Robin Kanagasabay is in favour of performance data

The conundrum of the heart surgery performance data is that for people to get the best surgeon, they may need to pick the one with the worst survival rate.

Consultant cardiac surgeon Robin Kanagasabay says: "The surgeons who operate on the riskiest patients are often the ones with the most experience."

Whereas, he added, the most straightforward cases, with the most chance of survival, can often be done by surgeons with less experience.

But the fear nagging away at many in the profession is that this will not be understood and that patients will see surgeons with higher survival rates as better performers and choose them.

The issue of publishing individual performance data has divided surgeons, with 13 hospitals unable to publish data because some felt it would be misrepresented.

If it is published as league tables somewhere, it would be easy for patients to misunderstand the data and that is when problems may occur Christopher Munsch Death rates published

Mr Kanagasabay works at St George's Hospital in south London - one of the most open trusts in the country.

The hospital started publishing heart data over a year ago and expanded this to all of its branches of medicine a few months later.

Mr Kanagasabay said: "As far as heart surgery goes, it has not been a problem. Patients have been able to understand the data and if anything it has made them more confident about it all.

"They can see the survival rate is at least as good as it should be."

But not everyone is quite as confident. Christopher Munsch, a heart surgeon at Leeds General Infirmary, who has a survival rate slightly lower than some of his colleagues because he carries out riskier operations, said the data could be easily misused.

'Misunderstand'

"If it is published as league tables somewhere, it would be easy for patients to misunderstand the data and that is when problems may occur.

"It has not been easy publishing this data, not everyone agrees on how it should be presented.

"At Leeds, we have done it on a surgeon by surgeon basis because we believe it is best to be open and transparent."

But Mr Munsch, who has been a consultant since 1991, added if patients were misled and people started favouring doctors with the highest survival rates he would have to consider whether he would continue doing the riskiest surgery.