Surgeons' deaths list 'a danger' to patients

Published on Wednesday 8 October 2008 10:30

A LIST of surgery deaths published by the Scottish Government could harm both patients and surgeons, it was claimed today.

The massive document lists every surgeon in the country and reveals how many patients died during, or soon after, surgery. It also includes the type of surgery and the hospital where the operation took place.

But the release of the information is a controversial move, given that a similar initiative in America some years ago led many to say surgeons there became too scared to take on tricky operations.

However, others have said that if the statistics are considered thoroughly it is a helpful development for the country.

In the last year there were 267 deaths following operations across Lothians hospitals; 152 at the Edinburgh Royal Infirmary; 85 at the Western General; 14 at St John's in Livingston; and 16 at the Sick Kids Hospital.

Margaret Watt, chairwoman of the Scottish Patients' Association, said: "I don't think this is a good thing. It's not going to stop mistakes and it could add to waiting lists because patients might only want to go to one surgeon."

And the British Medical Association in Edinburgh said that while surgeons in general did not have any fears over these figures being published, there were concerns about how they could be interpreted.

For example, a surgeon who either took on more complex challenges and operated on older or more sickly patients would have a far higher mortality rate than one who embarked on fewer, more straightforward procedures.

Dr Charles Saunders, chairman of Scotland's consultants committee, warned: "What we would prefer to see would be the development of some form of like-for-like comparison so we can examine other factors."

It was originally ruled in 2005 by the Scottish Information Commissioner that data relating to surgeons' mortality rate should be published. And while health chiefs abide with this ruling, many privately believe there is a danger some surgeons will opt out of difficult operations.

They feel there is enough regulation already with live monitoring and believe that, because surgeons work in teams, if anyone was even slightly under-performing this would come to the attention of bosses straight away.

All surgeons are also made to sign the General Medical Council code of conduct which dictates if someone has reason to believe a fellow surgeon isn't reaching acceptable levels to report it.

There is no way of telling from the table why the patient died, nor does it indicate if the person died during surgery or soon after.

Dr Charles Swainson, NHS Lothian's medical director, said: "Surgery is safe and is getting safer. We have a number of measures in place to protect and reassure the public as to the competence of staff involved in their care. Every death after surgery is reviewed, both through our own arrangements and through the independent Scottish Audit of Surgical Mortality."