Cardiology inquiry finds expectation of poor health in deprived areas and ethnic communities and calls for review of GP numbers

24/09/2012

A parliamentary inquiry into cardiology services has found people living in deprived areas and in Scotland’s ethnic communities expect poor health.

The committee of MSPs has also called for the Scottish Government to review whether GP numbers are adequate to meet the needs of these patients.

In its inquiry report published today, members of the Scottish Parliament’s Public Audit Committee were shocked to find that some patients ‘normalised’ pain, while others did not recognise the symptoms of a heart attack, mistaking it for indigestion.

The committee has called on the Scottish Government to set out how it proposes to address the apparent fatalistic attitude from patients within certain communities that poor health is to be expected.  

The MSPs acknowledged that Scotland has a higher ratio of GPs to people than the rest of the UK, and welcomed the Scottish Government’s present recognition of the additional needs of patients in deprived areas through GP funding levels.  However, the MSPs learned that this did not necessarily provide for higher GP levels in deprived communities where there is a prevalence of ‘comorbidity’.

The committee has therefore called on the Scottish Government to review whether GP numbers are adequate to meet the needs of these patients.

Public Audit Committee Convener Iain Gray said:

“The committee discovered during its fact-finding visits to Glasgow that many people from poorer areas and from certain ethnic minority communities simply have an ‘expectation’ of ill-health.  The powerful but deeply disturbing message was ‘people like us die of heart disease, and that’s how it is’.

“We learned that many simply do not expect to enjoy good health and have an almost resigned acceptance that ill-health, including heart disease, is what life brings.

“From speaking with patients and health professionals we found that some people would ‘normalise’ their pain or consider it not significant enough to discuss with their GP.

“And in some cases, patients even indicated they did not recognise the symptoms of ill-health to the degree that they confused having a heart attack for indigestion.

“The Public Audit Committee is therefore calling on the Scottish Government to set out how it proposes to address this fatalistic attitude within deprived communities and some of Scotland’s ethnic minority communities.”

On GP services, Mr Gray added:

“While Scotland does indeed have a higher ratio of GPs per head of population than elsewhere in the UK, the current government formula for allocating resources does not necessarily lead to higher GP levels in deprived communities.   And that’s where there is a concentration of comorbidity. 

“We are therefore requesting that the Scottish Government reviews whether GP numbers are adequate to meet the needs of people in deprived communities and ethnic minority communities.”

Elsewhere in the report, the committee welcomed the reduction in death rates from all types of heart disease over the last 10 years with most councils experiencing rates comparable with that of the rest of Europe.  However, in eight Scottish councils the rates of heart disease are the highest in Western Europe. These rates are also higher for men, some ethnic groups and for people living in deprived areas.

The committee acknowledged from the evidence it received, that the Scottish Government’s national anticipatory care programme, called Keep Well, is the right approach to targeting health improvement in the most deprived communities.  However, the committee was concerned that the results from the Government’s evaluation of Keep Well will not be available until summer 2014.  Given £11.3 million has been committed to this programme in 2011/12 and again in 2012/13 the committee has sought clarification from the Scottish Government about its plans for any interim evaluations prior to summer 2014.

Comorbidity refers to either the presence of one or more disorders (or diseases) in addition to a primary disease or disorder, or the effect of such additional disorders or diseases.

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