Leading Article: Patient moves towards freedom of information

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The Independent Culture
WHAT MOST of the public has always known from experience has now been proved by investigation. Your chances of surviving a life-threatening illness do vary according to where you are treated. The NHS league tables now include, for the first time, a measurement of a mortality rate, for breast cancer. You are more likely to survive breast cancer if treated in a hospital in East Surrey than if treated in one in Shropshire.

So what? After all, common sense tells us that hospitals are no more likely to perform uniformly than schools or factories. Someone will always come bottom, even if they are, in absolute terms, perfectly effective. And there will, of course, be many local and particular reasons for these outcomes. They do not necessarily cast doubts on the conscientiousness or quality of care of the staff in those hospitals. It may well be that, say, if the staff in Shropshire had not been as dedicated and skilful, then the mortality rates would have been even higher. Statistical variations can arise from the underlying health of patients, their relative prosperity and their dietary habits.

Many league tables, from schools to international economic performance, as well as medical care, contain flaws. But that misses the point. The point is that the more information we have, the more chance there is of some sharp questions being asked. There is now more evidence, however imperfect, with which to hold health professionals and politicians to account. And, as far as we are able to exercise choice about where we are treated, we can make better informed decisions.

The Government plans to extend tables to emergencies, heart attacks and other cases. They should be available for individual doctors, too. Freedom of information and patient choice are, slowly, becoming realities.

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