Leading article: The costs of prevention and cure

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The Independent Online

Heart disease accounts for 40 per cent of all deaths in Britain, yet it often seems the poor relation so far as high-profile medical research and fund-raising go. Perhaps because it afflicts so many people, a heart condition often seems to be regarded as a fact of life rather than something that can and should be tackled as a national priority.

The research findings we report today expose the folly of such a view. In 2004, the NHS spent almost £16bn - more than 20 per cent of the entire health service budget - on treating cardiovascular diseases. This is much more, as a proportion of total spending, than the health services of either France or Germany. When you add the estimated cost of lost production and informal care by family and others, the total cost approaches £29bn a year.

The Government, to be fair, has set itself the priority of reducing the number of deaths from coronary heart disease by 40 per cent by 2010. And there has been some success. Deaths related to heart disease fell by 7 per cent in 2004. The Department of Health also claims that death rates from heart disease have fallen by 31 per cent since it came to office. Last year there were reports that waiting lists for heart operations had fallen so sharply that cardiac units were being closed and heart surgeons encouraged to train in other specialities.

This measure of success, however, while welcome, may mask a separate failure. The fall in the number of deaths from heart disease largely reflects a rise in the use of prescription drugs - mainly statins. And the medicine bill has risen exponentially. The forecast is for an increase in the costs of treating heart disease, even as the death rate falls.

For very many people, however, there is another way. The doctors we quote today say that the onset of much heart disease could be prevented or delayed if we all lived more healthily. A reduction in smoking, attention to diet and more exercise would not only cut the incidence of illness, but the medicine bill as well. This is where the Government's ambition seems at odds with its actions.

It was back-bench pressure that secured a ban on smoking in public places, but it will not come into force in England for another year. The food industry has been allowed to get away with a labelling scheme that is more complicated than is necessary. It took Jamie Oliver's campaign even to start improving the quality of school meals, while the sale of school playing fields, like the closure of public swimming pools, was far advanced before any real public outcry got under way. Building and subsidising new sports facilities might seem an expensive outlay. Compared with statins for all, however, it could be cheap at the price.

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