Lack of cardiologists limits care: Celia Hall reports from the 14th Congress of the European Society of Cardiology in Barcelona

A LACK of heart specialists in Britain means that only two out of three people who need pacemakers to regulate their heartbeat are fitted with them.

Dr Michael Petch, consultant cardiologist at Papworth Hospital, Cambridgeshire, said that parts of the UK had the highest levels of heart disease in Europe, but Britain had the lowest number of cardiologists per head of population. Although there are 229 coronary care units in 203 health districts there were only 37 major centres where invasive, high-tech cardiology was practised, he said.

Dr Petch said that only 55 cardiologists at senior registrar level were in the four-year training, which is soon to be increased to five years. At the same time, 26 cardiologists would retire within five years. 'There will not be enough cardiologists even to fill existing posts,' he said.

As a result people are going without specialist care and some would die early because of it. Britain spent far less on health care - pounds 640 per head - compared with other nations, representing 6.5 per cent of the gross national product. 'This is way below the average for Europe, which is 9 per cent, and is far below America at 12 per cent.'

The British shortage meant that many of the new and advanced procedures available would be undertaken by general physicians or not at all. 'If you are short of specialists you put in fewer pacemakers, for instance. We do far fewer than in other countries.'

The reason, Dr Petch said, was not that the need for pacemakers varied so greatly across Europe, rather that there were people in the British community whose need was not being identified.