Heart surgeons cut queues and run out of work

Heart surgeons are running out of work after scoring spectacular gains against Britain's biggest killer.

A huge push to increase the number of patients treated for heart disease over the past three years has nearly eliminated the long queues for heart surgery, with just 375 patients waiting more than six months at the end of June.

The Government is now poised to achieve its pledge of eliminating waits of more than six months for heart patients by Christmas, two years ahead of its target date of the end of 2005.

But success has come with a sting in the tail. Hospital units and surgeons dedicated to treating heart patients are under threat because there is not enough work. Urgent discussions are being held at the Heart hospital in London and the William Harvey hospital in Kent to re-allocate beds and operating theatres. At national level, plans are being developed to retrain heart surgeons in other specialties.

The development highlights the risks of the seismic changes under way in the NHS as enormous sums are being invested to modernise and reform it. While the cuts in heart surgery waiting lists are good news for patients, they could destabilise a health service unused to the rapid pace of change.

Heart disease kills more than 120,000 people a year in the UK, and the long wait for heart surgery used to be one of the clearest signs of the failing NHS. The risk of dying on the waiting list was higher than the risk of dying on the operating table, as patients waited for up to 18 months for an operation.

Two years ago, more than 4,000 patients were waiting for more than six months. Last April that was down to 2,341, and by the end of this year doctors predict it could be reduced to zero.

The waiting lists have fallen so far and so fast that they have caught surgeons and NHS managers by surprise. In London, the 95-bed Heart hospital is in difficulty. It was purchased with great fanfare from the private sector two years ago by University College Hospitals NHS Trusts to provide much needed extra capacity for cardiac surgery.

Surgeons say there are three reasons why heart surgery rates are plummeting. First, increased investment of hundreds of millions of pounds and extra capacity has meant more patients could be treated, including 2,800 who opted to go to other hospitals under the patient choice scheme.

Secondly, more patients are being kept well on drugs, such as statins. Spending on statins, prescribed to lower cholesterol, has increased eightfold since 2000, to £640m a year. Treatments offered by cardiologists, which avoid the need for heart surgery, are more effective and long lasting.

Lastly, the epidemic of heart disease which started in the 1930s and peaked in the 1970s is heading downwards. Deaths from heart disease have fallen by a third in the past decade and have halved in the past 30 years. The reasons for the fall are complex, but include improved diets.