Lower death rates after publication of heart surgery league tables is not a green light for league tables

12.00.00am UTC (GMT +0000) Tue 24th Apr 2007

Dr Evan Harris, Liberal Democrat MP and former hospital doctor commenting on the study published by the BMJ today suggesting an association between improved survival following an operation and the publication of hospital league tables, said:

"This study does not provide justification, as some are claiming, for publishing league tables based on raw figures which do not take into account risk factors, but rather underlines the importance of ensuring that mortality scores are adjusted for such risk factors. So far it is only in cardiac surgery that some league tables make the necessary adjustments so it is not a surprise that there is little evidence of high-risk patients being refused treatment as surgeons are confident that the mortality score will be adjusted. If raw, unadjusted data were to be published there is a danger that high-risk patients would be refused treatment as their high-risk would not be taken into account in the mortality scores.

"League tables like Dr Foster are too crude to help patients select better treatment and may actually mislead them. Even this study of cardiac surgery cannot exclude the possibility of some patients being turned down as too high risk.

"We really need comparisons with other countries' changes in cardiac surgery death rates over the same time period to see whether publication of league tables is even a reason for improved performance."