Axeing of lifesaving heart scheme slammed

A leading GP has called for adequate investment to be made in programmes that prevent patients from being hospitalised with or dying from heart disease.

Dr Andrew Murphy, Professor of General Practice at NUI Galway, pointed out that a programme called Heartwatch, set up in 2003 in a limited number of general practices and aimed at effectively treating people with heart problems, had led to major reductions in hospitalisations and deaths in these patients.

However, no funding had been provided to expand this programme to the entire country.

Under this scheme, GPs and practice nurses actively intervene with heart disease patients through regular check-ups and provide tailored lifestyle, smoking cessation and dietary advice as well as drug treatment.

Prof Murphy told the annual conference of the Irish College of General Practitioners (ICGP) in Galway he did not accept that there was no money for this type of programme to be adopted nationally.

He said the money was there, but it was being spent elsewhere in the health service.

Prof Murphy said choices were being made in how funds were spent but there was a need for greater transparency.

Comparing the provision of breast cancer screening with the provision of programmes to reduce heart disease and heart disease deaths, Prof Murphy pointed to a recent controversial UK review on the effectiveness of breast cancer screening that questioned its effectiveness.

The review showed that with mammography, for every 2,000 women invited for screening, only one would have her life prolonged, and some women would suffer psychological distress from false positive findings.

However, with the Heartwatch scheme in Ireland, for which funding was frozen, with 2,000 patients taking part over three years, 160 had their life prolonged.

Prof Murphy said recent research had shown that the death rate for patients treated under Heartwatch was 5% after three years compared to a rate of 14% in patients not in the Heartwatch scheme.

He said hard choices had to be made in funding screening and prevention programmes.

Prof Murphy stressed that he was not advocating abandoning breast screening here in favour of heart disease prevention schemes, and he believed BreastCheck to be an excellent programme,

However, he felt that when compared with the benefits of breast screening. there was a strong evidence base for funding heart disease programmes in general practice.

Prof Murphy said breast screening should continue to be carried out but there were other programmes that were needed as well.

He said strong evidence had been built up over 30 years that that heart disease prevention programmes in general practice worked.

[Posted: Mon 14/05/2012]