Surgeons' mortality rates: the public has a right to know

The Sunday Times submitted a Freedom of Information Act request to the Common Services Agency (CSA) of the Scottish Health Service in February 2005. The request was for the mortality rates of all surgeons since 2000, including their names, specialities, hospitals and the number of operations that they had carried out each year. The CSA refused, claiming that the information was exempt under the Freedom of Information (Scotland) Act because it was personal and could damage the “effective conduct of public affairs”.

The Sunday Times points out that when a parent’s child requires a life-threatening operation, the medical profession expects the parent to take the surgeon on trust: "Only the legal profession is equally determined to protect the reputation of its practitioners. But things are changing. Notice has just been served that, when a service is provided in the public’s name, the public has a right to know how good that service is."

John Sinclair, a consultant surgeon from Glasgow, thinks that the public is perfectly capable of interpreting the data and that most of the profession have nothing to fear: “It is inevitable and only right that surgeons’ death rates will become available to the public. At present, those of us working in hospital have a pretty good idea of who is the best surgeon to perform a particular operation. If doctors, and many hospital staff, already have this information, why should the general public not also have access to it? A surgeon who is conscientious, self-critical, safe and aware of his limitations has nothing to fear from the publication of death rates.”

However - opponents to the release of the information argue that publication of raw data without any supporting information that puts the figures into context, could be misleading and “at worst, grossly irresponsible”.

The Scottish Information Commissioner commented positively on the media's handling of the issue: “We recognise that this is a landmark decision. The media have shown themselves to be willing and capable of putting information of this kind into context and doing a service to their readers and the general public. Hopefully this will foster a better culture of openness and greater willingness to have a mature exchange of information.”

Focus: Secrecy sliced open: A 10 month battle has forced the NHS to reveal its death rates (Sunday Times, 11 December 2005)