Jeremy Laurance: For the first time, patients can vote with their feet

Medical Life

Fifteen years ago I got hold of a story about death rates in hospitals which upset a number of doctors. It provoked a writ that cost the paper I then worked for £10,000.

I had obtained details of death rates following general surgery across the country which showed a six-fold variation and produced a league table, which was published in the newspaper. Unwisely, as it turned out, I made some uncomplimentary remarks about the areas with the worst rates, based on a separate report which suggested that extra deaths could indicate incompetent surgeons or poor nursing care. The hospitals in the areas I named took umbrage and, on the advice of the paper's lawyer, the dispute was settled quickly.

You might think I would remember this episode with embarrassment. Certainly there were aspects of the story that I could have written better. But its central thrust – that the only way to check the value of what hospitals do is by looking at their outcomes – was as true then as it is now.

Five years later, I won vindication of a sort when Frank Dobson, then health secretary, published hospital death rates for England. Intended chiefly for internal NHS consumption, the report was hard to access and difficult to interpret but was meant to stimulate critical self-appraisal, especially by those hospitals at the bottom of the league.

Last week, a decade later, a new boundary was crossed with the Government's decision to publish death rates for every hospital on the NHS Choices website. For the first time, patients can check for themselves – and vote with their feet if they don't like what they see. If the doctors who sued me in 1994 are reading this – welcome to a brave new world.

Critics say death rates are too crude a measure to be valuable. I have looked at my own hospital – the Whittington in North London – and compared its death rate for hip replacements with three neighbouring hospitals. The NHS Choices website tells me that the Whittington (100 hip replacements a year) and the Royal Free (113) perform too few operations for a "comparable survival rate" to be calculated. University College hospital (178 ops) and the Royal National Orthopaedic hospital (479) have survival rates "within the expected range".

This is useful information. It tells me that University College and the Royal National Orthopaedic have the most experience and are likely to be safest. Other information on the website about infection rates and re-admission rates confirms this. More sophisticated data – how long the replacement hips last, for example – is promised.

The scandal of Stafford Hospital, where appalling standards of emergency care went undetected for years, revealed by the Healthcare Commission in March, was the trigger for the Government's decision. Managers had focused on waiting times and financial targets and ignored the most basic outcome – the high mortality rate.

In future that will be less easy. It has taken 60 years, but NHS patients can at last find out how likely they are to leave hospital alive.