Dr Kailash Chand - Time to shun flawed NHS health checks

Health screening, on the face of it, seems like an excellent idea.

Politicians love the idea because the thought of doing something 'good' has populist appeal, but most or all doctors believe that these 'tests' are scientifically flawed while also being a bad idea. My experience of 30 years in general practice tells me, you always find something, 'false positive' or a 'false negative', that you can't explain.

Then you do more tests. An individual may end up with diagnoses with diseases or risk factors which wouldn't have caused any symptoms in his lifetime.

A review of the evidence confirms what many doctors have argued for years: that annual health checks not only do no good, but might actually be harmful.

Researchers from the Cochrane Library reviewed 14 trials involving 182,880 people. Their findings were twofold: the health checks they studied did not reduce morbidity, and they also had no effect on the risk of death. Following this report, the Danish government reversed its plan for routine checks, but it seems NHS England is totally ignoring the results and pushing ahead.

The screening results in over-diagnosis, over-treatment, benefiting pharmaceutical/insurance companies and not patients at all.

Who can disagree with RCGP chairwoman Professor Clare Gerada when she says: 'Patients were being needlessly worried and family doctors were wasting time that should be spent treating people who were actually sick?'

In this economic climate, the government's flagship £300m-a-year screening programme will not benefit patients and will put them at risk of unnecessary treatment costing more to the hard-pressed NHS. The proliferation of these screenings has proceeded largely without the guidance of any systematic evaluation of their quality, accuracy, or ultimate efficacy either for detecting disease or for reducing risk factors for chronic disease.

Instead, the government should invest in more primary care infrastructure and GPs to deliver meaningful healthcare.

  • Dr Chand is a retired GP from Lancashire.

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