Why hospital death rates in Wales are so important

 

It's difficult to think of many things more important than mortality rates at hospitals - for the public for obvious reasons and politically for the Welsh government.

Their importance was reflected on Wednesday with a huge amount said about them.

The Welsh government announced it's going to change the way the death rates are measured, and the subject came up in debates at the assembly and in the Commons. This is the story of the day.

Before we launch into it, here's a reminder of why it's been such a hot topic.

Death rates, or mortality rates, are measured in different ways in Wales and England.

That difference has been the centre of attention since the most senior doctor in England, Sir Bruce Keogh, wrote to the deputy chief medical officer in Wales, Chris Jones, to say concern about the rates in Wales merited further investigation.

'Basket of indicators'

The subject became even more inflamed when Charlotte Leslie, the Conservative MP for Bristol North West, said it echoed warnings that were ignored before the Mid Staffordshire hospital scandal came to light.

The Welsh government said on Wednesday that it is going to accept a recommendation to change the way that deaths are measured.

A taskforce set up to look into the matter concluded that no single measure can give a rounded accurate indication of how a hospital is performing.

Instead, a "basket of indicators" should be referred to.

The day started with an interview with Dr Chris Jones, deputy chief medical officer for Wales, on the Good Morning Wales programme on BBC Wales.

Presenter Oliver Hides asked him repeatedly whether the death rates can be compared between Wales and England.

Pre-emptive strike

It's a complicated subject obviously, but I think one of the key responses was this quote: "I think what I'm trying to describe is an approach that actually will take us closer in some ways.

"We should be more able to compare the 30 day mortality after a heart attack from a hospital in Wales with that in England.

"I think that is more legitimate but the single figure comparison at a whole hospital level is not legitimate."

So the answer was that comparisons will be able to be made, but between departments within hospitals, rather than entire hospitals.

There has also been a debate in the Senedd and a vote, which was defeated, to hold an independent inquiry into mortality rates at Welsh hospitals.

The Conservative shadow minister for health, Darren Millar, described the Welsh government's decision to change the way the data is collected as a pre-emptive strike ahead of the debate.

'Shameful manipulation'

He said: "The answer, minister, is not to blame the data for giving you the responses you don't like, it's to establish the causes of the higher than expected death rates and to address any problems identified."

Mr Miller did go on to say he agreed with the recommendation of the taskforce but he claimed it could not be denied that the figures should act as a "fire alarm".

After some emotional accounts from AMs describing some of their experiences in the NHS, Health Minister Mark Drakeford announced that the first set of new figures would be published on 21 March.

He said if they give rise to legitimate concerns then action would be taken and he repeated his claim that the criticism of mortality rates in the Welsh NHS had been politically motivated.

He described it as a "cynical, deliberate, Lynton Crosbie-like way in which they set out to drag the reputation of the Welsh NHS through the mud for naked, partisan political purposes".

He added: "It was a disgraceful and shameful manipulation."

Meanwhile, the same issue came up at the Commons in a debate marking a year since the Francis inquiry in the wake of the Mid Staffs scandal.

Health Secretary Jeremy Hunt told MPs that there had been a rise in pressure on hospitals in border towns because of a 10% rise in Welsh patients.

Mr Hunt said: "If this creates pressure in England, it is a tragedy for Wales. But still the authorities there continue to act as if the lessons of Mid Staffs stop at the border.

"If Labour, who run the NHS in Wales, will not listen to the government on this, they should please, please listen to their own backbencher - the remarkable (Ann Clwyd, MP for Cynon Valley) who following her own terrible family experience has campaigned tirelessly to improve standards of care in Wales, particularly with respect of mortality rates at six Welsh hospitals."

So the politicians have had their say and I suspect the issue is not going to go away as we head to the general election.

 
Nick Servini Article written by Nick Servini Nick Servini Political editor, Wales

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  • rate this
    +3

    Comment number 44.

    It seems Wales is the only place that has NHS problems according to certain folk. Let's get real please!! As said there's a London Tory agenda and Wales is the easy target just accept it. Granted Welsh Labour's been in power since 1997 thanks to the Welsh electorate misguided loyalty to a party that cares only for itself, Westminster obedience who wants ultimate power in perpetuity in Wales.

  • rate this
    +3

    Comment number 43.

    42: Again you use this forum for an anti Welsh language tirade. Yes Welsh Labour are a shambles but they have done some good under duress but your lot whether it would be UKIP or the Tories would be worse in power. Instead of oozing hate put what small ability have to a better cause or stay silent. Us who want better will reserve the right to vote out this lot next Senedd election if desired .

  • rate this
    -1

    Comment number 42.

    40 I think most people would agree that AM's are at best average with many verging on the incompetent WAG has made it clear that the prime function of devolution is to create bilingual nation Immediately all aspects of public life had to change and in my view not for the better We are now seeing the results of bilingual policy and no good news anywhere Welsh media SILENT Media must challenge WAG

  • rate this
    -1

    Comment number 41.

    #39 Unfortunately, the NHS isn't about democracy, apart from politicos avoiding unpopular inevitable changes.
    The managers and public don't talk the same language. Managers talk about optimising the expertise of consultants costing (not earning) over £200K p.a. Also lower mortality in specialised units.
    The public talk about kindness, visiting granny, knowing the staff, convenience.

  • rate this
    +1

    Comment number 40.

    The issue isnt about party politics or the Welsh Language it's simply that our rulers in the Bay cannot / wll not (delete as appropriate) admit that there is ever a problem with ANYTHING. Not only is it immature but it is also very dangerous.PS why has no one got back to me to explain how Wales plans to annex the Old Severn Crossing? Are we going for the M6 Toll and Dartford crossing next?

 

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