Surgeons' success rate to be published

Hospital surgeons will be graded in official league tables to be published within a year, giving patients information about doctors' success rates for the first time.

Patients will be told what their surgeon's precise speciality is, how often they perform the operation, and details of their track record of saving lives and avoiding complications.

The league tables are part of the Government's strategy to improve information and choice for patients. Last month the Government published star ratings for all hospitals in the country.

This week Alan Milburn, the Health Secretary, will announce plans to give patients choice of which hospital they can be treated in. He wants patients to be able to choose freely between joining waiting lists at their local hospital, or going further afield to be treated more quickly.

Publication of the figures is expected to revolutionise the way patients relate to those treating them, providing comparisons between different consultants.

It will help avoid tragedies like that at the Bristol Royal Infirmary where parents sent their children to heart surgeons so incompetent that other doctors dubbed the hospital 'the killing fields'.

It will also mean patients will be able to tell whether their cancer surgeon has had specialist training, or likes to do a cancer removal once a year to keep his hand in.

Doctors' groups have always maintained basic statistics on surgeons, but have either kept them secret or published them without identifying individual doctors.

However, they have come to accept that publishing the clinical outcomes of individual doctors and their teams is now inevitable, and have been working with the Deparment of Health to work out ways to make information accurate and meaningful.

The Department of Health has also been working with the medical information company Dr Foster, whose chief executive Tim Kelsey said: 'We have been talking with the DoH and other interested parties about providing information on individual consultant teams. We need to ensure the information is robust and serves a purpose.'

Department of Health officials have been studying the effect that such reforms had in New York, and claim that the immediate impact will be to raise standards by putting pressure on second-rate doctors to improve their performance. However, the Government says that, although it is planning to publish the surgeon's league tables, it has no immediate plans to give patients a free choice of surgeon.

The first information to be published will be the precise specialism of individual surgeons, many of whom like to do a wide range of operations even though this means they don't keep up with the latest advances, and means their survival rates are lower. The information should help GPs and patients ensure they are using the right consultant.

Figures will then be published showing how often surgeons do different types of operations. The figures will be particularly important for conditions such as hip replacements, where it is difficult to find an objective measure of how successful the operation is. Patients will be reassured that a surgeon does the operation regularly, and so is presumably better at it.

The first full league table to be published including mortality and complication rates will be for heart surgeons, who almost exclusively perform heart bypasses. It is planned that the 30-day survival rates of each individual surgeon will be published within a year.

Dr Peter Hawker, chairman of the BMA's Consultants Committee, said: 'My colleagues accept it is a good thing to do. We've a new generation of doctors coming through who have grown up in the age of greater communication, and we've got better educated patients.'

However, the Government has no immediate plans to let patients choose which surgeon operates on them, which would involve a major shake up of the NHS. Jim Johnson, chairman of the Joint Consultants Committee, said: 'It would be all right if the patients had a choice, but they just get sent to whoever - they might have consider-able anxiety about it.'

There is also concern that publishing the league tables could encourage poorly performing doctors to operate only on the safest patients, and refuse to take on high-risk cases. 'If you had bad figures and wanted to improve them, you'd just stop operating on anyone over 70,' said Johnson.