Friday, June 14, 2013

Doctors should be able to veto treament data until 'happy' with it, say surgeons

Doctors should be able to veto the publication of data showing how their patients fare after treatment until they are "happy" with the figures, the Royal College of Surgeons has said.

Hunt: doctors who refuse to publish patient data will be named and shamed
Mr Hunt's intervention provoked fury from the Royal College of Surgeons Photo: PA
Professor Norman Williams, president of the surgeons' group, said some doctors are concerned the data is not "reliable and robust" enough, given the complexities of their work.
His comments come after Jeremy Hunt, the Health Secretary, said there was “no valid reason” why doctors should be able to stop the release of the information, which would help patients identify the best place for treatment.
The Government is preparing to "name and shame" surgeons who refuse to make their data public.
It comes after the Daily Telegraph disclosed that doctors were secretly being given the opportunity to opt out of new Government league tables next month.
However, the Royal College of Surgeons has said the plan to name and shame doctors risks undermining public confidence and "stigmatising" them.
Professor Williams said the medical profession is committed to publishing surgical data, but there is a risk some doctors could shy away from doing difficult operations to keep up their good records.
He said the "way forward" is for all surgeons to publish their data when they are "happy with it". Only a small minority are vetoing publication, he added.
The first data – covering ten different surgical specialisms – will be released imminently before the transparency drive is extended throughout the NHS.
However, 92 surgeons have so far vetoed the publication of “their” data. Many are thought to have death rates which are worse than the average.
NHS England refused to name the surgeons and Mr Hunt has now ordered his officials to draw up plans to “name and shame”.
He said: “Subject to proper risk adjustment of the data there can be no valid reason why it should not be published – and the majority of consultants strongly support the case for doing so.
“In an era of public concern over patient safety issues at Mid Staffordshire Hospital, this will be a major step forward in restoring public confidence.”
Senior health officials said that the public can “draw their own conclusions” about whether they wish to be treated by those withholding data about performance. Whitehall sources have described the situation as “farcical”.
This newspaper disclosed that the surgeons were being privately contacted and asked if they wish to opt out of the publication of so-called “outcomes data”.
The Royal College of Surgeons said that its members were being asked to give their consent to comply with data protection laws.
However, it has now emerged that the Government has not even sought legal advice to establish whether this is the case – but relied on the advice given to it by the professional bodies.
Stephen Dorrell, a former Conservative Cabinet minister who chairs the health select committee, said the law should be rewritten if it was preventing full disclosure. “If it’s true that the Data Protection Act cuts across the principle of professional accountability as it needs to be applied in the modern world, then in my mind it’s very clear that the Data Protection Act needs amendment.”
On Thursday NHS England released further details of the approval process which will lead to the data being published, or withheld. For reasons which are unclear, surgeons with average survival or recovery rates will automatically have their data published unless they raise objections – but those with poor mortality rates will be asked to give explicit approval to publication.
Mr Hunt had hoped that the new system would drive up standards across the NHS and save hundreds of lives by embarrassing those with poor records.
Prof Norman Williams, the President of the Royal College of Surgeons, said the College was “not there to defend 'bad’ doctors, or those who are not performing as well as they should. Patients have a right to know of doctors who are not meeting the standards expected of them.
“We always expected this information would be mandated but it was the Government’s own legal advice, taken earlier this year, that made it clear that in preparation for the publication of data from nine national surgical clinical audits, they would have to ask for doctors to consent to the use of their data, under the Data Protection Act of 1998.
“We would urge the Government to work with us on this, for the sake of better patient care and more transparency.”

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