League tables to highlight low-performing hospitals

Ministers gave notice to the National Health Service yesterday that wide variations in its performance would not be tolerated and announced that targets would be set and sanctions applied if change was not achieved.

Alan Milburn, the health minister, said variations in quality and efficiency were wasteful and unfair. Giving details of the NHS White Paper's proposals on raising standards, at a meeting in London, he added: "If targets aren't met then there will be sanctions to penalise failure, just as there will be incentives to reward success. Failure will not be tolerated."

Examples of unacceptable variations included emergency readmissions to hospital, 70 per cent higher in one area than another. In some hospitals, 70 per cent of operations are done on a day-care basis compared with only half in others. The costs, excluding pay, of running some hospitals could be four times that of others. "If one in four trusts can keep their costs down, why can't the rest?" Mr Milburn said. "We will set targets for improvement and progress against those targets will be monitored."

The old hospital league tables, which focused on measures such as waiting times, cancelled operations and ambulance response times, would be replaced with new tables based on measures including death rates, operation rates and length of stay.

A Commission for Health Improvement would able to send "hit squads" into failing NHS trusts.