Heart and Circulatory Diseases: Premature Deaths
(9 months ago)
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Dean Russell (Watford) (Con)
I beg to move,
That this House has considered premature deaths from heart and circulatory diseases.
I start with something I never thought that I would stand here discussing. As I shared in Prime Minister’s questions a few weeks ago, at 47 I had a heart attack. It happened back in August last year, but I must admit that it took several months for me to feel comfortable talking about it more publicly—although I knew that I was on the path to full recovery, and I feel that I am now recovered. As I said in Prime Minister’s questions, I feel a bit thinner for it—that is the physical response. One thing that came through, beyond the fantastic support of the NHS, to which I will refer later, friends and family and my team, was the support of the British Heart Foundation. Its online resources, support and guidance were invaluable in helping me when I was on my own, to find a way through this, get on the path to recovery and understand the stories of others.
I hope the debate will not just share my story—this is not about me—but raise awareness of the early signs and symptoms and some areas of prevention, as well as raising with the Minister, on behalf of others who were perhaps not as fortunate as I was, some of the challenges to early identification of risks. I will aim to cover as much as I can, but I know that others will want to speak, so I will not hog the short time we have. I hope that even one person might come away from watching this debate— I am sure there are millions at home following this debate this afternoon—able to spot a sign for themselves or for a family member or friend, which might save or change their lives.
To start, let us talk about the symptoms. I appreciate that symptoms differ slightly for everybody, and the British Heart Foundation has excellent examples and guidance for what they might be. For me, it started with feeling a sort of numbness and tingling sensation in my left arm and an increasing tightness in my chest, which, as it grew, started to filter to the back of my body. It was not immediate. One often thinks of a heart attack as a cardiac arrest, which is where the heart literally stops and one needs a defibrillator or CPR, but a heart attack can feel more like a slow process that happens quite quickly, if that makes sense.
Even though many years ago, I worked on campaigns to talk about these symptoms with the British Heart Foundation as a client of mine, and even though I knew instinctively what was happening to me, as I started to get those symptoms, even I thought, “I don’t want to phone 999. I don’t want to waste their time.” I ended up calling 111, expecting to hear, “Don’t be silly; take a pill. Go to your GP tomorrow and they’ll get you sorted out.” But they did not say that. The message I had back immediately was that an ambulance was on its way, at which point, I thought, “This might be a bit serious”—but even then I was still in a little denial about the situation.
I will not tell the full story, but I was transferred very quickly to Watford General Hospital, where I was seen and given exemplary care. The East of England Ambulance Service was absolutely incredible with its speed and the compassion and support I was given—the same was true at Watford General, a hospital I love dearly. I was then transferred to Harefield Hospital, where I was again seen very quickly. During that process, I realised the enormity of the situation I was in and the potential that I could lose my life, although I was then unlikely to because I was in the right place at the right time.
Mark Tami (Alyn and Deeside) (Lab)
The hon. Gentleman mentioned the work of Harefield Hospital. My son has been at Harefield for four months after having a heart transplant just before Christmas; it has been a very traumatic time. I would like to place on record the incredible support and care the hospital provides. I also want to say that we think of heart attacks, heart failure and similar conditions as affecting people my age—maybe people a bit younger or a bit older—but heart failure and heart conditions can affect young people as well. We must not have lazy diagnoses where people think just because somebody is young, they cannot possibly have heart issues, cancer or other issues. As I said, I really want to put on record the great support that Harefield Hospital provides.
Dean Russell
May I send my best wishes to the right hon. Gentleman’s son? From my experience, his son is in absolutely the right place, and I hope he has a swift recovery. I echo the right hon. Gentleman’s comments—the staff at Harefield were exemplary at every stage of the process.
Again, I put on record—for my own benefit, rather selfishly—my gratitude to the East of England Ambulance Service, Watford General Hospital and Harefield Hospital, but also the cardiac rehabilitation teams. The experience of being in hospital and having a heart attack was a matter of days, but that of the rehabilitation, exercise programmes and diet changes—all the things that are so important—was a matter of months. I can talk about it not so much as having saved my life, but it has changed my life. I cannot say that I am pleased that it happened, but I am pleased that it happened the way it did, if that makes sense, in making a difference.
I recognise that my experience is not unique, however lucky I am in the experience I have had and the subsequent opportunity to use the platform of Parliament to raise awareness of these conditions and the work of the British Heart Foundation and the NHS. It just felt very apt to have this debate this month because it is World Heart Month. Back-Bench debates are an opportunity to have these conversations and to raise concerns.
Cardiovascular diseases include conditions that affect the heart and circulation, including high blood pressure, stroke and vascular dementia, which I will refer to collectively in the debate as CVD. Over the past six decades, huge strides have been made in improving outcomes for those affected by CVD, with the annual number of deaths falling by around half since the 1960s in part thanks to decades of medical and scientific breakthroughs. That is why research is just so essential.
Today, more than 7 million people are living with heart and circulatory diseases in the UK, and they cause more than a quarter of all UK deaths. In 2022 alone, over 39,000 people in England died prematurely of cardiovascular conditions. That is, on average, 750 people a week. Just to provide a sense of scale, that would fill the Chamber two times over. Despite the premature death rate for CVD continuing to fall by 11% between 2012 and 2019, sadly it remains one of the UK’s biggest killers. The British Heart Foundation is doing a lot of work to raise awareness of waiting lists going up for heart tests and treatment. We need to ensure that we tackle that head on. There is no room for manoeuvre on this. Let us keep moving forward to make a difference.
More analysis is needed. From lifesaving research by the British Heart Foundation, we know that the causes of premature deaths from CVD are multifaceted and complex. The NHS long-term care plan intends to look at many of those areas, but I call on the Government to be bold and consider co-ordinated action to address the issue in three ways. I urge them to prioritise heart care within the NHS to accelerate vital care; to ensure better protection from heart disease by addressing the drivers and underlying health conditions, such as obesity and smoking; and finally, to create a research and development ecosystem for breakthroughs, treatments and cures.
I welcome the significant work already under way through the Government’s major conditions strategy and the inclusion of cardiovascular disease in it. The interim report, published last summer by the Department of Health and Social Care, made clear the scale and urgency of the Government’s priority to address this issue. Urgency is absolutely key here. Around 80% of cases of CVD are attributed to modifiable risk factors such as high blood pressure, obesity, poor diet and smoking, making CVD largely preventable through a number of lifestyle choices.
Politically, I am not one who thinks that the state should intervene and stop people from being able to enjoy their lives, but I think education is key. Education can come through many different means, including engagement with the NHS and GPs providing advice. It is not about the state stopping people making lifestyle choices, but it is fair enough to let them know what those lifestyle choices might lead to, and what can make a big difference to them and their family.
Nearly two thirds of adults in the UK, around 64%, are overweight or living with obesity. Up to 8 million people have either undiagnosed or uncontrolled high blood pressure. From my own personal experience, I admit that I knew I was not going to be running in the Olympics any time soon—I cannot exactly describe myself as an Adonis—but while I knew I was slightly overweight, I thought I would be okay. I thought that these things do not happen to somebody at the age of 47. Like most of us, I thought these things happen to somebody else. That is the way our minds work. This was a wake-up call for me, and that is why I want to make a wake-up call to others from this wonderful platform of the House of Commons Chamber. Do not assume that it is all okay. Get checked out and make sure that you watch out for the signs.
I therefore welcome the Government’s ambition to halve childhood obesity by 2030, and to help adults reach a healthier weight through a range of preventive measures to empower people to take control of their own health. Of course, everyone has different ways of doing that. I will not share my own dietary habits, because I am sure that some dietician will watch this and tell me I have got it totally wrong, but I have lost about 2 stone in the past four or five months. I did not do it by fasting—I know the Prime Minister does his fast each week, so I will not comment on that—or by adopting a fad diet; I simply made some small changes in my lifestyle and the way I live my life.
Like many people, we as Members of Parliament work long hours. My father was a lorry driver, and I am proud of the long hours he worked and the work that he did to bring me up. Our job here is not particularly physical, but it does involve long hours and is quite sedentary at times, and the same probably applies to the jobs of a great many people throughout the UK. Being mindful of that, and going for a walk and getting a bit of exercise, can make a big difference.
The NHS long-term plan sets out the Government’s determination to prevent 150,000 heart attacks, strokes and dementia cases over the course of 10 years. I welcome the focus on early intervention to help people live longer, healthier lives, but we all know that smoking is still the single leading behavioural cause of preventable death in this country. I very much support the Government’s desire for a smoke-free generation by 2030, and I am glad they are pressing on with a tobacco and vapes Bill to ensure that children who are now 14 or younger—that is, anyone born on or after 1 April 2009—can never legally be sold tobacco products.
Addressing lifestyle concerns and identifying underlying conditions earlier could help to prevent tens of thousands of heart attacks and strokes, and could support the Government’s ambition to increase healthy life expectancy by five years by 2035, but I think it means more than that. To me, it means that a child will grow up seeing their father or their mother. It means that friends and families can see a loved one reach the age at which they can call that person a grandparent, or that person can see them graduate. This, for me, is not just about Government policy; it is about the impact on real people who can be helped to lead a positive life.
When we talk about heart attacks, heart disease and the other issues we are discussing today, we are of course talking about premature deaths, but for most people who are affected those conditions constitute a restriction on their lives, and I want to ensure that we improve that situation for everyone in the country. I am proud to say that the UK continues to lead the way in medical research, establishing innovative methods of early diagnosis and effective treatment.
As many Members will know, I campaigned vigorously with West Hertfordshire Teaching Hospitals NHS Trust to secure the necessary funding for the new hospital in Watford, and it was a proud and important moment when we did. One reason I supported that so strongly was the incredible work I saw being done at Watford General Hospital, especially in relation to the virtual hospital programme. It has led the way in showing that there are other ways of supporting people’s health, particularly at home, and adopting the idea of using technology and data to help improve people’s lifestyles. The beauty of the modern age is that many apps can give people guidance on their health. They have Apple watches or Fitbits or whatever else is out there; I do not want to go down the route of one particular brand. We are now able to track so much more of our health, but I think we need more education on what that data means. We can all see our heart rates, but what is the actual impact on people’s lives?
Virtual care is important in this regard, but—I will not go too far down this route, Madam Deputy Speaker, because I think it is for a different debate—I have long argued for what I call data donation. At present someone who sadly loses their life may donate an organ, but if we could donate our lifestyle data throughout our lives, the NHS and other organisations could start asking themselves whether they could, for instance, cure cancer by using that data, which would be anonymised, with all the necessary checks and balances to ensure that it was done well.
I am conscious of the time, and I am sure that I am going over my allocated period, but I want to highlight the fact that despite all the developments, CVD continues to have an impact on the wider economy, costing an estimated £21 billion annually in England alone. As I say, behind every figure is a person or a family who have been deeply affected by these conditions. As part of this process, I was fortunate to work with the House of Commons Chamber engagement team, who reached out to constituents across the country to share their own experiences in preparation for this debate. I believe that the correspondence should be in the Library; if not, I will make sure that it is shared with colleagues and put online. One respondent really moved me. They said that their daughter
“has half a working heart; she’s had two open heart surgeries and will need another. If it hadn’t been detected early, she wouldn’t be with us today.”
That is a life, an ambition and a future that is still there because of the support that has been given.
I know that I am doing a bit of a plug for the British Heart Foundation today, but one of the other comments, which rings true with my experience, was that the
“British Heart Foundation has a brilliant website for facts, and the consultant team we are under at our local hospital are fantastic.”
There were many quotes from people sharing very similar stories. A common concern, though, was about aftercare following surgery or medical treatment and the effects that people’s conditions have had on them mentally and socially. From my own experience, I have to admit that I suddenly started to feel twinges all the time and think, “Is there something wrong with me? Is it happening again?”
My experience is that within two weeks of having a heart attack, I promised that I would go to a local event; I did not want to let people down. I remember going to it on a searing hot day. I was genuinely frightened about going out in the heat with people and not knowing whether my body would still work in the way I hoped it would. I am glad I did it, because once I had gone through the experience of being there and realising that I could still be me, I was able to overcome that and continue to work as safely and as best I could as I recovered.
However, not everybody gets that opportunity. When someone has had a physical illness, particularly when it affects the heart, it is easy for them to suddenly worry that they do not have control over themselves, and they do not know what might happen next. I must admit that there have been many times when something has twinged and I have thought, “Is this a heart attack again?” Thankfully, it has not been, but aftercare is absolutely essential. We can fix the body, but helping to support the mind through that psychological process is absolutely essential. I know that colleagues in the House will have far more powerful stories about their experiences than mine, and I look forward to hearing them later.
This is about multidisciplinary care that does not end when the patient leaves the hospital. It is about supporting their full recovery and helping them with some lifestyle changes. I have to admit that the cardiac rehabilitation team I worked with were phenomenal. When I was extremely concerned, they would put my mind at rest, which meant that I was better physically and mentally. I therefore ask the Minister whether consideration will be given to offering counselling services and mental health support to those affected by heart and circulatory conditions.
As I have said, heart and circulatory diseases cause a quarter of all deaths in England, amounting to over 140,000 each year, 480 a day or one every three minutes. Sadly, in the time that I have spoken today, five people will have lost their lives. I therefore call for urgent action to do more to protect our hearts. By prioritising the right action and supercharging the progress that has been made on addressing heart and circulatory diseases, we can improve the nation’s health, grow the economy and give people hope for a brighter, healthier future.
Several hon. Members rose—
Madam Deputy Speaker
Order. It will be obvious to the House that we have very little time this afternoon, so I hope that Members will limit their remarks to around five minutes.
Andrew Bridgen (North West Leicestershire) (Ind)
Five minutes?
Madam Deputy Speaker
Would the hon. Gentleman like to find some way to make the House sit longer?
Andrew Bridgen
No, Madam Deputy Speaker. I am just rather surprised. We often have three hours for Backbench Business debates, but we have ended up with an hour.
Madam Deputy Speaker
I appreciate the point that the hon. Gentleman is making, but there is nothing I can do about it now. Don’t we all sometimes wish that we could turn back the clock? I do not have that power.
Andrew Bridgen (North West Leicestershire) (Ind)
I thank the hon. Member for Watford (Dean Russell) for securing this important debate, and for sharing his personal experience of suffering a heart attack. I am delighted to see that he has made such a strong recovery that he can be here in the Chamber today. I am sure that many Members have been affected by cardiac disease, or know people close to them who have been deeply affected by this appalling and shocking killer.
The Library briefing pack for this debate contains a startling statistic. Almost casually, it mentions that cardiovascular deaths per 100,000 population have risen by 10% since 2019, after falling steadily for decades.
Madam Deputy Speaker (Dame Eleanor Laing)
Order. I apologise for interrupting the hon. Gentleman, but I have taken what he has just said to heart. I have done my best to squeeze out more time, and he can have around seven minutes.
Andrew Bridgen
Thank you, Madam Deputy Speaker. That is a 40% increase. Ask and ye shall receive.
The previous steady reductions followed major improvements in public health policy, reductions in risk factors such as smoking, and the controlling of blood pressure, as well as improvements in medical care. Although I am grateful to the hon. Member for Watford for securing this debate, and to the other Members who will contribute, there is an elephant in the room—indeed, there are so few speakers that there is probably room for a herd of elephants. Why has there been a significant uptick in cardiac deaths in recent years? What novel intervention in public health has occurred since 2019?
Some might think that covid is the cause. Not so. The same uptick in cardiac deaths was observable in Australia and Singapore before those countries got covid but after they rolled out the experimental messenger ribonucleic acid injection. Ah, the jab! I can see some Members tutting and turning away. Everyone knows that MPs with a science degree are few and far between, and that some Members’ eyes glaze over when science is discussed. Well, I am one of those MPs fortunate enough to have a science degree. Another was Margaret Thatcher, who was rather prouder of being the first Prime Minister with a science degree than of being the first woman Prime Minister, and rightly so.
Some Members appear to have prejudged the issue. It is often said that it is easier to fool someone than to persuade them that they have been fooled. For posterity, we must remember that it was 11 years after the thalidomide scandal was exposed in 1961 before the word “thalidomide” was mentioned in the Chamber. I refuse to let this new mammoth medical scandal be ignored in the same way.
We are witnesses to the greatest medical scandal in decades—perhaps in living memory, and possibly ever. It is bigger than thalidomide and bigger than the Tuskegee untreated syphilis scandal, in which some black people were deliberately not treated to see what would happen to their bodies over time. It might be bigger than the Vioxx scandal, hitherto the grandaddy of medical scandals.
I can see some Members looking puzzled. Vioxx was a new drug invented by Merck as an alternative to aspirin—a mild painkiller. A researcher first highlighted an issue to Merck’s senior management in 1997, two years before the drug was approved. One in 115 people who took Vioxx suffered a heart attack. Merck’s profits from Vioxx comfortably exceeded the criminal fine, the compensation and the litigation costs after the drug was pulled. It was a good business decision for Merck. Not one pharma executive went to jail for skewing the trial results, for deceiving the regulators or for recklessly causing the deaths of 60,000 ordinary Americans for profit. It is always for profit—lives tragically cut short, families destroyed and children devastated. Imagine the incentive structure in an industry where profits like that can be made, and the corporate greed where there is full immunity from prosecution. In 1986, pharma companies got immunity in the USA for all vaccines. The number of vaccines administered to children in America has exploded since then.
Sir Christopher Chope (Christchurch) (Con)
Does the hon. Member share my hope that the Minister, in responding to the debate, will address the article in The Daily Sceptic on 20 February this year by Will Jones, headlined “Covid Vaccines Linked to Large Increase in Heart, Blood and Neurological Disorders, Major Study Finds”?
Andrew Bridgen
I hope that the Minister will address that, and of course this will go on. Cardiac deaths were already the biggest killer in our country, but we have a mysterious 10% increase. I am sure that the hon. Gentleman, like others in the Chamber, has witnessed the horrifying sight of super-fit athletes keeling over on pitches around the world. A mountain of peer-reviewed evidence is emerging and hypotheses are being proposed. Numerous cardiologists have concerns, but unfortunately, many experts do not feel able to speak out openly about their concerns because of the climate of fear, and the consequences of whistleblowing or speaking out against big pharma, which has so often been found to be not operating in the public interest, and causing harm. I am afraid that we will see much the same, following the roll-out of the covid-19 vaccines, as we saw with Vioxx and thalidomide, and in so many other cases.
The evidence is mounting up so rapidly, and the only people who cannot appreciate what is going on in this country are those who really do not want to see. The public will be extremely harsh on this Parliament and our response to the covid-19 pandemic, including the roll-out of the vaccines. We were going to stop vaccinating after the over-70s, but we then decided that vaccination would include the over-50s. We then decided it would be for everyone. Then this House took the appalling decision, unsupported by the Joint Committee on Vaccination and Immunisation, in September 2021 to vaccinate children who were at very little risk, if any, of covid, but who have been harmed seriously by the vaccines.
Why ever did we use a systemic vaccine for a mucosal respiratory virus? One expert said last year:
“it is not surprising that none of the predominantly mucosal respiratory viruses have ever been effectively controlled by vaccines. This observation raises a question of fundamental importance: if natural mucosal respiratory virus infections do not elicit complete and long-term protective immunity against reinfection, how can we expect vaccines”
to work, when natural immunity does not give protection? And what is the name of this expert? Mr Anthony Fauci, the former head of the Centres for Disease Control and Prevention in America, who pushed the vaccines.
I wish I had more time, Madam Deputy Speaker; this is a huge issue and we need to debate it again. It is the biggest killer of our constituents, and our fear is that the rate of increase in cardiac deaths will not slow in the UK, or the rest of the world.
Philip Davies (Shipley) (Con)
It is a pleasure to follow the hon. Member for North West Leicestershire (Andrew Bridgen), as I often seem to in these debates, which often resemble Madame Tussauds: the same faces appear, time after time. As you will know, Madam Deputy Speaker, I have a reputation for brevity in my speeches, and I intend to support that reputation now.
I congratulate my hon. Friend the Member for Watford (Dean Russell) on securing this important and rather timely debate, and I echo the hon. Member for North West Leicestershire in saying that we enjoy seeing him looking so fit and healthy after the trauma that he had. This is a really important matter, and he is right to raise it today. As I highlighted in last month’s Westminster Hall debate on excess death trends, a recent article in The Lancet found that although the causes of ongoing excess deaths in the UK
“are likely to be multiple”,
Office for National Statistics data showed some clear trends—in particular, the “largest relative excess deaths” since the pandemic occurred in young and middle-aged adults, with the number of cardiac deaths happening outside hospitals being the most elevated. In other words, young and previously healthy people are dying at home from cardiac-related events, and we do not know why.
These are not just numbers and statistics—these are real people, loved ones, often from younger age groups, who are dying before their time. It is urgent and our duty to get to the bottom of the situation sooner rather than later. As I am sure we are all aware, there are many theories circulating about the causes of these excess deaths. One is the possibility of a causal link between the population-wide use of covid-19 vaccines and the marked increase in cardiovascular-related critical events, including heart attacks and strokes, among otherwise apparently healthy people. We do not know if that is the cause or not, because the data is not being released. Until certain data sets are released, it is impossible to rule that theory in or out.
That is why I, along with cross-party colleagues, wrote yesterday to the Secretary of State for Health and Social Care; Professor Steven Riley, the director general for data at the UK Health Security Agency; and Dr Alison Cave, the chief safety officer at the Medicines and Healthcare Products Regulatory Agency. We warn that by withholding official data, the Department, UKHSA and MHRA are helping fuel concerns and hesitancy about public health. We have asked that anonymised record-level official mortality data be released, alongside vaccination dates, doses and co-morbidities, without delay. We understand that the MHRA has collected and already shared this data with pharmaceutical companies to enable those companies to produce post-authorisation safety studies for their products, so I see no reason why it cannot also be shared with parliamentarians and the public right away. Will the Minister say whether that data has been shared with pharmaceutical companies? If so, why is not being shared with the rest of us?
As the Minister surely realises, repetitive generic assurances that the Government and the UKHSA take excess deaths “seriously” and monitor them “constantly”, and that the MHRA have
“systems in place to continually monitor the safety of our medicines”—[Official Report, 16 January 2024; Vol. 743, c. 235WH.]
do not serve to reassure anybody at all. Likewise, the news from the Office for National Statistics this week that it has revised its excess deaths methodology, and that there are suddenly 20,000 fewer excess deaths last year, has done little to quell public concern. If anything, it has done the exact opposite: people cynically see it as a convenient sleight of hand.
As we say in our letter, if the Government and their agencies are not willing to share the data we have requested, will the Minister explain to us why not? We are all on the same side and want to look after people. We are all concerned to do the best we can for everybody, but until we have all the data, we just do not know what we do not know. If there is any potential that public health interventions, such as covid-19 vaccines, are causing harm and premature death to some, we must act on that without delay. If the evidence shows that that there is no issue, then it is in everybody’s interest for that reassurance to be in the public domain as quickly as possible.
Sir Christopher Chope
If that information was in the public domain, then the Prime Minister would have been able to answer the question that he was asked in the GB News interview the night before last.
Philip Davies
My hon. Friend is right. It is in everybody’s interest that the information be in the public domain, so that we can reassure people, or at least let them know. Frankly, there is never any harm in giving people information and letting them make their own mind up about what has happened.
Opinions need to be put to one side, and the data need to be examined in the cold, hard light of day. Otherwise, we will do harm to people, and we will do even more and irreparable damage to trust in public health policy. I hope that the Minister will provide some reassurance that the data will be forthcoming as soon as possible, and that the Government do not give the impression that there is something to hide.
Jim Shannon (Strangford) (DUP)
I commend the hon. Member for Watford (Dean Russell) for setting the scene today. We have spoken many times on this issue. It is a real pleasure to see him back to health and strength, and working very effectively in this House.
The rates of premature death from heart and circulatory diseases do not make for easy reading. The British Heart Foundation has been clear about how stark the situation is. As the DUP’s health spokesperson, I try to involve myself in all health matters—whether they be in ministerial questions or in debates—in this Chamber or in Westminster Hall, because that is part of my duty.
The number of people dying before the age of 75 from heart and circulatory diseases has risen to the highest level in more than a decade. Waiting lists for heart operations and other heart procedures are nearly 100,000 higher than they were a year ago. Those figures are stark and worrying.
I am very pleased to see the Minister in her place. We all have great respect for her. Although we do not want to burden her with questions, we do need to ask ourselves why these figures are so high and what is being done to reduce them. Worryingly, there are more people over the age of 75 waiting over a year for treatment—the rate is 140 times higher than before the pandemic began.
Latest figures show that, in 2022, more than 39,000 people in England died prematurely of cardiovascular conditions, including heart attacks, coronary heart disease and stroke—an average of some 750 people each week. Again, worryingly, that is the highest total since 2008. What is being done to address those issues?
This backwards trend—because that is what it is—has been broadly mirrored in age-standardised premature death rates, which account for changes and differences in population sizes and demographics. Before 2012, the number and rate of deaths from these conditions under the age of 75 were falling, in part thanks to decades of medical and scientific breakthroughs.
But after nearly a decade of slowing progress, recent statistics show that the rate of premature deaths from cardiovascular disease has now increased in England for three years back to back. This is the first time that there has been a clear reversal in the trend for almost 60 years. Again, the question must be: what has brought that about and what has been done to stop it.
The British Heart Foundation has said:
“The reasons for the rise are multiple and complex. While increasing pressure on the NHS and the covid-19 pandemic have likely contributed in recent years, the warning signs have been present for over a decade.”
If those signs have been present for over a decade, the question we must all ask is: what steps have been taken to slow the trend that has been there for some time.
I know that there will be many in this Chamber with opinions as to the cause. I do not hold a medical degree. I am a very simple person, but I do have an interest in health and I do ask the questions. The fact is that the sharp rise needs to be better managed. I can quickly give some examples of what we are doing back home in Northern Ireland. We have a developing plan with the Irish Football Association that includes more defibrillators and CPR training, which is really important. Many people who are fit and healthy—the hon. Member for Watford referred to this—have had heart attacks on the football pitch. Those are things that we need to address. May I commend the Chest, Heart and Stroke charity back home for all that it does?
This month in Northern Ireland, 340 people will die from heart or circulatory disease, around 90 of whom will be younger than 75 years of age. Some 225,000 people are living with a heart or circulatory disease, 320 hospital admissions will be due to a heart attack, 130 people will die from coronary heart disease, and 13 babies will be diagnosed with a heart defect this year. Those are the figures for Northern Ireland. The statistics are shocking, especially given the small size of Northern Ireland. There are an estimated 225,000 people living with heart and circulatory diseases in Northern Ireland. An ageing and growing population and improved survival rates from heart and circulatory events could see these numbers rise still further. It is clear that this really is a ticking timebomb and therefore we do seek some help from the Minister here.
I can see the Minister formulating her response. Both she and I are glad to see that the Northern Ireland Assembly is up and running. As health is a devolved matter, may I ask her in a genuine fashion, as I always do, whether she can indicate what discussions will take place with the Department of Health in Northern Ireland.
We in Northern Ireland are in the situation in which every region of the UK finds itself: there is not enough funding, not enough staff, and not enough support. Across the United Kingdom of Great Britain and Northern Ireland, we need to address the growing problem with solutions, which can only come about with reasonably paid staff and a better system. Let us exchange our thoughts and ideas, and move forward together towards a system where we can help each other. An overhaul of the system is needed, and we look to the Minister for a plan of action, beginning here in this place and extending through the NHS and across the United Kingdom of Great Britain and Northern Ireland.
You told me to finish within a certain time, Madam Deputy Speaker; I have just done it.
Amy Callaghan (East Dunbartonshire) (SNP)
I congratulate the hon. Member for Watford (Dean Russell) on securing this debate on such an important and prevalent issue. He and I have a shared interest in health inequalities, largely due to our personal experiences. He and I joined the House at the same time. I remember sitting in this very Chamber for his maiden speech, in which he quoted Sir Elton John’s song “I’m Still Standing.” I am absolutely delighted that we are both still standing. [Hon. Members: “Hear, hear!”] Just a few short months after my hon. Friend’s maiden speech—I will call him my hon. Friend— I was in rehab recovering from a stroke. “I’m Still Standing” was one of the songs that we ironically listened to while doing physio—a dark sense of humour can be a powerful tool in the face of adversity, but of course we need to equip people with more than just a sense of humour to get through these very difficult conditions.
This issue is one that my party and I are deeply concerned about, with nearly three in 10 Scots dying from heart and circulatory diseases, equating to about 50 people per day or 1,500 people per month. Preventing those deaths, and in particular premature deaths, is something that the Scottish Government are committed to. The hon. Member for Watford outlined the signs and symptoms of many heart and circulatory conditions. I commend him for shining a light on them. We cannot overestimate the impact that a debate like this will have. Support for the mind after a health trauma is necessary, as he also outlined. After my stroke, I did not realise that I needed help for my mental health until I reached a crisis point. Getting help was the best thing that I could have done for myself. That support needs to be there for everyone.
As we have heard, there are clear risk factors for developing cardiovascular diseases centring around people’s lifestyles. We can call them lifestyle choices, but the choices are often heavily influenced by inequality and poverty. We know that people in poverty have poorer health outcomes, and improving people’s ability to make healthier choices on diet, smoking and alcohol consumption are essential to change that. We know that sadly the prevalence rates for circulatory and cardiovascular diseases are significantly higher in the most deprived areas. We also know that poverty rates are higher for some minority ethnic groups, and therefore they are often disproportionally vulnerable to health inequalities.
That is why improving health and reducing health inequalities across Scotland are clear priorities for the Scottish Government, especially in the face of UK Government austerity measures. The British Heart Foundation says that there has been
“a lack of meaningful action”
from the British Government
“over the last 10 years to address many of the causes of heart disease and stroke, such as stubbornly high obesity rates”.
Obesity and unhealthy lifestyle choices are intrinsically linked to poverty. That is why the SNP’s action to mitigate the effects of this Tory Government’s cost of living crisis are so important to today’s debate.
Recent analysis from the British Heart Foundation shows that the number of people dying before the age of 75 in England from heart and circulatory diseases has risen to the highest level in over a decade. We know that 700,000 people in Scotland are living with circulatory diseases. We do not know how much that is affected by covid-19 or other factors, but it is clear that an increasingly unhealthy population plays a key role in these worrying statistics. This is why the SNP’s focus on tackling these inequalities and tackling poverty is such an important and proactive step in reducing these premature deaths.
The Scottish Government’s focus and commitment to tackling poverty and other risk factors relating to cardiovascular disease are despite this Tory Government’s austerity measures. The British Government’s austerity policies are harming the economies across these isles, driving more people into poverty and making our health outcomes worse. Health inequalities are rampant the length and breadth of these isles. I stand here as proof of that. I had cancer as a teenager and had a stroke in my mid-20s—an example of the health inequalities prevalent in the west of Scotland.
Economic austerity is to blame for the slowing progress in health outcomes over the past decade. The British Government would do well to cast their eyes up to Scotland and consider a focus on our wellbeing economy, with people at its heart, as we do. Funding—or, in this case, the lack of it—is a political choice. The UK has considerable wealth, so it is shameful that so many people are in poverty and that their health is suffering as a result. The levels of universal credit have been too low for too long. The SNP and the Scottish Government continue to call on the UK Government to introduce an essentials guarantee to ensure that social security benefits adequately cover the cost of essential goods and properly support our most vulnerable people. The Scottish Government have gone to great lengths to increase income for Scots by promoting fair work and improving the value of social security through bold measures such as the Scottish child payment and the real living wage.
I know that we are short of time, Madam Deputy Speaker, so I will bring my remarks to a conclusion. I urge the Government, and whomever forms the next Government, to consider taking the Scottish Government’s approach to tackling health inequalities by reducing poverty and guaranteeing that people have the resources to make healthy lifestyle choices. It is abundantly clear that while Scotland is tied to this place, Westminster and the British Government hold the purse strings, and any action that the Scottish Government take can be outdone by austerity measures in this place. Only with the full powers of independence will we truly be able to tackle health inequalities in Scotland and reduce the number of premature deaths from cardiovascular disease.
Karin Smyth (Bristol South) (Lab)
I thank the Backbench Business Committee for granting the debate and pay tribute to the hon. Member for Watford (Dean Russell) for securing it. I think we all agree that he made an excellent and heartfelt speech not just about his own experience, but about the effect on his family and his team. He thanked the British Heart Foundation, and I agree that the resources of such organisations are well received at such times, which can often be very lonely. We wish him and his family the best of health going forward.
My right hon. Friend the Member for Alyn and Deeside (Mark Tami), who is no longer in his place, spoke about his experience as a family member of a young person who has suffered a heart condition, and the SNP spokesperson, the hon. Member for East Dunbartonshire (Amy Callaghan), highlighted her own experience. Cardio- vascular disease affects not only us, but our families too.
As has been said, every week in 2022 an average of 750 people died prematurely of cardiovascular disease, including heart attacks and strokes. Every premature death is of course a tragedy, and our thoughts are with all affected families. NHS England has reported that cardiovascular disease is responsible for one in four premature deaths in the UK. As we have heard, the rate of premature deaths has risen for the past three years consecutively—that is something that we all wish to understand. Many of my constituents, and people across the country, are worried about the state of heart and circulatory disease services. Despite the best efforts of staff, there is a significant backlog in treatment, the number of people on waiting lists for cardiology services is rising, with a huge 189% increase in the past 10 years.
According to the Institute for Public Policy Research, waiting times for cardiology treatment have risen even more sharply than for elective waiting lists as a whole. That is deeply concerning, because long waits mean poorer outcomes for patients, often with devastating results. An estimated 7.6 million in the UK are currently living with heart or circulatory disease. It is vital that every one of those people receives effective and timely diagnosis, referral and treatment, yet under this Government the NHS has lurched from crisis to crisis, and far too many patients are not receiving that timely care.
Labour has an ambitious 10-year plan of reform and modernisation to speed up treatment, with 2 million more appointments a year. We want to return to the constitutional waiting-time targets within a Parliament. As our mission sets out, it is vital to restore the NHS as a world-leading health system—something that we have lost under this Government. The Government have promised to eradicate waits of over a year for elective care by 2025. It would be good if the Minister indicated whether they are on track to do just that.
Labour has a mission to reduce deaths from heart attacks and strokes by a quarter within 10 years, so that fewer lives are lost to the biggest killers. Under our “Fit for the Future” fund, we would double the number of scanners—speeding up heart and circulatory disease diagnosis—and ensure that patients receive the timely treatment that is so vital for managing those conditions. We would also incentivise continuity of care in general practice, which would improve care in our communities for people living with heart and circulatory disease. It would be helpful if the Minister explained why, in the past 14 years of Conservative Government, we have seen such paltry ambition on cardiovascular care and a decline in cardiovascular health. The Minister is probably going to talk about the major conditions strategy, which was announced 13 years into the Conservative party’s time in power, but when can we expect the full strategy to be published, and will it explore the reasons for the backward trend in cardiovascular disease that we are currently seeing? I agree with other hon. Members: we all need to understand the reasons for that.
One of the most concerning aspects of cardiovascular disease in this country is that many of its drivers are higher in areas of greater deprivation and, as we have heard, for black and minority ethnic groups. That is exacerbating health inequalities; we have heard from the SNP spokesman, the hon. Member for East Dunbartonshire, and from the hon. Member for Strangford (Jim Shannon) about the levels in their communities. In 2022, those in the most deprived 10% of the population in England were more than twice as likely to die prematurely from circulatory diseases than those in the least deprived 10% of the population, something I see very much in my own constituency of Bristol South. That is utterly unacceptable across the United Kingdom in the 21st century, particularly given that cardiovascular disease is largely preventable.
Tackling the issues that impact cardiovascular health, from obesity to high blood pressure or smoking, is vital —not only to tackle CVD, but to improve population health overall. That is why we have to tackle social inequalities that influence health and focus more on prevention, improving capacity in local public health teams that do so much vital work to improve the health of their communities. Innovation will also be vital to centre prevention in our health service, and I would welcome an update from the Minister about the NHS digital health check trial in Cornwall. Given that results from that trial will inform the roll-out this spring, can the Minister indicate any challenges apparent in the trial? When can we expect the results to be published?
As we have heard, prevention starts long before the age of 40, when that health check takes place. That is why Labour will introduce a child health action plan that will put prevention at the top of the agenda, ensuring that the next generation can live healthier lives. There are also widespread concerns that the restructuring of the Office for Health Improvement and Disparities could have a detrimental impact on health inequalities. It would be good to hear a reassurance from the Minister about how those concerns about health inequalities will be prioritised in the event of changes to that body.
Finally, research is crucial to preventing further premature deaths. That is why Labour’s regulatory innovation office would make Britain the best place in the world to innovate by speeding up decisions and providing a clear direction based on our modern industrial strategy, alongside a plan to make it easier for more patients to participate in clinical trials. That will deliver better treatment to patients. We owe that to all those families who have lost a loved one to premature death, as well as those who—we are pleased to see—are surviving and living well with this disease. We must improve outcomes; I look forward to hearing the Minister’s comments on the major conditions strategy, but that strategy must be delivered in tandem with a plan to provide the NHS with the staff, technology and resources it needs to bring down waiting lists and improve patient care. I am pleased that a future Labour Government has a plan to do just that.
The Parliamentary Under-Secretary of State for Health and Social Care (Dame Andrea Leadsom)
First, may I congratulate my hon. Friend the Member for Watford (Dean Russell), and say how pleased we all are to see him fighting fit and in his place? I also say to the right hon. Member for Alyn and Deeside (Mark Tami) that we wish his son absolutely all the best and a speedy return to full health, and to the hon. Member for East Dunbartonshire (Amy Callaghan)—who has had so many health problems of her own—that we all wish her very well and a full recovery. Some very good contributions have been made to today’s debate. I would just like to mention a very, very dear friend of mine who died of a sudden cardiac arrest very unexpectedly aged 55. It was a tragedy for his young family, so I really do understand—thankfully not personally, but through very close friends—how terrible this is.
I will write to the hon. Member for North West Leicestershire (Andrew Bridgen) and my hon. Friends the Members for Shipley (Philip Davies) and Christchurch (Sir Christopher Chope) about the statistics. I do not have any information today; I wanted to focus on the Government’s strategy for preventing cardiovascular disease, but I will write to them. As ever, I thank the hon. Member for Strangford (Jim Shannon) for his thoughtful remarks, and say to him that I have already been in contact with the Minister in Northern Ireland about the smoking Bill. Meeting with him will be one of my early priorities.
My hon. Friend the Member for Watford is a vocal supporter of the British Heart Foundation. On behalf of the Government, I thank the BHF for all the incredible work it has done throughout Heart Month, including introducing online CPR training that takes just 15 minutes to complete—15 minutes that could genuinely save a life. I also pay tribute to the many other charities that work tirelessly to support people at risk of, or living with, cardiovascular disease.
Over the last decade, the Government have taken significant action to prevent cardiovascular disease and its causes. Just over 10 years ago, we launched the NHS health check, which is our CVD prevention programme. Health checks play a key role in preventing heart disease, stroke, type 2 diabetes, and some cases of dementia and kidney disease. The numbers show that, through health checks, people have a lower likelihood of being admitted to hospital for CVD and type 2 diabetes, and for all causes of death one, three and five years after attending a check. So far, well over 10 million checks have been delivered, and data shows more people are receiving checks than before the pandemic. We are now investing £17 million in the creation of a digital NHS health check.
In fact, we are looking at every opportunity to prevent CVD throughout the course of a person’s life. Two years ago, the NHS published its CVD prevention recovery plan, setting out four high-impact areas for every part of the health service to focus on risk factor detection and management. This began by rolling out blood pressure checks in high street pharmacies and helping people measure blood pressure at home, and we are now helping thousands more people detect hypertension earlier. Our forthcoming major conditions strategy will focus on prevention throughout the life course, which is essential in creating a more sustainable NHS. It aims to improve care and health outcomes for those living with multiple conditions and an increasingly complex set of needs.
We are tackling salt, sugar and calories through the voluntary reduction and reformulation programme. Working with industry, we have already delivered reductions of up to 20% in some foods. The second pillar of our prevention plan is smoking cessation. I am proud to be part of a Government who will introduce the ground- breaking smokefree generation, so that children aged 15 and younger will never legally be sold cigarettes. This will be the most significant public health intervention in a generation.
I now turn to managing risk factors. Once we have diagnosed hypertension, it is vital that we properly manage it, and we are doing more than ever before. Among those under the age of 80 with GP-recorded hypertension, 170,000 more people had their condition managed to safe levels by March 2023 compared with the same month in 2020. The NHS has set hypertension management as a key priority, investing over £3 million to bring CVD leadership roles within every integrated care board.
We recognise that outcomes are often worse in different parts of the country, and understanding why variations occur is critical so that the NHS can take the right action. I support it in its launch of CVDPREVENT, a national primary care audit, which will provide data to highlight gaps in diagnosis, identify inequalities and find room for improvement. I am confident that the programme will help integrated care systems make real change in their areas.
A heart attack is a medical emergency, and recognising the symptoms can be a matter of life or death. People’s chances of surviving a heart attack are far greater if they seek care as soon as possible. In August last year, the NHS launched a lifesaving campaign, helping people to recognise the common signs of a heart attack that are often dismissed or ignored, and to seek help by calling 999. I absolutely applaud my hon. Friend for raising his specific symptoms in this Chamber so that others can understand more about what to look out for. Of those who reach hospital early to receive treatment, about nine in 10 survive a heart attack, compared with only seven in 10 of those who do not. That is why raising public awareness is so critical. To improve survival rates for out-of-hospital cardiac arrest cases, the Government have announced a new £1 million fund to expand defibrillator access in the community. We have already delivered over 700 defibrillators towards an estimated total of 1,000.
We are also taking huge strides in making our NHS simpler by providing for patients at home, because we know that patients prefer to avoid hospital if they can be safely supported in their own homes. The NHS programme “managing heart failure @home” is pioneering this approach, and addressing health inequalities as a key aim. Thanks to record funding, we are rolling out up to 160 community diagnostic centres, which will provide echocardiography services by March 2025, and I am pleased to update the House that 153 CDCs are live at this time.
Amy Callaghan
Will the Minister join me in congratulating East Dunbartonshire Council on its good work in getting so many community defibrillators for use across East Dunbartonshire ?
Dame Andrea Leadsom
Absolutely. I am happy to do that, and I would encourage all local authorities across the country to make best use of the funds that are available to them.
Let me turn to mental health and counselling services. As my hon. Friend the Member for Watford discussed, surviving a heart attack can have significant psychological impacts on individuals and their families, and I am grateful to him for sharing his own experience so powerfully. Integrating NHS talking therapies with physical health services can provide better support to people with combined physical and mental health needs, including people with cardiovascular disease.
Mark Tami
The right hon. Lady is making an important point. This should not be a bolt-on. It should be part and parcel of the treatment. We tend to address the physical side of the illness, open the door and away we go, and we do not ask people about some of the issues that they are struggling to cope with.
Dame Andrea Leadsom
I completely agree with the right hon. Gentleman. As part of the NHS long-term plan, all integrated care boards are expected to expand services locally by commissioning NHS talking therapies services integrated into physical healthcare pathways. I encourage anyone experiencing symptoms of depression, anxiety or post-traumatic stress disorder, even a long time after the event, to reach out to their GP or NHS talking therapies for support.
To conclude, I thank my hon. Friend for raising such an important issue. Across the House we all share the ambition to bring down premature deaths from heart and circulatory disease. Specifically, this Government aim to prevent 150,000 heart attacks, strokes and dementia cases in the next five years. Prevention is not only kinder but so much cheaper than cure.
Dean Russell
I thank the Minister for her response to the debate, and all the contributors, including the hon. Members for North West Leicestershire (Andrew Bridgen) and for Strangford (Jim Shannon), my hon. Friends the Members for Christchurch (Sir Christopher Chope) and for Shipley (Philip Davies), and the incredibly moving points raised by the right hon. Member for Alyn and Deeside (Mark Tami). I truly wish his son the best of health—he is in the right place in Harefield Hospital. I also remember the joy of seeing the hon. Member for East Dunbartonshire (Amy Callaghan), my hon. Friend, when she returned. We were on the Health and Social Care Committee when we first joined Parliament, and it was a joy when she returned. I am pleased she is doing so well.
Several themes came out today, and one that several Members raised was about transparency and data. The more transparency we have in data, the easier it is to calm people’s concerns. The three outcomes are about protection, including through education, and ensuring that we protect our society and that people know the harm they might be doing to themselves. We must focus on that area, as well as on opportunities to break through with research. I thank the Minister for the work the Government are doing, and if anyone at home is worried, they should get checked. If they are concerned that they have symptoms, they should get them looked at. It is better to get rid of fears before the event than to wait for them to become a reality and have to deal with the outcomes of that. I thank all contributors, and I hope everybody has learned something from today’s debate.
Question put and agreed to.
Resolved,
That this House has considered premature deaths from heart and circulatory diseases.