SURGEONS in Scotland have urged the National Health Service to improve care for patients who are close to death, saying that many are left to die on emergency or surgical wards because of a lack of hospices and poor palliative care.

The annual Scottish Audit of Surgical Mortality also found, however, that fewer people were dying after surgery than at any time in the past 11 years.

The report, which aims to highlight problems and improve standards, revealed that orthopaedic, thoracic, and vascular surgeons showed the most unhappiness, with 20 per cent or less expressing satisfaction.

The report said that there appeared to be better provision for some groups of patients, such as those with cancer, than others. “This represents an important shortfall in care and needs to be addressed,” it stated.

The quality of care also varied across the country, with West Lothian scoring highest and the Borders scoring lowest.

The annual audit also found that for nearly a quarter of patients who died after surgery, infection was believed to have contributed to the death. About three quarters of the patients acquired the infection in hospital, while the rest had it when they were admitted.

But the so-called MRSA superbug was involved in only a quarter of the cases where a patient had a hospital-acquired infection and died after an operation.

The report found that the total number of deaths under surgical care in 2004 was 4,091, an all-time low. More than half of these were deaths after an emergency admission.

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