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Peripheral Arterial Disease

I congratulate my hon. Friend the Member for Bolton, South-East (Dr. Iddon)on securing this important debate and commend him for his excellent work in the all-party group on diabetes, which is a sign of his commitment to reducing vascular disease. He said that he was seeking to persuade me, and as always the points he made were persuasive and well-informed. They shone a light on something that perhaps few have drawn attention to. My hon. Friend has raised an issue that perfectly illustrates the challenge the NHS must meet in the coming years. His speech reminded me of a quotation. At the turn of the last century, George Bernard Shaw despaired of a society that""will pay a surgeon to remove a leg, but nothing to save it"." In this century, the NHS has changed and continues to change: it is not just a service for treating illness, but a national health service for the promotion of good health. Specifically, it is true that we must do more to save more people from the terrible tragedy of limb amputation. As my hon. Friend says, although peripheral arterial disease can have devastating consequences and affects a significant number of people, it is not often in the public eye. That is why I particularly welcome the debate and am grateful to him for drawing attention to the matter. To give a wider context, under our five-year plan "From good to great", the NHS must do three things: take a more preventive approach, stopping more people developing serious illness, as we have discussed; be more people-centred, organising services around the individual, and in particular managing long-term conditions in more effective ways; and put quality at the heart of everything it does—improving diagnosis, treatment and management of disease, and building stronger multidisciplinary teams to improve the care that a patient receives. I absolutely agree with my hon. Friend that peripheral arterial disease is a clear case in point. We must get better at preventing and diagnosing it and managing it at primary care level, and get better at joining up primary and secondary care so that fewer patients end up facing limb amputation. As to awareness, it is an unfortunate fact that by the time many of us get to 50, we will have some fatty build-up in our arteries, which can lead to peripheral arterial disease, or indeed to heart disease or stroke. A typical candidate for peripheral arterial disease might be over the age of 50 and would probably be a smoker—often male—and perhaps would have diabetes. Many GPs therefore come across cases fairly regularly, and in the early stages of the disease can treat it themselves with advice about blood pressure and the means to lower cholesterol levels. However, I accept the points that my hon. Friend raised about awareness. It is always good to ensure that GPs are brought into contact with the latest thinking about diagnosis and treatment.