Death twice as likely in some hospitals

Death rates among patients in some Scottish hospitals are almost twice as high as in others, the first NHS mortality rate figures show.

The figures, published yesterday, reveal that one in six heart attack patients admitted to the Western General Hospital in Edinburgh dies within 30 days, while at the Queen Margaret Hospital in Dunfermline, Fife, the figure is one in three. One in six patients admitted to the Western General after a stroke dies within 30 days - half the rate at the Falkirk Royal infirmary near Glasgow.

Scottish Office ministers, who decided to publish the hospital death league tables in spite of opposition from Virginia Bottomley, the Secretary of State for Health, said that higher mortality rates in some hospitals than others did not mean that the quality of care was worse.

Lord Fraser of Carmyllie, the Scottish Health Minister, stressed that the statistics did not take account of patients' age, sex, general health or the area in which they lived. He denied that they would frighten and confuse the public. Patients, he said,would recognise that the statistics were raw "These are figures for grown-ups and I hope they will not be treated in an infantile fashion," he said.

The "clinical outcome indicators" give the the results of treatment for patients with 17 common conditions at 30 NHS trusts between 1990 and 1993. They are designed to help health boards and GP fundholders determine which hospitals provide the best services.

Lord Fraser, said the Scottish Office had decided to make the information public to prevent details leaking out and spreading "unjustified and hysterical" fears. "I want to be open about this and to make sure that people understand what these figures show," he said.

The publication of the figures provoked strong protest from some hospitals, where mortality rates were above average. Grampian NHS Trust, whose death rate of 40.34 per cent for heart attack patients is almost twice the Scottish average, said it did not provide acute care for heart attack patients and should not have been included in the death tables for coronary patients. Fife Health Board said the figures were out of date and the high death rates for heart attack patients at hospitals in the area were the result of treatment at one particular hospital, which was now closed.

Others welcomed the figures. Ian Mullen, chairman of the Falkirk and District Royal Infirmary Trust hospital, which has the highest death rate for stroke victims, said: "We have been aware for some time that mortality rates for stroke patients are high and these figures will help us to see how we fare alongside other hospitals and to decide how to improve our position." In response to the figures, the hospital had already hired a new clinical expert for stroke patients and spent £500,000 on ne w equipment.

Doctors gave a cautious welcome to the figures. Professor Vivienne Nathanson of the British Medical Association, said: "These tables are the first attempt to look at the outcomes of what happens to patients when they go for healthcare. That's very important because in the past all we have been looking at is output - the numbers of patients having different operations. It is good to collect this information because when we have analysed it, we will know more about why some patients do better than others.

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The statistics were published first for Scottish hospitals because more detailed clinical data is gathered north of the border. The Department of Health in London said that similar clinical outcome league tables were likely to be published for hospitals in England and Wales next year.