After people have had an operation who is there to look after them - it is nothing to do with the surgeon at that stage

Margaret Davidson Scotland Patients' Association

The report found that while problems arising after non-emergency surgery continued to fall, those after emergency surgery were at a "continuing fairly high level".

It also found that proper provision for facilities for good post-operative care had been lacking at some hospitals.

The report suggestd that 14% - or one in seven - of patients who died after being admitted for emergency surgery may not have received the best of care.

David Smith, a surgeon at Glasgow's Victoria Royal Infirmary, is chairman of the advisory group which produced the report.

He accepted that the 2000 death rate was in part due to a lack of high dependency units which offer specialist care.

Information demand

Mr Smith added: "The problem which arises after emergency surgery are continuing at a fairly high level, not because of problems with the surgery, but because a great deal of emergency operations are carried out on people who are unwell and very elderly.

"Unfortunately there is not very much a surgeon can do about that when they are presented with such a patient."

The mortality audit does not include the names of surgeons or hospitals.

The Scottish National Party's health spokeswoman Nicola Sturgeon said: "There is a wealth of information that people should have access to in a modern NHS and the performance of surgeons is part of that modern NHS."

Findings

0.11% of patients die after elective surgery Just less than 4% of patients died after an emergency surgical admission in 2000 Not all deaths occurred after operations Some deaths occurred before surgery Poor post-operative care was a factor in 14% of deaths Poor post-operative care was the cause of 1% of deaths 3.5% of patients died after an emergency surgical admission in 1999

The kind of information on hospital performance, which is available in England, should be made public in Scotland.

The MSP said: "No-one underestimates the problem of presenting the information properly but those problems are not insurmountable.

"We live in an information society and the fact is we need information for patient of hospital is unacceptable."

But Scotland's chief medical officer, Dr Mac Armstrong, is against issuing league tables because he fears such information would only lead to a "culture of blame".

The chief executive of Scotland Patients' Association, Margaret Davidson, said: "There is no need for league tables. They tell us nothing."

Patient monitoring

Commenting on the hospital mortality rate, Ms Davidson said: "People should be in a ward where there is round the clock care, like a high dependency unit.

"That should be enough to look after them after an operation."

She said there should be constant monitoring to identify changes in a patient's condition following surgery.

"What we need to know is, after people have had an operation who is there to look after them?

"It is nothing to do with the surgeon at that stage. Is there enough care on the ward after the operation?

"If the operation is successful then it must be something after the operation that is going wrong. Are they left lying in bed, or are they being monitored to make sure that everything is working?" asked Ms Davidson.