Patrick Nulty (Dublin West, Independent)
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239. To ask the Minister for Health if his Department, the Health Service Executive or the Health Information Quality Authority has plans to monitor, collate and report on a regular basis on the death rates of patients undergoing major surgery at hospitals to identify variations if they exist, to address such variations with corrective action and to improve standards in hospitals by publishing such data; and if he will make a statement on the matter. [34048/13]

James Reilly (Dublin North, Fine Gael)
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It is important for a health system and the people it serves that it collects, analyses and interprets high quality information about is performance against its objectives, including quality and safety objectives. This information can be used to inform decisions about the planning, design and delivery of services, to monitor and evaluate the effectiveness and safety of services and to identify areas of performance which may require further exploration and action. The Department of Health recognises this as an important issue and the office of the Chief Medical Officer in the Department has been focusing on this agenda. Currently, the Department is working with the HSE and HIQA on this agenda, focusing on generic quality and safety indicators. The Minister hopes to be in a position to announce further developments in this area towards the end of the year.

Patrick Nulty (Dublin West, Independent)
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240. To ask the Minister for Health if his attention has been drawn to the fact hat according to a study of mortality after surgery in Europe, Ireland has one of the highest rates of post-operative mortality amongst 28 European countries surveyed; the action he is taking to reduce our high levels of post-operative mortality; and if he will make a statement on the matter. [34049/13]

James Reilly (Dublin North, Fine Gael)
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My Department and the Health Service Executive (HSE) are extremely concerned in relation to the findings of the Lancet Study of mortality after surgery in Europe. While it has been acknowledged that there may be some methodological explanation for the results obtained, e.g. private hospitals not included and only 17 public hospitals participated, I can assure the Deputy that the findings are being taken seriously. In direct response the Royal College of Surgeons in Ireland (RCSI) has established a group to complete a full re-examination of the data collected for the EuSOS (European Surgical Outcomes Study) and to completely re-do the study.

The HSE is undertaking a number of general improvements in surgery provided in Irish hospitals. These include:

- the centralisation of complex cancer surgery to high expertise centres;

- the establishment of pre-operative assessment clinics for patients with planned surgery;

- promotion of the use of a safe surgery checklist in all surgical theatres;

- expansion of Intensive Care Unit capacity with new beds being opened in St James Hospital, Cork University Hospital, Tallaght and Drogheda;

- prospectively measuring mortality rates for a number of key conditions;

- increasing the use of simulation and human factors training, as used in the airline industry, as part of surgical training;

- developing surgical standards and training programmes in collaboration with the UK colleges of surgery.

The HSE has also been active in developing its data sources in order to improve the safety and quality of surgical treatments. The National Office of Clinical Audit (NOCA) has been established as a result of collaboration between the HSE Quality and Patient Safety Directorate and the Royal College of Surgeons in Ireland. The primary purpose of NOCA is to establish sustainable clinical audit programmes at national level which will ultimately improve outcomes for Irish patients. It is intended that the Irish Audit of Surgical Mortality (IASM) will be the first audit stream from NOCA to be rolled out nationally. It will be based on the methodologies used by the Scottish Audit of Surgical Mortality (SASM). The IASM will review all "in-hospital" deaths occurring to patients under the care of surgeons in Ireland. The overall aims of the audit are:

- to reduce surgical mortality through peer review processes

- and, crucially also, to examine the patient pathway with the aim of improving services for all surgical patients in Ireland.