Is the star system a Government gimmick?

The county's two main trusts, Worcestershire Acute Hospitals Trust and South Worcestershire Primary Care Trust, were only awarded a star each.

More surprisingly, Hereford and Worcester Ambulance Trust, which hit all but one of its key targets, was also docked a star by the Commission for Health Improvement.

On the face of it, this is disastrous for the county's health service. But some politicians and health organisations have attacked the rating system rather than the lowest rated trusts.

Shadow Health Secretary Liam Fox condemned the ratings as "ludicrous" and called for them to be scrapped. The British Medical Association is equally disparaging about them.

So, what is the truth of the situation? Is Worcestershire's acute trust one of the worst in the country, or is the star system a Government gimmick that does more harm than good?

Nobody would be stupid enough to pretend that all is well at the acute trust. Its finances fell into disarray last year, and Worcestershire Royal has been put on red alert on numerous occasions when it has run out of available beds.

Trouble-shooter Graham Smith was drafted in as acting chief executive to rescue the trust, and promptly scrapped 50 management posts within the organisation.

It has been a terrible 12 months and there could be more difficult times ahead.

Its debts are set to rise to £12m by the end of this financial year, which could put paid to any hopes of achieving a better star rating next year.

Other causes for concern have been raised in the ratings process. The trust failed to hit key targets such as seeing cancer referrals within two weeks, and not all breast cancer patients received treatment within 31 days.

However, this does not mean that patients take their lives in their own hands when they visit the county's hospitals.

The vast majority of patients receive good treatment and speak highly of the dedication of the nurses and doctors.

While nobody likes to wait longer than they have to for operations or appointments, I'm sure most people would be more concerned if their treatment was below par at the end of their wait.

The fact is that the acute trust would surely have been awarded two stars if it had kept its finances in order.

Unfortunately, it is now saddled with a low star rating, which is not going to help its cause.

One of the main reasons for its financial problems was the over-reliance on expensive agency nurses, caused by difficulties in recruiting permanent staff.

The trust has worked hard to reduce its agency costs, but a one star rating is far from attractive to potential employees.

Whatever else the trust might have to offer, it cannot escape from its star rating. If a nurse has to choose between a three star trust and a one star trust, there can only be one winner.

The trust therefore finds itself in a Catch 22 position. If it overspends, it gets a low star rating. If it gets a low star rating, it's harder to recruit staff, which leads to greater reliance on agency staff and inevitable overspending.

Furthermore, the existing workforces at the hospitals will no doubt perceive that all their hard work has been deemed worthy of no more than one star, and morale will be affected.

The rating is also sure to worry patients in the county. They are bound to associate star ratings with hotels and restaurants.

Nobody really wants to stay in a one-star hotel or eat in a poorly-rated restaurant. And nobody is going to be happy to be treated in a hospital with one star shining dimly above it.

The difference is that most patients don't have a great deal of choice in where they are treated.

Health Secretary John Reid announced last week that patients will soon be able to choose from a selection of hospitals when they need surgery.

But surely Worcestershire residents would prefer to have a good hospital to go to close to home. It would be absurd if patients started to snub the new, state-of-the-art Worcestershire Royal because they were not confident of receiving quality treatment.

The star system does have some benefits. It puts pressure on trusts to improve standards, and highlights specific problem areas.

But it's hard to see it as anything more than a "name and shame" policy. Three-star trusts will be feeling very smug at present, but one and zero-star organisations are faced with the tough task of keeping the public's confidence.