Mortality rate league tables for surgeons

League tables of mortality rates for surgeons and a new patients' watchdog are expected to be unveiled by the Government when it publishes its response to the Bristol heart surgery inquiry.

Alan Milburn, the Health Secretary, will announce reforms to ensure the scandal at the Bristol Royal Infirmary, where an estimated 35 babies died after heart operations, never happens again.

In a Commons statement, Mr Milburn will tell MPs how the Department of Health plans to revolutionise the way the NHS deals with cases of negligence and end the "club culture" that has seen doctors protecting their colleagues.

A new National Patient Safety Agency will be created to log reports of medical errors and act as an "early warning system" to spot patterns of suspicious deaths.

A sliding scale of fixed-rate compensation payments for specific medical injuries is also expected to be announced in an attempt to curb rising NHS legal bills for negligence.

But the most controversial element of the package would be the league tables for surgeons, which would give patients details of their doctors' success rates for the first time.

The tables will list what a surgeon's precise speciality is, how often they perform the operation and their track record of saving lives and avoiding complications.

Basic statistics on surgeons have previously been kept secret or published without identifying individuals, but many in the British Medical Association have now accepted the move is inevitable. Department of Health officials have been impressed with the effect of similar reforms in New York.

But some surgeons will be vehemently against the idea, claiming it would deter them from the riskier areas of treatment. Patients will not be given the right to refuse treatment from named surgeons.

A three-year inquiry by Professor Ian Kennedy concluded last summer that parents in Bristol were denied information and staff who raised the alarm were ignored. Other doctors referred to the Bristol Royal Infirmary as "the killing fields".

NHS officials repeatedly failed to act on evidence that the experimental operations performed on babies by the heart surgeons James Wisheart and Janardan Dhasmana were leading to deaths.

The first full league table to be published including mortality and complication rates is expected to cover heart surgeons.

Fixed-rate compensation payments are seen as a compromise that will meet patients' desire for redress when things go wrong without ruling out their right to sue.