It was perhaps inevitable that the publication of NHS surgeons’ mortality rates would, at first glance, look like a league table. And sure enough, within hours of the data on 450 vascular consultants being released, a handful of doctors were in the spotlight for coming top (or perhaps bottom) in a measure of the proportion of fatalities in their operating theatres.
Amid hysteria about “Doctor Death”, the NHS trusts involved tried to fill in the blanks, pointing out that the figures are skewed for those consultants who carry out a relatively small number of procedures. Similarly, those taking on more complex cases, in more complex disciplines, will “score” poorly when they should be commended. Raw numbers alone, then, are rarely the whole story in so complex an area as surgery.
That is not to say that mortality rates should not be disclosed, though, for all that yesterday’s events appear to vindicate such arguments. A little knowledge may be a dangerous thing, but absolute ignorance is no answer. As much data as possible should be in the public domain, as a matter of principle. Furthermore, patients have a right to have any anomalies justified. It is up to hospitals, then, to provide the context that makes sense of the numbers – and to do so swiftly.