TRAINING of the next generation of heart surgeons is being disrupted by plans to publish death rate "league tables".

The claim is made by heart surgeons at the Freeman Hospital in Newcastle, who predict that surgical league tables "will inevitably result in additional premature deaths".

It follows warnings from a surgeon at the James Cook University Hospital, in Middlesbrough, earlier this year that the plan to publish surgeons' death rates could damage the reputation of surgeons who attempt more difficult operations.

In a letter published in the British Medical Journal this week, consultant cardiothoracic surgeon Stephen Clark and specialist cardiothoracic registrar Christopher Wigfield set out their fears about the impact of league tables.

According to the surgeons the tables could undermine" the future provision of surgical care.

They go further by suggesting that the process has already begun.

"Already, some consultant supervisors are reluctant to provide adequate training to the next generation," the surgeons write.

"Because of their concern over the influence an adverse result may have on their league table position, some consultants are handling cases where there should be consultant-supervised training."

With good supervision there should be "no risk" to the patient but, according to the pair, "league tables have changed the consultant mindset".

They fear that this will result in the best surgeons declining to perform very difficult operations and straightforward surgery being performed "by less competent future consultant surgeons."

The announcement that all cardiac surgeons will see their death rates published by April 2004 was made in January.

It is part of a controversial Department of Health initiative designed to build a safer NHS.

Hailed as a "catalyst for change" by Health Secretary Alan Milburn, the plan was part of the Government's response to the Bristol heart surgery inquiry.

At the time, the secretary of the Society of Cardiothoracic Surgeons, Bruce Keogh, said there was some anxiety among surgeons about the move as the best surgeons in the world can have the highest mortality rates.

Steven Hunter, a heart surgeon at the Middlesbrough heart unit, said earlier this year that league tables should be corrected so that top surgeons who regularly attempt difficult operations should not be adversely compared to surgeons who only perform straightforward operations.

Both North-East heart units are said to have death rates close to the national average, according to information published by the independent Doctor Foster guide.