HOSPITAL patients will soon be able to refer to league tables to find
which hospital or individual doctor offers the best chance of a cure.
Greater Glasgow Health Board expects to have data available in two or
three years covering a range of conditions, a senior board planner said
yesterday.
Awarding of contracts for treatment will have to take into account
objective data comparing outcomes between different hospitals and
clinicians, said Dr Harry Burns, deputy director of planning and
contracts.
Preliminary work by Dr Burns, which will feature in a BBC Panorama
programme tonight, compares treatment for two relatively uncommon
cancers, melanoma and testicular teratoma, at six West of Scotland
hospitals.
He found that the Beatson Oncology Centre at the Western Infirmary
offered a 10% higher chance of being still alive five years after
treatment.
''If it were my brother suffering from teratoma, I know which hospital
I would want him to go to,'' said Dr Burns, a former surgeon at the
Royal Infirmary.
''With this kind of information I don't think I would be able to sleep
at night if I had not made some contractual effort to make the best
choice.''
Dr Burns admitted that getting accurate data which presented a fair
picture would be complicated.
One factor in particular is that the best surgeon may appear to lose
more patients because he is handling the most desperate cases.
Not all the evidence will be as clear cut as the specialist Beatson
centre's performance on two relatively rare diseases.
''When it comes to something like breast or colon cancer, if we tried
to direct them all to the best hospital it would be swamped,'' said Dr
Burns. ''It means we will have to find out why some hospitals are better
and apply that to the others.
''I imagine most hospitals will be similar on most things. About 90%
will rank on a par, with only a few outstandingly better or worse.
''But if the changes in the NHS are going to mean anything in terms of
patient accountability, we must make the information available.
''It is only a matter of time before league tables are published of
hospitals and doctors, just as they are for schools, but it will be
equally complicated.
''It is important to get across to the doctors that this is not a
blaming exercise, but a recognition that some people are better at some
things than others. There is a lot of specialisation taking place
informally, worked out by doctors among themselves, and this raises
standards.
''But it means an end to the attitude that Doctor Knows Best. Too many
services have grown up because this doctor or that was interested in it.
We have to determine what the patients need and want.''
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