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.