledward a statistical outlier? Retrospective analysis using routine hospital data to identify gynaecologists' performance

I welcome the paper by Harley and his colleagues. I was the nurse
member of the Ritchie inquiry team, which the Secretary of State
established in 1999 to consider why the serious failures in Rodney
Ledward’s practice were not identified and acted on earlier. The
gynaecologist member of the team and I ploughed through reams of medical
and nursing notes, doing our best to tease out relevant information and
set it in context.

During the inquiry I watched and listened as colleagues of Mr Ledward
talked about how difficult they had found it to raise their concerns and
call him to account. I was also privy to the accounts of patients and
their relatives, who talked about how they believed their personal and
family lives, had been disrupted and in some cases destroyed by Mr
Ledward’s lack of care and professionalism.

As Harley et al note, our inquiry, like others, made little use of
comparative data regarding the performance of individual consultants. In
retrospect, if the kind of statistical analysis of hospital data that they
now report had been presented in an easily understood format during the
early 1990s, it seems likely that fewer women would have suffered, and a
time consuming and costly enquiry might have been avoided.

Competing interests:
I was a member of the Ritchie Inquiry team