Middle classes get better heart treatment

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.”