PATIENTS undergoing operations in some parts of Scotland may be twice as likely to die than those in other areas, official figures have suggested.
A new report appears to show surgical death rates vary dramatically between health board areas.
The apparent discrepancies, revealed under Freedom of Information legislation, last night sparked calls for further investigations into health bo
ards' death rates, which have been kept secret until now.
The report, by the Information and Statistics Division of NHS Scotland, reveals NHS Lanarkshire, Forth Valley and Tayside had the highest death rates in Scotland last year.
The death rate in Lanarkshire was 0.95%, in Forth Valley 0.9% and in Tayside 0.76%. The Scottish average was 0.64%. Despite treating the highest numbers of patients, and some of the most complex cases, NHS Greater Glasgow and Clyde's mortality rate was slightly above average at 0.7%.
NHS Lothian, another area with large numbers of patients and complex cases, was well below the average, at 0.49%.
Last night leading surgeons warned the figures were unreliable as individual cases had not been examined, while health boards said they had no concerns about clinical practise.
The figures include all 429,656 patients assigned to the care of a surgeon for a full range of procedures, from serious heart and brain operations to minor day cases.
Anyone who died just before, during or within 30 days of surgery was included in the figures. Although many deaths would have been judged unavoidable, some are almost certainly due to "areas of concern", such as hospital-acquired infections, inappropriate medical care and delays to surgery.
Across Scotland, survival rates of patients have significantly improved over the past four years from 0.8% to 0.64%. In NHS Fife, the percentage of patients dying during surgery has dropped from 0.73% to 0.43% over the same time.
Nick Pace, a consultant anaesthetist at Gartnavel Hospital in Glasgow and clinical director of the Scottish Audit of Surgical Mortality, said the figures could not be accurately interpreted as individual cases had not been examined. He said: "There will be areas such as brain or heart surgery which are less safe but, hand on heart, I do not see problems with surgery in Scotland.
"We will never be able to give guarantees that patients will not die. The risks are relatively low, but adverse events are rarely down to individual failings."
But the figures have raised alarm among patients' groups and politicians. Dr Richard Simpson, Labour MSP for Mid Scotland and Fife, which includes NHS Forth Valley, said: Boards need to examine their own results closely. We need to … see if any improvements could be made."
Margaret Watt, chairwoman of the Scotland Patients' Association,
said: "I want to know if there is anything that could be done better in some of these hospitals. We are very concerned about patients going into hospital for routine procedures and dying."
Scottish Conservative health spokeswoman Mary Scanlon said: "These figures are essential knowledge, but the Government needs to give more information about the under-lying reasons behind these figures."
Gareth Davies, medical director of NHS Forth Valley, said: "We review all surgical deaths and have no concerns about the clinical practice of our surgeons." NHS Lanarkshire insisted it had "clinical governance procedures in place for the review of all surgical deaths" and had "no concerns" about its surgeons.
An NHS Tayside spokeswoman said: "Any figures associated with surgical mortality are complex to analyse. These figures do not in any way reflect case load or competency of surgeons."
A Scottish Government spokesman said:
"Scotland's surgeons are a credit to the NHS – making the difference between life and death every day of their working lives. Surgeons have regular appraisals."
