Viewpoint: Invest in general practice - not flawed NHS health checks

Health screening, on the face of it, seems like an excellent idea, writes BMA deputy chairman Dr Kailash Chand.

Dr Chand: 'Government should invest in more primary care infrastructure and GPs to deliver meaningful healthcare.'
Dr Chand: 'Government should invest in more primary care infrastructure and GPs to deliver meaningful healthcare.'

Politicians love the idea because the thought of doing something ‘good’ has populist appeal, but most or all doctors believe these ‘tests’ are scientifically flawed and 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 and 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 published last year in the BMJ confirms what many doctors apart from the ones who are paid to do annual health checks for big private health companies, 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 £300 million-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 health care.

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