Poor surgical care caused or contributed to the deaths of more than 270 people in Scotland last year, according to new figures.

Nine of the deaths were directly attributable to sub-standard care and a further 268 were closely linked to it, according to an independent report.

In all there were 4,493 recorded deaths in surgical departments in 2001, of which 4,049 were examined by the study.

The figures come in a review carried out by the Scottish Audit of Surgical Mortality (SASM) into deaths under the care of a surgeon in hospital before and after operations.

In 330 cases, the participating surgeon or anaesthetist said there were shortfalls in the quality of care received by patients but thought this had not affected their condition.

It is only by undertaking a careful and critical look at the work we do that we can hope to improve further Dr Peter Terry British Medical Association

Health Minister Malcolm Chisholm welcomed the report, which he said was a thorough examination of care provided by hospital surgeons.

"It enables surgeons to receive feedback on individual cases, while for patients and their families, it provides the reassurance that their surgeon's work is reviewed by professional surgical and anaesthetic colleagues," he said.

He said steps were being taken to improve areas in which some surgeons were under-performing.

'Cause for concern'

But Scottish National Party health spokeswoman Nicola Sturgeon said it was "a matter of genuine concern" that 277 deaths had been linked to poor surgical care.

She said: "A single death is one too many and we must forever be working to improve standards and prevent mistakes."

She also called for the publication of individual death rates for all consultants.

Professor John Temple, the chairman of SASM, said the study showed that surgeons' performance had improved in recent years.

The study examined 4,049 deaths

"This report contains much good news: a continuing reduction in elective deaths and improvements in pre- and post-operative care," he said.

The chairman of the British Medical Association's Scottish Committee for Hospital Medical Services, Dr Peter Terry, said the figures showed that most surgeons were continuing to do a good job, despite upheavals in the NHS.

He said: "It is only by undertaking a careful and critical look at the work we do that we can hope to improve further."

Deaths falling

Overall, the number of reported patient deaths in surgical care has fallen from a high of 4,579 in 1996.

The audit is compiled from forms filled out by surgeons about deaths in their care, which are then assessed by consultant surgeons and anaesthetists.

Participation is voluntary, and this year consultants failed to return forms on 444 deaths.

Members of the SASM board have expressed concern that the number of forms which are not returned has increased in recent years.