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Hunt’s campaign against 14 trusts is aimed to discredit NHS and ease in privatisation

Noting where unusually high mortality rates have occurred in certain hospitals is clearly very important, but it is equally important to discover what were the causes of those deaths. That may well tell a very different tale from the commonly assumed one. Basildon & Thurrock Hospital, one of the 14 trusts targeted by Hunt today in the Commons, illustrates this well.

According to the summary hospital-level mortality indicator (SHMI) there were 112 excess deaths there last year, but they were in non-elective admissions, i.e. emergency cases.   But they were not in trauma or A&E or heart surgery, they were in general, palliative and geriatric medicine.   That indicates that the main problem was among the elderly, not among women giving birth for example.   It is still a problem to be investigated, but not one of the kind that Hunt sought to present.   He has a different agenda.

Whilst of course any problems in health care need to be identified and dealt with, the government’s highlighting of a string of hospital failings in recent months takes on a very different pattern. First, the use of mortality rates by themselves can be deceptive. In the case of Basildon, adopting a different measure of excess deaths – the hospital standardised mortality ratio (HSMR) – brings the hospital just within the acceptable range.

Second, the higher than expected mortality ratios that the government has been looking for reflects to a significant degree the cuts and market mechanisms introduced by the government itself. In the case of 7 of the 14 trusts targeted, there has in the last two years been a cut of over 1,100 nursing staff. This is now a common experience across the NHS as it seeks to wrestle with £20bn cuts within 5 years, but it must lead to a deterioration in both the quantity and quality of care.

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