That this House has considered the matter of reducing levels of premature deaths from heart disease and stroke.
It is an honour to serve under your chairmanship, Dame Siobhain. I thank hon. Members for attending the debate.
Cardiovascular disease remains one of the United Kingdom’s biggest killers and one of the greatest public health challenges facing our country. It devastates families, communities and livelihoods in every corner of the UK. It has touched countless families, including my own. My challenge is not cardiovascular disease but a congenital heart defect— a silent killer that was diagnosed last year following a routine health check. I am still completely symptom-free, but will have to have open heart surgery to replace my aortic valve at some point. I am, however, in the very safe hands of the NHS.
Today is about ensuring that the voices of those living with cardiovascular conditions are heard in the House, but it is also about something even more fundamental. For the first time in more than half a century, we have seen progress on cardiovascular disease moving in the wrong direction. The question before us today is simple: are we willing to accept that, or are we prepared to tackle it? With the right political will and the right action, we can once again make the UK a country in which fewer people die young from heart disease and stroke.
My hon. Friend is making an important and passionate speech, especially in the light of the personal circumstances that he mentioned. I agree with him about deprivation. Does he agree that access to fresh, affordable food is incredibly important, particularly in the most deprived areas? In Castlemilk in my constituency, it is much easier to get a bottle of vodka than it is to get a banana. Does he agree that fixing that is part of the solution?
I absolutely agree. If we could get fresh food to more of our communities and young people, it would have a massive positive effect on dealing with CVD—that must be dealt with.
This debate could not be more timely. The Government have rightly identified CVD as one of the UK’s biggest killers, and have set a welcome ambition to reduce premature deaths from heart disease and stroke by 25% over the next decade. Parliament has a responsibility not just to welcome those commitments, but to scrutinise how they will be delivered.
The forthcoming CVD modern service framework for England, which Ministers have said will be published soon, presents a rare opportunity to reset our approach to heart health, but the real question is whether it will be equal to the scale of the challenge before us. This debate is also an important opportunity to press the Government on what the framework will contain, how it will be implemented and whether it will deliver significant improvements in prevention, diagnosis, treatment and care. Although the framework will focus on England, the challenge of CVD knows no borders. This is a UK-wide challenge, and the lessons, opportunities and ambitions that we discuss today must resonate across all four of our nations.
Let me move on to the role of research and innovation. If CVD is one of our greatest challenges, research is one of our greatest opportunities. The remarkable progress made over the past six decades did not happen by accident; it happened thanks to charities such as the British Heart Foundation, great universities, researchers, clinicians and patients, who all worked together to transform outcomes. People like Jared are alive today thanks to research breakthroughs that were once thought impossible.
It is a pleasure to speak in this important debate about preventing premature death from heart disease and stroke. I congratulate the hon. Member for South Ribble (Mr Foster) on securing the debate and introducing it so ably. It is courageous of him to talk about the medical challenges that he has faced, and I am sure that the whole House wishes him the very best of luck on his journey. It is also nice to be with him in Westminster Hall, having spent five months debating with him in the Armed Forces Bill Committee. Stockholm syndrome kicked in, and we even started to like each other by the end, so it is doubly pleasurable to follow him in this debate.
It is great to see the shadow Health Secretary, my right hon. Friend the Member for Daventry (Stuart Andrew)—a man I have always respected—in his place, and to see the Minister, whom I also respect. I have bumped into her in the Portcullis House lifts many times down the years, and it is wonderful to see her in a ministerial position.
I wish to declare two interests. First, I am a long-time supporter of the British Heart Foundation, which does great work to research heart disease and improve the technology and techniques to combat what is still, I am sad to say, one of Britain’s greatest killers. I pay tribute to that wonderful charity. I also wish to pay tribute to my wife Olivia, who has worked in the NHS for some two decades now, and who revels in the title of lead neurointerventional radiographer. That is a bit of a mouthful, but if someone has a stroke, she is the girl they need. I say that because she works in the specialist neurointerventional radiography department at Queen’s hospital in east London. As the Minister will no doubt know, there are 26 specialist units around the country, and her team at Queen’s is very ably led by Mr Tufail Patankar, an internationally recognised surgeon and an absolute expert in his field. He has built up that team over time at Queen’s, and, from what I hear, he leads it very well indeed.
It is a pleasure to serve under your chairship, Dame Siobhain. I am grateful to my hon. Friend the Member for South Ribble (Mr Foster) for securing this important debate and for his opening remarks on his own health. We all wish him well.
My speech today will focus on heart health. I am a former chair of the all-party parliamentary group on cardiac risk in the young, where unknown heart conditions among young people are discussed. Keeping hearts healthy carries a broad message around prevention, lifestyle and early intervention, but what tools are we giving people? Diet is a key example, and it starts with our young people.
We cannot talk about reducing premature deaths from heart disease and stroke without talking about the environments in which people live. As an active member of the APPG on school food, where I was proud to serve alongside the Minister, I know how important it is for school food to meet nutritional standards and build healthy lifestyles and eating habits from an early age. Last year, 34% of year 6 children in my constituency were classed as obese. Meeting them where they are at with healthy habits when they are young is crucial. That is why I am so pleased to see free breakfast clubs rolling out across the country—I have two in my constituency—as well as plans to overhaul school food standards for the first time in over a decade.
It is now about convincing parents that school food is healthy and nutritional for their children, particularly when under 2% of packed lunches meet the current school food nutritional standards. Will the Minister outline what steps will be taken to change the perception of school food, in line with the valuable work the Government have been putting in to change it?
Meeting people where they are at with lifestyle changes is also crucial when we look at exercise. The majority of my constituents work in logistics, manufacturing and retail, doing physically demanding jobs that are often shift-based, which can make it really hard to maintain regular diet and exercise routines. Will the Minister outline what steps the Department is taking to ensure that infrastructure in semi-rural constituencies like mine can support walking, cycling and everyday physical activity, as well as allowing access to good, nutritious food? For example, my constituency is home to the heart of the national forest, a beautiful green space that encourages physical activity and exploration, but the only way to get there is by car, which seems counterintuitive.
It is a pleasure to serve under your chairship, Dame Siobhain. I thank the hon. Member for South Ribble (Mr Foster) for setting the scene incredibly well on a subject that affects all of us. As always, I will give some stats for Northern Ireland, where unfortunately we seem to have a particular problem when it comes to premature deaths from heart disease and stroke. I declare an interest as the chair of the all-party parliamentary group on vascular and venous disease, which has looked at the subject in some detail.
It is a pleasure to see the Minister in her place. I wish her well; she seems to be in Westminster Hall almost as much as I am, but with much more authority, I have to say. She and I have been friends for many years. I always start looking forward to her contributions the day before I hear them, because I know she will work incredibly hard to give us the answers we wish for; I thank her for that in advance.
It is also nice to see the right hon. Member for Daventry (Stuart Andrew) in his place. He was a busy man when he was in Government and is now a busy man as a shadow Minister. He is always approachable, always dedicated and always dependable. We thank him for his commitment to the subject.
We cannot shy away from what the British Heart Foundation has rightly called a “ticking timebomb” on heart health. Across the United Kingdom, cardiovascular disease claims a life every three minutes. This debate will last for about an hour and a half, so the mathematics are quite clear: 20 people will have passed away between the start and the end.
I must do what I always do in this Chamber, which is to bring a specific perspective from Northern Ireland, where the crisis is acutely felt. It replicates the rest of the United Kingdom, in a way, but unfortunately the stats tell us that it is probably worse for us. The stats for Northern Ireland are indeed scary: an estimated 225,000 people are living with heart and circulatory diseases. To put that into context, because it is important that we do so in this Chamber, our total population is 1.95 million, so one in 10 of our citizens are fighting these conditions. When I walk up the high street in Newtownards in my constituency of Strangford, every 10th person I see will potentially be affected by heart disease, stroke or circulatory disease. That concerns me greatly.
The hon. Gentleman is, as always, generous with his time. We all fully appreciate the slant that he brings from Northern Ireland. Would he agree that there is also the issue of regional inequalities within England? We see in Yorkshire and the north of England some of the worst rates of survival when it comes to cardiovascular disease. Does he agree that we need to do more to close the gap when it comes to people from more deprived backgrounds and the poorer health outcomes that they face as a result of heart disease, stroke and other CVD?
The hon. Gentleman always sums up the thrust of the debate in his interventions; he has outlined that there is sometimes a postcode lottery. He is also right to underline that in areas with deprivation where the emphasis on health is probably less, the issues and the number of those with heart disease rise as well.
I must also declare an interest: I have lived with type 2 diabetes for over 20 years. To put that into perspective, I could call myself a big fat pudding—I was 17 stone at one time. I am now 13 and a quarter stone. I have done that through a bit of willpower, but also by trying to cut out the sweet stuff. I am not always successful, but I do try very hard. My diabetes is controlled by medication, and I thank God every day that we are able to control it that way. I know first hand how closely linked diabetes and high blood pressure are. I take a tablet for blood pressure; I cannot speak for anybody else here, but when hon. Members come to a certain age, they probably will as well. Along with high cholesterol, those two things increase the risk of a catastrophic stroke or heart attack.
I was recently at the diabetes event in the Churchill Room. The lady in charge told me that people with diabetes must always get a check at least once a year—have their heart checked and ensure that their blood pressure is under control.
As chair of the all-party parliamentary group for diabetes, I should say that we have been pushing to make sure that, when people with diabetes have those diabetic care processes, those are better linked with other comorbidities and ancillary services. Does he agree that we need to see more of that to get better outcomes for people with those comorbidities?
I certainly do; the hon. Gentleman and I most definitely agree about that.
The tragedy is that so much of this premature loss of life is entirely preventable; if it can be prevented, then we should be doing more. The British Heart Foundation reports that half of all strokes and heart attacks are linked directly to high blood pressure. In his intervention, the hon. Member for Harrogate and Knaresborough (Tom Gordon) has again underlined that, as I have likewise tried to.
Right now in Northern Ireland, over 42,000 diagnosed hypertension patients are not being treated to clinical guidelines. That is unfortunate. Furthermore, 66,000 high-risk individuals are missing out on statins to control their cholesterol. There are things that can be done and prevention strategies that we should focus on. My hope would be that those will improve. If we optimise care, we can save hundreds of lives almost immediately. Surely if we can do that, we should be doing it. If we can treat blood pressure properly over the next three years, we can prevent 380 strokes and 260 heart attacks in Northern Ireland alone—the place I am bringing the stats from.
The issue is not just about statistics, of course. It is about early detection, standardising care and addressing health inequalities. I look to the Minister to outline what direct, co-ordinated action the Government are taking with their devolved counterparts: the hon. Member for South Ribble referred to that in his speech—I thank him for referring to the devolved Administrations, because this issue is about us all.
It is a pleasure to serve under your chairship, Dame Siobhain. I congratulate my near-neighbour and hon. Friend the Member for South Ribble (Mr Foster) on securing this important debate. I wish him well. I also congratulate the right hon. Member for Rayleigh and Wickford (Mr Francois) on achieving the childhood ambition of having his very own bat-phone. I am, as they say, well jel.
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The debate also comes at a significant moment for the British Heart Foundation. That charity, which was founded in July 1961, marks this month 65 years of funding lifesaving research. I am pleased that representatives of the foundation are here with us today, and I thank them all for the crucial support that they continue to champion and deliver day after day.
Let me move on to the scale of the challenge that we face. CVD is responsible for about 170,000 deaths each year in the UK—that is more than one quarter of all recorded annual deaths—with one life lost every three minutes. Put simply, while we hold the debate this afternoon, about 30 lives could be lost to CVD—let that sink in. More than 8 million people across the country are living with CVD, with many waiting for vital care, and many more living with conditions that increase their risk of CVD or a cardiac event. Yet much of that burden is not inevitable; it is preventable. About 70% of CVD cases in the UK are linked to modifiable factors such as obesity and smoking, alongside manageable risk factors such as high blood pressure, high cholesterol and diabetes.
While I am on the subject of diabetes, it is great to see one of my closest friends, Mr Jared Fox, sitting in the Public Gallery. This is also very personal for Jared, a type 1 diabetic who, back in 2018, suffered three heart attacks linked to his diabetes, resulting in his undergoing a triple heart bypass. The proof of the pudding is in the eating, as the saying goes, and Jared is sitting with us now and smiling away, but I believe that, as a diabetic at higher risk, he should have undergone screening, not been left to get almost to the point of dying, unaware of the increased risks that he faced.
British Heart Foundation analysis shows that, despite decades of progress, premature deaths from CVD have been rising again for the first time in more than half a century. That should concern every single Member of the House. The cost is not just measured in lives; CVD also has a major economic impact, costing the UK an estimated £12 billion in direct healthcare each year and costing the wider economy about £30 billion.
CVD is also a stark reminder of health inequalities in the UK today as well. People in our most deprived communities are still far more likely to die prematurely from CVD than those living in the most affluent areas. That is just not acceptable.
The life sciences sector plan recognises the UK’s potential to be a world leader in research and innovation. Cardiovascular health must be at the heart of that ambition. From artificial intelligence and technology that can prevent and enable early diagnosis to the development of cutting-edge treatments and medicines, the United Kingdom has an opportunity not only to improve outcomes here at home, but to lead the world in tackling cardiovascular disease.
I respectfully ask the Minister not to simply restate the Government’s ambition, but to detail how that ambition will become reality for the 8 million-plus people who are affected daily by cardiovascular disease. Let me ask some specific questions. First, when does the Minister think the modern service framework for CVD will be published? Secondly, how will the Government ensure that the framework is backed by clear delivery plans, accountability and measurable milestones, especially during a time of great challenge and change for the national health service?
Thirdly, what action will be taken to improve prevention, early diagnosis and management of major risk factors such as diabetes, high blood pressure, high cholesterol and atrial fibrillation? Fourthly, how will the Government ensure that action on CVD reduces health inequalities? And fifthly, how will the Government work with devolved Administrations, researchers, charities, clinicians and patients to deliver progress across the entire United Kingdom?
The UK has made significant progress on cardiovascular disease before, and we can do so again, but progress is not inevitable. It requires leadership, sustained investment and a laser focus on delivery. This is a pivotal moment, and we should all look to support the Government in their delivery of their cardiovascular ambition and to drive progress in heart health once more. I thank the Minister for setting out for us how the Government will turn their cardiovascular ambition into measurable action, tangible progress and, ultimately, the saving of thousands of lives.
The technique that the team uses is called mechanical thrombectomy. It is an emergency procedure for treating acute-onset stroke caused by a blood clot blocking a large artery in the brain—that is effectively what a stroke is. During the procedure, the interventionist neuroradiologist —the surgeon—passes a thin tube through an artery. It usually enters the body through either the groin or the wrist, goes up into the brain, finds the blocked blood vessel and then extracts the clot, which can sometimes be a couple of millimetres long—not an easy target to find. When it is withdrawn, blood flow is restored to the affected area of the brain, helping to reduce permanent disability, particularly if the procedure is performed quickly.
The department has a mnemonic: “Time means brain”—the quicker the operation can be performed, the more damage is averted and the greater the likelihood of recovery without complications. This was, admittedly, an exceptional case, but the team performed one of those operations on a man in his 20s within 90 minutes of the stroke occurring. He lived locally, and he basically walked out of the hospital a few hours after the stroke none the worse. That is what that relatively new technique can achieve.
As the radiographer, my wife guides the surgeon to the target. I call her the “bomb-aimer”. Last year, Queen’s had a “bring your hubby to work” day, and I was taken to work. The hospital has two operating theatres back to back, with an observation area in the middle, so we could stand there and watch the operation taking place on a large screen. We could see the instrument going up into the brain towards the clot, at which point it attached itself to the clot and withdrew it. I have to say that it was not for the faint-hearted; I was there with the hon. Member for Romford (Andrew Rosindell), and we stuck it out and saw the whole thing.
It is a very odd procedure to watch, because the patient is lying anaesthetised on the operating table. One would think that all the activity happens around their head, but it does not. The surgeon stands by their groin, where they have gone in, and then uses a very fine guiding device—almost like a gaming console—to control the instrument, taking their lead from the image on the screen that is provided by my wife, the bomb aimer. That is how it works.
Last year, the department at Queen’s performed something like 300 of those operations. It operates 24/7, so over the weekend the staff are on a cover rota, or on call, as they say in the NHS. If my wife is at home and the bat-phone—as I call it—goes, she has an hour to get from our home to Queen’s, get scrubbed up, fire up all the equipment and be ready to receive the patients, some of whom may be coming from as far as Norwich and some of whom arrive by air ambulance. When the bat-phone goes, there is no time to grab a cup of tea and a slice of toast; she is in the car and gone. Can I just say that the sooner they finally sort out the chronic mess at Gallows Corner, the quicker and easier that journey will become? But I digress.
There are only 25 hospitals in the country that perform the procedure. The reach of the department covers Essex and goes out some way into East Anglia, at which point it hands over to Addenbrooke’s in Cambridge. The department also has friendly rivals who do the procedure at the Royal London hospital in Whitechapel, which tends to cover Kent and south London, but that is on a rota. When the Royal London is off for a given week and Queen’s covers all the areas, it is responsible for a potential patient population of over 5 million. That is a tremendous responsibility, which is why we obviously need to have 24/7 cover.
The service is also growing. Anecdotally, I can say that the bat phone rings more than it used to. On one level that is a good thing, because the technology is advancing all the time and patients can now be treated who could not have been treated a few years ago. However, that obviously puts pressure on Olivia, Dr Patankar and the team.
I will make a plea to the Minister, if I may. I understand that the Government are evolving their strategy for stroke, as part of the 10-year plan for the NHS. Olivia and her team are keen to see that work evolve, but they are particularly keen to know what role there is for mechanical thrombectomy in the overall strategy. I have literally seen it at work for myself. It is a wonderful, lifesaving technology and technique that the NHS has been doing for barely a decade, and we are getting better and better at it all the time.
I pay tribute to the team at Queen’s, as well as all the other teams that do this work around the country, including, for the record, at the Royal London. Most of all—I hope the House will forgive my indulgence—I pay tribute to my wife. Being a Member of Parliament can sometimes be a time commitment, but being the husband of a woman who does this work can be a bit of a time commitment, too. Sometimes, when we are making plans to see people or go to dinner parties, I am not the long pole in the tent. I am very proud of what she does, I am very proud of what her team do, I am very proud of what all the people who work at Queen’s do and I am very proud of the national health service. For the record, I am also proud of the stroke unit at Southend hospital, which provides a very good service, although it does not do mechanical thrombectomy; it defers to Queen’s on that.
Well done to everyone who works in this area. I thank the House for its patience and indulgence. God bless all the people who work to save lives from stroke.
On a positive note, the recently announced £8 million investment to improve community healthcare and access to weight management services across Leicester, Leicestershire and Rutland through the Government obesity pathways innovation programme is greatly welcome. Having served on the health scrutiny committee for five years as a county councillor, I have seen at first hand the impact that providing easier access to support can have on improving people’s health outcomes and reducing pressure on our NHS later in life. That investment will make it easier for people to access the support that they need in their own communities, whether that is advice on healthy living, behavioural support or clinical support where needed.
Like the right hon. Member for Rayleigh and Wickford (Mr Francois), I pay tribute to the service of our colleagues in the NHS. We are incredibly proud that the children’s heart health facility provided by Glenfield hospital is still in the east midlands.
Although ambulance times have improved nationally, the east midlands is still a little way behind national standards. As of May this year, we have the second highest average ambulance wait time across England for category 2 responses, which would include a suspected heart attack or a stroke, at 36 minutes. That is 11 minutes longer than the current national target, and twice as long as the target set pre-pandemic. For those who are aware—I thank the British Heart Foundation for its continued support for me in my role here—every minute counts. Every minute that somebody suffering a heart attack spends away from crucial health advice can mean a 10% lower chance of survival. It should therefore not be a surprise that as of February last year, the survival rate among people who had an out-of-hospital cardiac arrest in the east midlands was only one in 14. Will the Minister set out what further action her Department is taking to bring down wait times, focusing on regions such as the east midlands, which is far behind the rest of the UK average?
As the former chair of the all-party parliamentary group on cardiac risk in the young, I want to highlight the importance of cardiac health screening, of which I am an avid champion, as the Minister knows. Screening is a crucial way to target premature deaths. With the National Screening Committee consulting on whether to expand the recommendation of screening to people below 39, now is a pressing time to engage with it. In Italy, which introduced such screening in the 1980s, cardiac deaths among young people have dropped by 85%. We know that early detection through cardiac screening allows timely interventions that can save lives.
In my constituency, we have also been trying to build resilience. Rural communities are so much further away from main hospitals and health services, so we have been looking at how we can ensure that people know where their nearest defib is. We will now be doing an annual defib dash to encourage people to recognise where the defibs are. We have also been increasing CPR training and access in my community. The British Heart Foundation and the ResusReady campaign have been key to helping me deliver that.
Ultimately, reducing premature deaths from heart disease and stroke is about building a system and building the resilience that supports people at every stage, in every area of our country. I look forward to the Minister’s response.
The statistics from the British Heart Foundation’s Northern Ireland analysis are also deeply alarming. Cardiovascular conditions are responsible for 24%—nearly a quarter—of all deaths across Northern Ireland. That concerns me greatly, too. Even more heartbreaking is the fact that one in four of those deaths are premature, which means that the person could have been saved if they had had their checks or if help had come earlier. Because of my age, I can remember many occasions when someone has had a stroke or a heart attack and has died instantly. That includes some friends whom I have known over the years and who are not here any more.
It is also heartbreaking that those premature deaths are stealing the lives of people under 75. In a single year, we saw some 4,227 deaths due to cardiovascular disease. That means that every single month, 350 families in Northern Ireland are losing a loved one to a heart attack or a stroke. To put that into perspective, that is 350 empty chairs at the dinner table and 350 families left grieving. Sometimes, when we look at the stats, we think of the people who have passed away, but we must also think of the families on whom there is a significant impact.
I know the Minister is always very responsive; has she had a chance to talk with the Health Minister in Northern Ireland, Mike Nesbitt, to ensure that the good things done here are exchanged with him? What can be done with devolved counterparts to tackle the missing patients? They are missing patients, but if they are missing then it is time to put them on the list, to ramp up the diagnostic screenings and, please, to defuse this ticking time bomb before it claims any more of us in this Chamber, or our constituents.