Effect of socioeconomic deprivation on waiting time for cardiac surgery: retrospective cohort studyCommentary: Three decades of the inverse care law

Effect socio-economic deprivation on rationing

10 January 2000

Following the article that shows socio-economic deprivation worsens surgical investigation and treatment of coronary heart disease. It's January 9th and no-one has responded to this article with a sense of outrage. After 8 days, where are the cries of foul! Is it because we have heard it all before and can't bear the agony? Or is it because we are from middle class backgrounds and don't really care?

I am sure a large part of the problem is doctors under pressure to ration. The problem is particularly bad in cardiology, despite the poor prognosis of coronary heart disease compared to say breast cancer(1). Ideally, a person who has chest pain on Monday, should have an angiogram on Tuesday, and a CABG on Wednesday - and this should apply routinely to everyone. As with many other cases of rationing, I believe doctors have a duty on behalf of society to push budgets and harass politicians to provide for such services. We can start by being more outspoken when articles such as this are published.

1. Bunker JP, Houghton J, Baum M. Putting the risk of breast cancer in perspective. BMJ 1998; 317: 1307-1309

Competing interests: None declared

Nicholas Bulmer, GP Registrar

Sleaford Medical Group

Click to like: