Letter: Hospital deaths

Sir: Your report and leading article on NHS league tables (17 June) are well judged and most welcome.

A fundamental flaw in the Government's approach is to report only in- hospital deaths following surgery. In-hospital deaths not following surgery are not reported. In other words, patients who lost their lives because they did not receive life-saving surgery are not included in these figures.

Also, the unreported high mortality in cancer wards where patients are admitted with end-stage disease must be considerable in parts of the UK lacking proper hospice facilities.

We should turn away from our fascination and obsession with the concept that the only remarkable in-patient deaths are those that occur after surgery. The pill or its omission is as effective and as dangerous as the knife or its omission when the patient dies as a result.

M ADISESHIAH FRCS

University College Hospital

London WC1