Deaths from heart disease 'likely to be eliminated in 10 years'

Hardly anyone of working age will die of heart disease by 2013 thanks to spectacular gains against one of the Western world's biggest killers, ministers said yesterday.

Hardly anyone of working age will die of heart disease by 2013 thanks to spectacular gains against one of the Western world's biggest killers, ministers said yesterday.

Deaths from heart disease are falling so fast that, theoretcally, they should be eliminated altogether in the under-65s within a decade, if present trends are maintained.

The gains have been so impressive that heart surgeons are running out of work. The Heart Hospital in London has had difficulty filling its beds and the specialist advisory committee on cardiothoracic surgery has warned that the rise in the number of heart surgeons must be halted.

John Reid, the Health Secretary, said deaths from heart disease had been "scandalously" high when the Government took office in 1997, but in the five-year period from from 1995-97 to 2000-02 they had come down by 23 per cent. "That improvement is without parallel in the world," Mr Reid said.

He was launching the third report in a week designed to swing public opinion behind government reforms by demonstrating real gains in the NHS.

Mr Reid has become increasingly frustrated by the gap between public perceptions of the health service and the evidence of progress on the ground. Accompanied by senior doctors and managers to lend his claims credibility, he has trumpeted the growth in NHS staff and the success of the service in coping with winter pressures, and he is expected to announce in a couple of weeks that the Government has achieved its target of having no one waiting for hospital treatment longer than nine months by the end of March 2004.

Yesterday's figures on heart disease showed the number of patients waiting more than six months for surgery had come down to 390 at the end of February from 2,700 two years ago. The remaining 390 patients are expected to be cleared by the end of this month.

Mr Reid said: "Seven years ago, cardiac services were in a terrible state. Patients could wait years for diagnosis and over two years for surgery. This report shows that, thanks to the hard work of NHS staff, fewer people are dying and emergency care is vastly improved."

He attributed the progress to greater investment, new ways of working and new drugs, such as statins to reduce cholesterol, which are saving an estimated 7,000 lives a year.

But Roger Boyle, the Government's heart tsar, said the decline in heart disease deaths had begun in the early 1970s and was 60 per cent attributable to lifestyle changes, such as the decline in smoking, and 40 per cent to new treatments.

Mr Reid announced a £1m pilot project to provide round-the-clock access to angioplasty for heart attack patients - a procedure to unblock arteries in the heart which surgeons believe could cut the death rate further.

From April 2005, heart patients will be offered a choice over where they have surgery at the time they are told they need an operation. At present they are offered a choice of hospitals outside their local area once they have waited six months for surgery.

Mr Reid said: "We want to make the service more personal and give patients a degree of power, information and choice."

James Munro, a heart surgeon in Southampton and former president of the Society of Cardiothoracic Surgeons, welcomed the fall in the waiting list. But he said a six-month wait was still unacceptable. "In France no one waits longer than a month and in the US it's about a week," he said. "Cardiology waiting lists are rocketing. We need to get these waits down to three months. It is still not good but it is better than it was."

THE SURGEON

For two decades Professor Tom Treasure was one of the biggest names in heart surgery. He did everything from coronary bypasses to heart transplants and had gained an international reputation at St George's Hospital, south London.

Then in 2000 he recognised the work was running out. Demand for heart surgery was plummeting and lung cancer, where there had been little progress, offered one of the last great challenges for surgeons. Guy's and St Thomas' made him an offer - to specialise in surgery of the lung- he could not refuse.

"I was known to be successful and not short of work and at the time of my departure from St George's a lot of people asked what on earth I was up to.

"But a couple of weeks ago, at our meeting [of the Society of Cardiothoracic Surgeons] in Guernsey, colleagues were saying, 'It looks as if you made a smart move'."

The specialist advisory committee on cardiothoracic Surgery has ordered an "effective moratorium" on new training posts, according to Professor Treasure. Yesterday's health department report showed a 19 per cent increase in heart surgeons since 1999-2000.

"There was an undercurrent at this year's cardiothoracic surgeon's meeting which was: will our jobs be safe?

"There is a national feeling that people who have skills in both heart and lung surgery would not want to give up their lung surgery now," he said

Guy's and St Thomas' has 11 cardiothoracic surgeons, of whom three, including Professor Treasure, concentrate on thoracic surgery. "Giving up cardiac surgery was not a problem for me. In 10 or 15 years from now there will be nothing like the volume of open heart surgery there is today."

"I was lucky in that the move offered me, as a surgeon in his mid-50s, an opportunity to take on new challenges while being let off some of the heavy workload that I had carried in cardiac surgery.