Cardiovascular Illnesses

Lord Weir of Ballyholme Excerpts

Thursday 12th June 2025 Grand Committee

[Lord Weir of Ballyholme (DUP)]

My Lords, I thank the noble Lord, Lord Booth, for securing this debate. I say as an aside to his opening remarks that if the most common British response is, “I feel fine”, the greatest fear any British person has is of asking someone how they feel and actually getting a detailed response.

The significance of CVD is unanswerable. It is responsible for about one-quarter of deaths in this country and is probably the biggest single contributor to premature deaths and to people leaving the workforce early. It plays a key role in the level of economic inactivity in this country. In pure economic terms, different figures have been put about, but the British Heart Foundation calculates the cost to the UK as £29 billion a year.

Beyond the societal and economic impacts, every statistic that we will cite in this debate today represents an individual and an individual family. We are also faced with the major challenge that whereas mortality rates for CVD dipped in 2019, the figures seem to have begun to rise again after having largely been level over the past decade or so. There is a key challenge about how we can start to drive those down. I suspect that all of us will be united about what we are hoping to achieve—a reduction in the incidence, impact and level of deaths—so it is a question not of what, but of how. I will be interested in the Government’s response on a range of issues.

First, the 10-year plan for the NHS is the correct approach to look at this strategically, and I hope that it will lead to more holistic, joined-up approaches and mean that when it comes to budgeting we can look at things much more strategically. However, it has been highlighted by a range of key stakeholders in this field that there is a need for a specific cardiovascular disease plan. I would be interested in hearing the Government’s response on how we can balance the specifics of a plan with the more general strategic direction that we are seeking for the NHS. Similarly, we know that emerging technologies can play an important role, from AI to data science. Any information that the Government can give on how specifically they intend to harness those in the fight against cardiovascular disease will be critical.

Secondly, as highlighted by the noble Lord, Lord Moynihan, and others, prevention is the critical element to this. For many people who suffer from cardiovascular vascular disease, the first symptom is a major event, a stroke or a heart attack. It is quite often symptomless. Within that context, we know the range of risk factors, from smoking to obesity, alcohol and air pollution. I know that the Government are taking action on some of these fronts but, again, there is a concern, particularly given the figures, that we are starting to get diminishing returns on certain elements of behavioural aspects. It will be critical to say that in educating on the risk factors, we can act as a driver to harness that and make a real difference to people’s lives.

Thirdly, on testing, it is important that, for example, blood pressure tests are expanded and rolled out more. We know that NHS health testing could have a critical role in prevention and diagnostics, yet we see a mixed bag of take-up of those tests. In particular, we know that men can be more prone to cardiovascular diseases and have a higher incidence level but are perhaps more reluctant to go to a doctor to get those tests. This can also apply to a range of ethnic-minority groups such as the black and south Asian communities, who have statistically higher levels of CVD. I would be interested to hear how the Government can ensure that we better target testing and perhaps look at the commissioning of testing, and how we can incentivise primary carers to encourage people much more to do testing.

Fourthly, we need to raise our ambitions beyond simply the mortality rates. For strokes, for example, there is a target of a 25% reduction in deaths. I would like to see—and I ask the Minister whether there is an intention to have—a similar target of 25% in reducing severe disabilities as an impact of strokes. Allied to that is a key role for improving review and rehab facilities to ensure that, once someone has suffered a stroke or a cardiac event, it does not reoccur and we are not left with a far worse situation.

Finally—and this is not unique to CVD—there is the question of how we can have a level of consistency. I have mentioned testing already and the need for greater levels of use of community pharmacies, for instance, for blood testing. For something such as thrombectomy, the rates are very different. If you are in London, their usage is at around 10%; at the other end of the scale, in the east of England, it is about 1%. There is a range of issues around how we can drive greater consistency in treatments in the health service. I look forward to the Minister’s response.