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Hospital Trusts (Essex)

May I say to the hon. Gentleman that this ratio was developed by Professor Brian Jarman, and we very much encourage its use. However, it is not of itself a verdict on a trust's performance? It is simply a trigger that then gives cause for more investigation and inquiry. In many cases, trusts that have had a high mortality rate have been able to bring it down. There may be a number of reasons why a particular trust has a high standardised mortality ratio and the circumstances need to be investigated. I assure the hon. Gentleman that those trusts will be investigated. If we need to take further action, of course, we will.