NCPA - National Center for Policy Analysis

Unhealthy Heart Care In Britain

January 21, 2000

Britain's claim that the National Health Service (NHS) is efficient -- spending less as a proportion of gross domestic product than many other countries, yet providing just as good health results -- is misleading, says David Green of the Institute of Economic Affairs.

For instance, coronary heart disease (CHD) is the most common cause of premature (under age 75) death in the U.K., accounting for nearly 60,000 premature deaths in 1996. Yet the government's record at treating CHD is admittedly unsatisfactory:

  • Comparing death rates from circulatory disease for persons under age 65 throughout the European Union, the U.K. ranked 13th out of 15.
  • Deaths from CHD in the U.K. have not fallen as fast or far as in some other countries -- in 1993, the death rate for men in the U.K. fell by only 30 percent, compared with 43 percent in Australia, 41 percent in Sweden and 34 percent in the U.S.

Furthermore, treatments for the nation's heart unhealthy are often under-used or inadequate.

  • The 1991 "Health of the Nation" report conceded that the target of 300 per million population (pmp) coronary artery bypass grafts was "significantly below most targets adopted by other countries," and noted that even this inadequate target had not been achieved.
  • In the U.S., 598,000 bypasses were performed in 1996, at a rate of 2,255 pmp, compared with a rate of 412 pmp in the U.K.
  • The 1996 Health Survey for England found that over four out of ten men and over one in three women with hypertension are not receiving treatment, and of those receiving treatment a third remain hypertensive.
  • In 1997, 42 percent with hypertension were being treated successfully, 21 percent were being treated inadequately and 37 percent were not being treated at all.

Source: David G. Green "The Impact of NHS Rationing on Heart Disease" Economic Affairs, December 1999, Institute of Economic Affairs, 2 Lord North Street London SW1P 3LB, (0171) 799-3745.


Browse more articles on Health Issues