HEALTH SECRETARY Wes Streeting’s plan to introduce hospital league tables is deeply damaging, counterproductive and will ultimately be used as a means of closing hospitals.

At the beginning of the Tory-led coalition government, under David Cameron, the Tories and the media latched onto the so-called “Stafford Hospital scandal” that emerged from an inquiry ordered by Andy Burnham in 2009 into claims of poor care.

The Daily Mail made a lurid claim that up to 1,200 people had died avoidably at the hospital between 2005-08, and this idea was eagerly promoted by Cameron and co as an opportunity to attack the previous Labour government’s record on the NHS.

Ultimately, the “scandal” cost the people of Stafford most of their hospital services and continued to be used for years afterwards by right-wing politicians looking to criticise the NHS and particularly Labour’s NHS.

But it was a media creation based on defective statistics, not on reality, as the Guardian, Huffington Post and even the Telegraph and finally the Daily Mail that started the “scandal” eventually admitted.

Stafford Hospital’s management, looking to save money under government pressure, had laid off its qualified “clinical coders” who were responsible for recording all the other health issues that a patient is suffering from alongside the issue for which they were admitted, known as “co-morbidities.”

This information is crucial for the hospital for a number of reasons. The hospital is paid more for treating sicker patients, so there’s a financial impact, but also, the hospital’s mortality statistics are driven by the health of the patients it treats: sicker patients are more likely to die, so a sick patient who dies doesn’t have the same impact as the death of an otherwise healthy patient, but only as long as the co-morbidities are properly coded into the system.

Stafford, which was using unqualified clinical coders, was not properly recording these co-morbidities. This cost the hospital millions and caused it severe financial issues, and at the same time, it pushed the hospital to the top of the “mortality” league table and made it look like there were high levels of mortality among relatively healthy patients, which the media, looking for an NHS hammer to use on the Labour Party, equated to “avoidable deaths.”

However, the Francis Report into the supposed scandal did not reach this conclusion. In fact, though it avoided stating overall numbers, it suggested the opposite.

Families who were worried that their relatives may have died avoidably were invited to put their case forward for a detailed clinical investigation by senior doctors. The lead doctor in this process told the Francis Inquiry that in the 40 to 50 cases he examined, “he had come across perhaps one such [avoidable] death.”

Stafford Hospital was targeted because it occupied a prominently negative place in the mortality league table. Sir Brian Jarman was the creator of the “hospital standardised mortality ratio” (HSMR) methodology used to rank hospitals on their mortality performance and, as you would expect, an ardent advocate of their use.

But in a 2013 tweet, he acknowledged that Stafford was wrongly placed in his table and that its death statistics had been found by auditors PwC to be hugely inflated because of coding: “conclusion … appears to be coding (25-30 per cent due to wrong coding).”

And the very fact that a league table existed meant intrinsically that some hospitals would be in the bottom half of the table, even if they were all performing well, but the public perception was shaped by the supposed “rankings” and the narrative was easily turned to make this mean “failing” or “inadequate.”

The fact that the “scandal” was a false one did not prevent the people of Stafford from losing most of their services, including their accident and emergency department, and having to travel, on a good day, at least 40 minutes to Stoke Hospital, which then also began to struggle under the strain of extra demand.

They marched for months in protest at “the crucifixion of a good hospital,” but to no avail — after a cursory “consultation,” Stafford Hospital was reduced to little more than a health centre.

The false story has persisted despite being publicly debunked. In 2019, years after the truth came out, Channel 4 produced a drama about the supposed events at the hospital.

In its coverage of the drama, the BBC wrote: “The regulator … reported there had been at least 400 more deaths than expected between 2005 and 2008.” The same article also reported that patients had been so thirsty they were forced to drink from flower vases — but flower vases had not been used, for health reasons, at the hospital since the 1990s.

Even now, at the time of writing, the Daily Mirror’s page on Stafford Hospital continues to state that the hospital “was at the centre of an abuse scandal that saw 1,200 deaths between 2005 and 2008.”

The same newspaper, in 2017, rightly carried an analysis showing that the “Tories [under Theresa May] are using Mid Staffordshire scandal as an excuse to kill our NHS” and impose massive NHS cuts and closures. In July this year, right-wing news site CapX repeated the false claim, stating that Stafford’s “long history of poor care caused hundreds of patients to die between 2005 and 2008.”

The damage of “league tables” has also long been evident in the education sector. The Conservative government, keen to push the academisation of the school system, abolished the “satisfactory” rating for schools, forcing Ofsted to classify schools as either “good” or “inadequate” — and forced schools who receive consecutive grades below “good” to become privatised academies, regardless of the wishes of parents and with no choice over the corporate “sponsor” who would take over the school and run it for profit.

Streeting has already made clear that his plan to drive medical care out of hospitals will be the vehicle for cost-saving measures and lead to hospital closures — and the “integrated care systems” push that the Tories began and Streeting supports is aimed at rationing and cheapening care to make it more attractive to private providers.

It is a safe bet, in an NHS mandated by Labour to move even further in this direction and which has farmed out more than £2.3 billion in contracts to private firms in just the last couple of months, that the “hospital league table” will be used to target hospitals for either closure or for complete privatisation, even though the history of privately run hospitals in the NHS has been awful.

Our campaign, “Save Our NHS,” could not be more needed than now.

Claudia Webbe was the Member of Parliament for Leicester East (2019-24). You can follow her at www.facebook.com/claudiaforLE and twitter.com/ClaudiaWebbe.