The Welfare State We're In, The website of the book by James Bartholomew
November 27, 2008
Heart disease - your chances are better outside Britain

Here is one of the ways in which you would be better treated in an American (and doubtless also a Japanese, German, French or Swiss) hospital for heart disease than you would be in Britain. In America and, I suspect, the other countries mentioned, you might get a scan with a 64 slice CT scanner that will show quickly - and without ill effect on you - just how bad your arteries may be obstructed.

In Britain, you have a much lower chance of having access to this scanner.

The Daily Telegraph today carries a report that the 64-CT scanner has been shown as effective in revealing coronary disease as the traditional, much more invasive method. The chances of anyone surviving heart disease depends crucially on being assessed quickly and effectively and then getting an operation, if needed, quickly. But the process of assessing the disease is bound to be hindered in an medical system which does not have the use of 64-CT scanners.

I saw such a scanner at the Mercy Hospital in Miami about four years ago. It had been installed the day I arrived. That was the only hospital in America that I visited and it had the new scanner. There must have been many such machines even at that time. I looked up to find how many hospitals in Britain had it then. The answer appeared to be only one.

Now, according the Telegraph, still "only a handful" of these scanners are in British hospitals. I wonder how many that means? Is it five, perhaps? Clearly nothing like enough to scan more than a small fraction of those with heart disease.

I am afraid this is another example of the way in which the treatment you are likely to receive in Britain is years behind what you would expect in America and in other countries which have systems of medical care that use up-to-date equipment.

It is worrying that Americans still apparently think that the NHS may be a model worth following. It would be useful to see an estimate of how many people in Britain die prematurely of heart disease each year because of the inferior diagnosis and treatment here. We have such an estimate for cancer from Professor Sikora (10,000).

Incidentally, the 64-CT scanner has other important uses as well.

The Telegraph article is here.

Posted by James Bartholomew • Indexed in NHS

Comments (6) TrackBack (17)


Yes, James, but the NHS has other priorities to spend its money on - like the ballooning cost of pensions for its staff.

CT scanners come way below this in the list of priorities.

Posted by: HJ at November 28, 2008 11:15 AM

Hmmm, this is a very poorly referenced article. "A handful" is as non-descriptive as you get. I'm a radiography student and have had 3 cinical placements in 3 different hospitals as part of my course - each hospital has had a 64 slice CT scanner. Maybe the SW is particularly blessed, but either way, my figures are as substantial as those in the article (i.e. barely substantiated).
As an interesting aside, the over availability of CT in the US (whole body scans can be requested with little clinical indication, unlike the rigorous structure we employ here) means that they also have one of the highest levels of radiation induced cancers in the world...

Posted by: Jason at November 30, 2008 01:45 PM

The NHS hospital where Dr Grumble works has a 256-slice scanner on order so it is not all bad in the UK. As Jason says, where's the data to support these allegations?

Posted by: Dr Grumble at December 2, 2008 01:28 PM

It seems that in the US the scans are overused. Perhaps these machines are being used to generate income rather than help the patient.

Posted by: Dr Grumble at December 7, 2008 05:46 PM

It is not true that a CT scan can be carried out 'without ill effect on you'. The radiation dose is substantial. Wikipedia even makes comparisons with the survivors of Hiroshima and Nagasaki. There are other risks too.

Posted by: Dr Grumble at December 9, 2008 08:40 AM

Just to prove to you that Dr Grumble is not some NHS eccentric even a top American blogger is saying that more advanced tests don't necessarily equate to better care.

Posted by: Dr Grumble at December 11, 2008 06:59 PM

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