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The number of people prematurely dying from heart attacks is on the rise because life-saving health checks that could prevent early deaths are simply not taking place, the UK’s official independent spending watchdog says in a damning report published today.
The report which comes in advance of the Government’s planned reforms for the NHS recommends a complete review of the health check system.
Some 6.4 million people in England suffer from cardio vascular disease which is estimated to cost the economy some £15.8 billion. The NHS is spending £7.4 billion treating it but a lot of problems are preventable.
Gordon Brown’s Labour government introduced five year health checks in 2009 for everybody between 40 and 74 who didn’t have a pre-existing condition.
However, in 2013 under the Conservative and Liberal Democrat coalition the government transferred the responsibility for giving these checks to local councils.
Now the NAO has found out that only three per cent of local councils provided full health checks for everybody from 40 to 74 and half the people are missing out.
The legislation which gave councils their new role is also flawed. The NHS which has to pay later for treatment of cardio vascular disease has no power to monitor council’s performance. And in turn local councils have no power to compel GPs to carry out the health checks.
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The public health grant, which includes paying for health checks, has been reduced by successive Conservative governments from £4.48 billion in 2015-16 to £3.53 billion in 2023-24. Money for tackling obesity, smoking, and encouraging physical activity, which all help counter heart disease, was also cut over the same period from £340 million to £262 million.
As a result the startling progress in halving premature deaths from heart attacks from 145 per 100,000 to 74 per 100,000 between 2001 and 2014 came to a grinding halt. And last year it rose again to 77 per 100,000 for the first time.
The figure masks big discrepancies across the country. The lowest rates of between 40 and 60 premature deaths per 100,000 are in Devon, Dorset, Hampshire, West Sussex and Surrey, while the highest at up to 140 premature deaths per 100,000 are in Liverpool, Hull, and North East England. Deprived areas are suffering the most.
The NAO is calling on the Government to review the health check system as it is not working effectively and also calling for incentives to be given to doctors to check those at most risk.
Gareth Davies, head of the NAO, said: “Each year thousands of lives are lost to cardiovascular disease, with billions of pounds spent tackling it.
“Health Checks can play a crucial role in bringing these numbers down, but the system isn’t working effectively, resulting in not enough people having checks. This is an unsatisfactory basis for delivering an important public health intervention.
“The Department of Health & Social Care needs to address the weaknesses in the current system for targeting and delivering Health Checks if it is to achieve the preventative effect it wants.”
Geoffrey Clinton-Brown, the Conservative chair of the Public Accounts Committee, said: “Health Checks have the potential to save lives and public money – it is a missed opportunity that less than half of those eligible are attending these checks.
The Department of Health & Social Care needs to take action to systematically boost uptake, target checks at those most in need, and drastically improve its data if the programme is to deliver the financial and health benefits intended.”
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A Department of Health spokesperson welcomed the findings and said they would “carefully consider” the report before coming forward with measures to deal with the problem.
“This Government is committed to taking action on preventable, deadly diseases like cardiovascular disease,” the spokesperson said.
“Since this research was conducted, we have begun to pilot comprehensive heart health checks in workplaces , and we are developing a digital version of the check to provide an even more accessible and convenient service for people. Our reforms will help us prevent and catch disease earlier, so it can be treated faster.”