Middle classes get better heart treatment

Published on Thursday 23 February 2012 12:51

Rich people are more likely than the poor to receive NHS treatment for heart disease, according to the public spending watchdog.

An estimated 182,000 people in Scotland have coronary heart disease (CHD), about 3.3 per cent of the population.

In some more deprived areas, about 25 per cent of men over 75 have CHD, but, according to Audit Scotland, people in deprived communities “are not always getting the same level of treatment as the rest of the population”.

Treatments such as angioplasty, which widens the arteries, or heart bypass surgery are more than 20 per cent fewer than expected in deprived areas. The least deprived areas saw over 60 per cent more than expected.

Audit Scotland said this “implies a lower level of access to these treatments for people in more deprived areas”.

The report states: “The Scottish Government and NHS boards should monitor rates of the main cardiology procedures, compare these by board and by different groups, particularly in more deprived areas and with other countries, and review whether variation is warranted, or if action needs to be taken to ensure patients are receiving the most appropriate treatment.”

It adds that they must also “continue to improve the evidence base on the impact and cost-effectiveness of measures to help prevent heart disease, and use this evidence to identify priorities for spending to help improve outcomes and address inequalities, particularly in deprived areas”.

The report found limited evidence of the effectiveness of the government’s Better Heart Disease and Stroke Care Action Plan which set a national target for cardiovascular health checks.

Rates of heart disease in Scotland remain the highest in western Europe, despite new cases falling by nearly a third in the past ten years. Death rates have reduced by about 40 per cent.

Audit Scotland found NHS cardiology spending had risen from £80 million in 2002-03 to almost £146m last year, a rise of 50 per cent when inflation is factored in.

The report found that the NHS could save at least £4m a year by making cardiology services more efficient.

The Royal College of Nursing has also highlighted pressure on funding for specialist heart nurses, with NHS Orkney no longer employing one and other boards, including NHS Grampian and Borders, facing uncertainty about future funding.

Director Theresa Fyffe said: “Cutting back on specialist heart-failure nurses is counterproductive, not just for patients but for NHS finances as well.

“Indeed, it is symptomatic of the wider approach that health boards are taking to saving money, [such as] cutting posts to reduce their wage bills and therefore storing up potential problems for the future when there won’t be enough nurses to deliver high-quality patient care.”

Labour health spokeswoman Jackie Baillie said: “If people from poorer communities cannot get treatment that would save their lives, ministers should hang their heads in shame.”

A Scottish Government spokeswoman said: “The report shows that people affected by heart disease are getting access to better treatments faster than ever, while service improvements have helped NHS Scotland cut the number of deaths from heart disease by almost 40 per cent over the last ten years.

“We are determined to do all we can to drive further improvements. Encouraging people to eat healthier options, become more physically active, stop smoking and drink less alcohol is key to achieving this, which is why we are taking forward a number of initiatives to create a healthier Scotland.”

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Mark Bishop

Friday, February 24, 2012 at 01:51 PM

#8 can't seem to find those figures, Charles. You are correct in the fact that when doctors are desperately trying to save a life, they will use smokers lungs, but as a last resort. http:www.dailymail.co.ukhealtharticle-1329606Brutal-reality-sick-transplant-patients-given-lungs-smokers-warns-surgeon.html There is, however, the risk that the patient will go on to develop lung cancer as a result. The doctors will also only supply transplants to smokers if all non smoking patients have had theirs first. However, much better not to have to have a transplant at all, wouldn't you agree? Time for you to stop smoking?

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Charles11

Thursday, February 23, 2012 at 03:18 PM

#7. Did you know that about half of all lung transplants were donated by smokers?

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Mark Bishop

Thursday, February 23, 2012 at 02:17 PM

Dearie Me Charles @1. Perhaps you can get an operation on the NHS to put a chip on the other shoulder. You'll be much more balanced then. @2 you hit the nail right on the head. Heart attacks are preventable. Smoking CAUSES 23 known diseases. The information is in every doctor's surgery in leaflet form and on the back of every packet of cigarettes. If people don't know it by now, they must be living on the moon. The NHS don't favour one person above another in A&E, they all get the same treatment. However, if the need for a new heart or liver came up, the Transplant Team would certainly say no to a heavy smoker and drinker who takes no exercise and eats chips. Much better to give the transplant to someone who actually understands and practices the need for a healthy lifestyle.

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Charles11

Thursday, February 23, 2012 at 10:10 AM

A year or so ago a nurse said on live radio that smokers should not get treatment, but should die.

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Huntly Loon

Thursday, February 23, 2012 at 03:14 AM

A final point those who have got treatment for heart attacks will be well aware that but for the SNP abolishing prescription charges they would be having to pay a considerable sum of money to cover the essential medication which they have to take for the rest of their lives, including blood thinners such as aspirin and clopidogrel, blood pressure tablets such as ramipril, beta blockers, cholesterol reducing simvastatins and nitroglycerine sprays. That must be near 40 quid saved compared to England for every prescription renewal.

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Huntly Loon

Thursday, February 23, 2012 at 03:05 AM

The middle classes are less likely to smoke or eat bad diets or fail to take exercise. The middle classes are probably more aware of their own health and take measures to check things like high blood pressure and be more aware of heart attack symptoms and get attention quicker. A&E services will not discriminate those who present themselves at casualty. If anything it is usually the deprived who will go there in preference to a doctors surgery. Anybody who has been to an A&E will have seen that themselves. But once there the Cardiac units will give first class treatment to all irrespective of class, but it might be easier to treat those effectively who have not led an unhealthy lifestyle.

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victor is back

Thursday, February 23, 2012 at 01:55 AM

Well said #2. The article above is politically correct driven tosh. Does anyone seriously believe that the nhs, doctors etc etc are all wandering around the hospital wards of this fair land saying lets operate on the rich (or middle class as the headline calls it which is far from rich) and try and save them but lets also not operate on the poor and hoepfully they will die off?!!!!! Garbage. Unintelligible garbage. Sadly all too prevalent these days in this rag.

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Willie Boy

Thursday, February 23, 2012 at 01:21 AM

Simple fact is that certain folks make lifestyle choices to disregard their health. Poverty of mind, poverty of ambition, the world is ful lof losers who choose an deathly unhealthy lifestyle. And whose fault is that - yours?

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Charles Linskaill

Thursday, February 23, 2012 at 01:16 AM

That's Society for you, The Winners and Losers, Just Don't be Born on the wrong side of the Fence, Terrible the Fact, our NHS and Scottish Government do not take our poor into more consideration.

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