HC Deb 05 February 1991 vol 185 cc148-9
5. Mrs. Gorman

To ask the Secretary of State for Health what is the rate of heart attacks in (a) men and (b) women (i) under 50 and (ii) over 50 years.

The Minister for Health (Mrs. Virginia Bottomley)

In 1989, the death rate per 10,000 population in England from acute myocardial infarction was 1.03 for men and 0.13 for women under the age of 50 and 68.81 for men and 45.88 for women over the age of 50.

Mrs. Gorman

I thank my hon. Friend for her reply. She is saying that young women hardly ever have heart attacks or strokes, whereas the number of women over 50 who suffer those conditions is rapidly catching up with the number of men. They are the largest single cause of death for women in that older age group. Is my hon. Friend aware of the research work carried out at King's College hospital showing that hormone replacement therapy is a way to protect women from such an early death? Will she state the amount of money currently spent in the health service on making hormone replacement therapy available to women in that older age group?

Mrs. Bottomley

It would be difficult to be in this place with my hon. Friend without having a passing acquaintance with the subject of hormone replacement therapy and the work undertaken at King's College hospital. She has identified the important contribution that the treatment can make. We spend £29.5 million in the health service on hormone replacement therapy and the number of prescriptions has tripled over the past 10 years. Although there is evidence of the contribution of HRT in preventing cardiovascular disease, it is not conclusive. My hon. Friend must bear with us while further research is undertaken to assess the effects of HRT on those with osteoporosis and cardiovascular disease.

Mr. Rooker

Will the Minister comment on the stark contrast highlighted by the Public Accounts Committee's report on coronary heart disease? In this country we spend£10 million on prevention and £500 million on the treatment of the biggest killer, which kills 3,000 people a week. That stark contrast in expenditure shows that the Government need to respond to the need for prevention.

Since the Public Accounts Committee reported, what has the Department of Health done about monitoring the training of ambulance crews so that they can deal with the matter? The Minister must know that half the people who die from heart disease die in the first two hours. When the Department of Health gave evidence to the Public Accounts Committee, the Department was not monitoring the extra training being given to ambulance crews in that vital sector.

Mrs. Bottomley

I appreciate the hon. Gentleman's recognition that prevention is better than cure. I hope that he will join us in carrying forward our strategies and priorities for health. Certainly, the prevention of heart disease—whether through the GPs' contract, the "Look after your Heart" campaign or environmental and lifestyle factors, especially smoking—is crucial. The hon. Gentleman will know that treatment is also costly. The number of heart transplants has risen from three to 295 in 10 years and the number of coronary artery bypass grafts has risen from 3,100 to almost 13,000.

As for the training of ambulance crews, a great deal of work is being done to ensure that they are properly qualified and that defibrillators are available in ambulances.