Heart Surgeons Fear Death Rate League Tables

Article excerpt


AN EARLY warning system to expose blundering surgeons is to be launched in the wake of the Bristol heart babies scandal.

It involves publishing the patient death rates of individual doctors and the hospitals where they work.

The move is part of sweeping reforms announced yesterday in an attempt to ensure patients' safety and offer high-quality services.

But it brought warnings that the information could create a 'culture of fear' with surgeons frightened to take on high-risk cases.

From April 2004, heart patients who are due to undergo operations will be able to check the death rates of individual cardiac surgeons. The arrangement will eventually be extended to other specialists.

Other reforms include the introduction of a national system of reporting adverse events and 'near misses' and new ways of monitoring standards and strengthening safety.

The shake-up - entitled Learning From Bristol - follows the tragedy in which up to 35 babies died when surgeons were allowed to continue operating despite poor survival rates at Bristol Royal Infirmary.

Three doctors at the centre of the scandal were found guilty of serious professional misconduct by the General Medical Council in 1998.

Consultant heart surgeon James Wisheart, 62, and John Roylance, 69, former chief executive of the United Bristol Healthcare NHS Trust, were struck off the medical register.

Another surgeon, Janardan Dhasmana, 60, was allowed to continue.

But the GMC ruled he must not perform heart surgery on children for three years and the ban has since been extended by a year.

After the scandal, Professor Ian Kennedy led a [pound]14million public inquiry, which reported last July.

Health Secretary Alan Milburn said he was determined 'some good' could come out of the tragedy.

He added: 'The Kennedy Report provides a searing analysis of the failings in organisation and culture that were prevalent not only in Bristol but throughout the NHS.' But surgeons' leaders last night expressed fears that they would take the blame for high death rates that might be due to other problems in the hospital.

Bruce Keogh, secretary of the Society of Cardiothoracic Surgeons, said the publication of death rates could lead to surgeons refusing to operate on high-risk patients, as had already happened in the U.S.

He said: 'The very best and innovative cardiac surgeons in the world have been those with the highest mortality.' Michelle Cummings, a member of the Surgeons Support Group, said league tables would create a twofold 'culture of fear', with surgeons worried about taking on complex or high-risk operations and parents afraid to take their children to 'poorly' performing surgeons. …