THE Health Secretary, Mr Alan Milburn, talked about a culture of inevitability when he unveiled the league tables for hospital performance this week.

What he meant, we believe, is the feeling that nothing can be done among some NHS staff faced with tight budgets and the ever-increasing demands for their services. Mr Milburn hopes the initiative will encourage those hospitals which have made progress against the odds, and encourage others to follow their example.

Publication of the tables, with hospital trusts rated on a zero to three-star basis, has provoked comment along the lines of the criticism which usually accompanies the publication of the league tables for school performance. The criteria used and the performance aspects chosen for measurement are matters for legitimate debate but hospital performance does lend itself more readily to this kind of statistical scrutiny than education. The number of weeks a patient has to wait for an appointment after referral from a GP for suspected breast cancer is a highly tangible aspect of performance: the confidence a skilled teacher imparts to an uncertain pupil is less easy to gauge objectively.

Hospital managers who find themselves with a one or no-star rating will no doubt argue that the nine key criteria chosen by the Department of Health are not fair - possibly they concentrate too much on waiting times and not on the quality of work carried out or successful outcomes.

But those basking in the glow of three stars, including South Durham (gratifyingly for the local MP, a certain Mr Milburn), will claim credit for doing what was asked of them. The rewards are extra cash and freedoms for their managers and, perhaps most importantly, it may put a small smile on the face of some of their staff.