NHS report author says claim of "13,000 needless deaths" is a misrepresentation

Bruce Keogh, the author of the report into 14 NHS trusts, writes: "Don’t believe everything you read, particularly in some newspapers."

The claim that there have been "13,000 needless deaths" at 14 NHS trusts since 2005 led several of the weekend's papers and has prompted 10 Conservative MPs to call for the resignation of shadow health secretary Andy Burnham, who was responsible for the NHS between 2009 and 2010. In an open letter they write:

It is clear now that the last Labour government oversaw thousands of unnecessary deaths in our NHS Hospitals and failed to expose or confront these care scandals. The patients we represent were betrayed. It would be an outrage if Andy Burnham were ever to return to the role of secretary of state for health.

But while the Tories have seized on the claim for political purposes, the man responsible for the report in question, NHS medical director Bruce Keogh, has entirely rejected the basis for this allegation. 

The figure of 13,000 is based on Hospital Standard Mortality Ratios (HSMRs), which are used to measure whether the death rate at a hospital is higher or lower than expected. But while HSMRS are able to tell us this much, they are, on their own, unable to tell us whether the deaths were due to poor quality care (and therefore avoidable) or other factors. The only way to judge whether or not the deaths were "needless" would be to study each individual's case notes. 

It was for this reason that Robert Francis QC, the author of the report into the Mid Staffordshire NHS Trust, warned that it was "misleading and a potential misuse of the figures to extrapolate from them a conclusion that any particular number, or range of numbers of deaths were caused or contributed to by inadequate care" and that "it would be unsafe to infer from the figures that there was any particular number or range of numbers of avoidable or unnecessary deaths at the Trust."

In addition, as academics at the University of Birmingham have noted, "The HSMR has a poor performance profile (10 of 11 elevated HSMRs would be false alarms and 10 of 11 poorly performing hospitals would escape attention). Crucially, the aim of a post-test investigation into an elevated HSMR is unclear. The use of the HSMR as a screening test for clinically avoidable mortality and thereby substandard care, although well intentioned, is seriously flawed."

When these points were put to Bruce Keogh, the author of today's report, by a reader of the Skwawkbox blog, he replied: 

Mr XXXX,

Thank you. I agree with your sentiments entirely. Not my calculations, not my views. Don’t believe everything you read, particularly in some newspapers.

I am very well versed in this topic, including the abstract you attach.

When you read my report you will regret sending this email!

With best wishes, Bruce Keogh

Having chosen to go on the offensive even before the report has been published, claiming not just that there were "thousands of unnecessary deaths" but that Burnham was to blame, the Tories may well be forced to backtrack when Keogh's conclusions are published in full at 2pm today.

Ambulances are seen at the Accident and Emergency department of St. Thomas' Hospital in London. Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

Photo:Getty
Show Hide image

Labour is a pioneer in fighting sexism. That doesn't mean there's no sexism in Labour

While we campaign against misogyny, we must not fall into the trap of thinking Labour is above it; doing so lets women members down and puts the party in danger of not taking them seriously when they report incidents. 

I’m in the Labour party to fight for equality. I cheered when Labour announced that one of its three Budget tests was ensuring the burden of cuts didn’t fall on women. I celebrated the party’s record of winning rights for women on International Women’s Day. And I marched with Labour women to end male violence against women and girls.

I’m proud of the work we’re doing for women across the country. But, as the Labour party fights for me to feel safer in society, I still feel unsafe in the Labour party.

These problems are not unique to the Labour party; misogyny is everywhere in politics. You just have to look on Twitter to see women MPs – and any woman who speaks out – receiving rape and death threats. Women at political events are subject to threatening behaviour and sexual harassment. Sexism and violence against women at its heart is about power and control. And, as we all know, nowhere is power more highly-prized and sought-after than in politics.

While we campaign against misogyny, we must not fall into the trap of thinking Labour is above it; doing so lets women members down and puts the party in danger of not taking them seriously when they report incidents. 

The House of Commons’ women and equalities committee recently stated that political parties should have robust procedures in place to prevent intimidation, bullying or sexual harassment. The committee looked at this thanks to the work of Gavin Shuker, who has helped in taking up this issue since we first started highlighting it. Labour should follow this advice, put its values into action and change its structures and culture if we are to make our party safe for women.

We need thorough and enforced codes of conduct: online, offline and at all levels of the party, from branches to the parliamentary Labour party. These should be made clear to everyone upon joining, include reminders at the start of meetings and be up in every campaign office in the country.

Too many members – particularly new and young members – say they don’t know how to report incidents or what will happen if they do. This information should be given to all members, made easily available on the website and circulated to all local parties.

Too many people – including MPs and local party leaders – still say they wouldn’t know what to do if a local member told them they had been sexually harassed. All staff members and people in positions of responsibility should be given training, so they can support members and feel comfortable responding to issues.

Having a third party organisation or individual to deal with complaints of this nature would be a huge help too. Their contact details should be easy to find on the website. This organisation should, crucially, be independent of influence from elsewhere in the party. This would allow them to perform their role without political pressures or bias. We need a system that gives members confidence that they will be treated fairly, not one where members are worried about reporting incidents because the man in question holds power, has certain political allies or is a friend or colleague of the person you are supposed to complain to.

Giving this third party the resources and access they need to identify issues within our party and recommend further changes to the NEC would help to begin a continuous process of improving both our structures and culture.

Labour should champion a more open culture, where people feel able to report incidents and don't have to worry about ruining their career or facing political repercussions if they do so. Problems should not be brushed under the carpet. It takes bravery to admit your faults. But, until these problems are faced head-on, they will not go away.

Being the party of equality does not mean Labour is immune to misogyny and sexual harassment, but it does mean it should lead the way on tackling it.

Now is the time for Labour to practice what it preaches and prove it is serious about women’s equality.

Bex Bailey was on Labour’s national executive committee from 2014 to 2016.