I READ with dismay but not surprise of the frightening situation that people face when all our local hospitals are in the bottom 20 in the country, as shown in the recent survey of hospital mortality rates.

It is said that this high death rate is related to the shortage of doctors. This is one reason, but not the only one.

Another major cause of death is infection and in many cases this is caused by doctors and nurses not adhering to basic hygiene rules, compounded by dirty hospital wards and toilets which leave patients exposed to much greater risks.

In our local hospitals we also have another reason for high mortality rates and that is because of certain consultants not resuscitating patients, because they feel it would be inappropriate. Neither do they discuss this final act with anyone, let alone the patient or their relatives.

Philip Randell, North Manchester's Medical Officer, has been quoted as saying that since 1997 there has been a 35 per cent improvement in mortality figures following surgery. Thank goodness then that there were no records for public viewing before that time!

Underfunding in the North West is obviously a problem, but Trust managers have to take responsibility by ensuring that staff of all grades, including consultants, adhere strictly to the guidelines draw up by management. If this is done, then some of these deaths could be prevented.

PAT PILLING,

Bury Old Road, Whitefield.