AS the hospital watchdog itself stresses today, these figures on so-called "standardised mortality" are not necessarily cause for alarm.
The warning system, which was overhauled last year to better reflect the expectations of modern medicine, is intended to act as a guide, pinpointing potential areas of concern. The crucial question for health bosses is whether the extra 43 deaths which occurred at the Vale of Leven and Royal Alexandra hospitals, and the unexpected deaths of 11 patients at Caithness General, were avoidable.
The HSMR algorithm is useful tool to flag up potential problems and enable those responsible for regulating the sector to ensure that care is up to scratch. It is not proof that anything is amiss.
However, its effectiveness was laid bare in April 2007 when it revealed that Mid Staffordshire NHS Foundation Trust in England had racked up 27 per cent more patient deaths than it should in 2005/6. The discovery triggered a long-running investigation which would eventually uncover a scandal of systemically poor care which had led hundreds of patients to lose their lives unnecessarily.
The fact that the Vale of Leven/Royal Alexandra combination has been red-flagged for the second time in 12 months is at least cause for review - something the health board and Healthcare Improvement Scotland say is underway.
It is not the first time the Vale of Leven has been in the spotlight, of course. The hospital was at the centre of a notorious superbug outbreak between 2007 and 2008, which sickened 143 patients and contributed to the deaths of at least 34.
It also comes amid persistent claims that the Vale of Leven is being scaled down as part of a centralisation drive by NHS Greater Glasgow and Clyde. The hospital's maternity unit closed in October 2002, followed by its A&E two months later. More recently there have been cuts to the haemotology clinics used by cancer patients and fears that the out-of-hours GP service will be next to go.
If its mortality rates are at odds with improvements nationally, this may bolster the case for centralisation. On the other hand, campaigners might argue that service cuts themselves are to blame
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