A regional public health director will meet trust medical directors this week in a bid to set up more scientific ways of ensuring that all doctors practise safe surgery.

Professor Rod Griffiths of West Midlands regional office has already instituted new monitoring systems which have helped identify poor performers. Some doctors have stopped performing operations as a result.

Last year he closed the surgical and laboratory services of Rugby St Cross Hospital, Warwickshire, after the death of an elderly patient, and when poor detection rates led to 18,000 cervical smears being retested.

Professor Griffiths said: 'Technically, we could have done nothing at Rugby. We could have walked away, because it was the trust's problem, not ours.'

His discussion with medical directors this week is part of an attempt to prevent medical disasters. He has compared data at different trusts and areas, and identified individuals who deviate from the norm.

He said: 'You often find people already know about the problem. They are more likely to do something if it is drawn to their attention.'

He said he had found that, where people had a problem with their performance, they would quite often address it and 'stop doing particular sorts of operations or change their technique and may give up surgery altogether'.

Professor Griffiths said changing case-mix was probably the simplest and most effective way of making things safer. But he added: 'The vast majority of doctors are perfectly safe. Poor performance is really the exception.'

He said he had been encouraged by the discovery that none of the poor performers were in top jobs, while the best performers were already known to him as leaders of the clinical community.

He is convinced that the real problems are organisational rather than individual. Recent inquiries, such as that on child killer Beverley Allitt, all found that preventive measures existed but were not used.

'Organisational issues are crucial,' he said. 'Anyone can make a mistake. It takes an organisation to have a real disaster.'