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The NHS has a higher death rate than most Western health systems - it requires bravery to set that right

By Mark Wallace
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New analysis by Professor Brian Jarman, the respected expert on comparing the performance of hospitals, has revealed some shocking home truths for our healthcare system.

Jarman's figures - compiled using 2004 data as the more recent numbers are not yet available - suggests that the death rate in English hospitals was 22.5 per cent higher than the average performance in six Western nations, and 45 per cent higher than America.

We're all aware of the Mid Staffs scandal, which Prof Jarman helped to expose, and the suggestions that some other NHS Trusts may have similar problems, but this report suggests our concern should be much broader. I've written before about the need for more fury when the NHS fails patients - that is certainly the case, as large numbers of patients are dying who would not do so if our health service performed even at the average level.

The political environment always makes it hard to talk about the NHS. The Opposition will jump on any perceived criticism, and the polls show voters' strong support for the service. 

But if politicians wanted an easy life, they should have chosen a different job. As a matter quite literally of life and death, this issue is too important to allow Westminster taboos to shut down discussion. Those who truly care about the NHS should also support scrutiny and reform to improve it.

Prof Jarman is perfectly open about the fact that the research may be imperfect. As he says, lots of money and various reform programmes have poured through the NHS since 2004, so the picture may have improved somewhat. He was so shocked by his initial findings he called in colleagues and other experts to find the mistake he assumed he must have made in his methodology. They found nothing wrong with his working.

It would be an act of pure folly to ignore this research because of its age or the stark nature of its findings. 

This type of mortality data has already been picked up by Jeremy Hunt in the aftermath of the Mid Staffs crisis, but its use should be extended - if there are such jaw-dropping findings in the numbers from 2004, then we urgently need to know what the picture is today. The Government should ensure that it scrutinises the NHS hospital by hospital on this basis, and that it makes those numbers public to inform the public about any successes or failures.

Coincidentally, the Royal College of Physicians has today published a list of 50 proposed changes to NHS practices which it believes would improve care standards. Ideas such as bringing specialists to patients, rather than moving sick people around so much, make good sense but would require structural changes in parts of the NHS. We must be prepared to make such changes where necessary. 

Prof Jarman's comparisons with the US also point to a cultural change which is required within our health service. Commenting on the possible reasons for the disparity between the two countries, he highlighted the American medical culture of whistleblowing, which encourages doctors and nurses to speak out when something is wrong. It contrasts sharply with the bullying and gagging clauses which have been used to silence various whistleblowers in this country.

Avoidable loss of life in the NHS may start due to poor care, managerial errors, budget problems or a host of other causes. But it is a lack of transparent data, an unwillingness to scrutinise and a culture which vilifies rather than praises whistleblowing which allows it to continue. That is a scandal in itself.


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