NHS hospital league tables attacked: Star gradings will relate to performance in five key areas. Celia Hall reports

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The Independent Online
A ROW broke out last night over the Government's decision to publish hospital league tables later this month, similar to controversial schools rating systems.

Opposition parties condemned the latest example of the market economy operating in the reformed National Health Service. Labour criticised the Government for reducing hospitals to commercial hotel status and the Liberal Democrats described the plan as grossly unfair.

Booklets will be published and lodged in libraries, doctors' surgeries and Citizens' Advice Bureaux allowing local people to see how their hospitals are doing.

The most sensitive aspect is the star rating system grading hospitals according to their performance in five key areas.

These, based on promises in the Patient's Charter, are: the percentage of patients assessed (but not necessarily treated) within five minutes of arrival in casualty departments; the percentage of outpatients seen within half an hour of appointment time; the percentage of operations not needing an overnight stay; the percentage of NHS patients admitted within three months and within 12 months of being put on a waiting list; and the percentage of patients still waiting within a month of a second cancellation of an operation.

The league tables will not include more crucial information which compares how well doctors do in treating their patients. But Tom Sackville, Under-Secretary of State at the Department of Health, made it clear yesterday that this was on the way. Although this information is now being collected, a decision has been taken not to publish information on 'outcomes', numbers of deaths and recovery after treatment.

The league tables will cover 470 English and Welsh hospitals and a total of 23 measures will be published for each one.

The British Medical Association, already incensed by a decision to impose perfomance-related pay on hospital doctors, responded angrily. A spokesman said it was 'highly suspicious' of the whole league table approach.

'We are not against patients having more information, but we believe that the information must be meaningful, and we are highly doubtful whether the concept of league tables will be based on information which will really help them.

'It will measure quantity, not quality, and that, we think, is a highly suspect approach. We think it will, as with school league tables, show those hospitals in the most deprived areas in the worst light, and those in more affluent parts of the country in the best light, and this will have a downward spiral effect.

'Some things are easy to measure - the number of operations conducted in a day, for example - but how do you measure the work of a geriatrician or a psychiatrist?' David Blunkett, Labour's health spokesman, said: 'The importance of achieving efficiency and quality in the NHS should not be reduced to a system of star ratings which is more appropriate to a commercial hotel chain than to a caring service. Any measures of hospitals' effectiveness should be done by measuring and comparing like with like and not in the form of meaningless PR stunts.'

Liz Lynne, the Liberal Democrats' health spokeswoman, accused the Government of dreaming up 'another hare-brained scheme instead of acting to halt the decline in the NHS. League tables will not only be grossly unfair to some hospitals, but they will also be grossly misleading'.

But Mr Sackville responded to the criticisms last night. 'These figures will not be a leap into the dark. They will measure - objectively - the performance of hospitals . . . This is just the beginning. We are working with the medical profession on providing more sophisticated figures on the quality of outcomes and treatment. We know this will be difficult and take time, but we are determined these figures will be accurate, clear and objective. Patients are entitled to information on a service which they pay for in their taxes.'

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