Keogh – Fact And Fiction

Did Bruce Keogh publish two reports yesterday? After reading the responses of health service professionals, and then those from the right leaning part of the Fourth Estate, this was the impression given. And anyone still believing that those NHS doomsayers who scrabble around the dunghill that is Grubstreet have patients’ interests at heart will have been roundly disabused of that notion.

Consider first those who work in and around the NHS: the Royal College of Surgeons (RCS) talks of universal adoption of best practice, eliminating mistakes in surgery, and especially “the right levels of staff and support services to consistently provide seven days a week care” (most of the Trusts covered by the review had cut staffing levels since 2010).

Roy Lilley, as ever of independent mind, says “Bruce Keogh's Review is the best NHS report I have ever read... and I've read a few since 1974”. Rather him than me. He picks up on this key quote: “the complexity of using and interpreting aggregate measures of mortality, including HSMR and SHMI. The fact that the use of these two different measures of mortality to determine which trusts to review generated two completely different lists of outlier trusts illustrates this point. However tempting it may be, it is clinically meaningless and academically reckless to use such statistical measures to quantify actual numbers of avoidable deaths”.

And Lilley also quotes this from Keogh: “It is important to understand that mortality in all NHS hospitals has been falling over the last decade: overall mortality has fallen by about 30% and the improvement is even greater when the increasing complexity of patients being treated is taken into account”. That one didn’t make the papers.

Instead, despite Keogh himself rebutting the wilder claims from the weekend – such as the flagrantly dishonest “13,000 deaths” one – the press has doubled down on them. “Damning probe into 13,000 deaths” thundered the Sun. And again, readers are told “13,000 people died needlessly”.

The Mail is on the same page – no surprise there – with “Labour's day of shame over the NHS: Thousands of unnecessary deaths, 14 hospital trusts condemned, and now devastating report demolished Labour's claim that the NHS was safe in its hands”. Did Keogh mention any political party? You know the answer to that one.

This is reinforced by the preposterously puffed-up Simon Heffer (who goes private) telling “The day Labour lost the moral high ground on the NHS”. The Trusts covered by the Keogh Review are labelled “death-traps”. You might not have known that the mortality rates that prompted the process are from after the 2010 General Election. Keogh reported on what was found three years after that event.

The Tories and their press pals are in a terribly draughty glasshouse right now.