The government has unveiled plans to offer everyone aged between 40 and 74 a health MOT in a drive to better the health of the nation, help tackle health inequalities, and reduce the strain of treating serious health problems on the National Health Service.

Vascular diseases – which encompass heart disease, stroke, diabetes and kidney disease - affect the lives of more than four million people and kill 170,000 every year, and also account for more than half the mortality gap between rich and poor. What the government is proposing is a new national screening programme to help identify those at risk from such illnesses and prevent them from developing in the first place, as well as detect existing cases earlier to boost treatment outcomes.

According to the Department of Health, the new programme is set to roll out in 2009/10 at an initial annual price tag of around £250 million, but should help save the NHS valuable time and resources through preventing 2,000 deaths, 9,500 heart attacks and strokes and 4,000 cases of diabetes every year. Furthermore, it is hoped that around 25,000 cases of diabetes and kidney disease will be detected earlier, allowing treatment and care to be better managed.

The checks are likely to be centred on basic measurements such as age, sex, family history, height, weight and blood pressure, as well as a blood test to gage levels of cholesterol, so that a report on each person’s level of risk and what they can do to reduce it can be generated. Measures to cut risks might range from offering general advice on how to stay healthy or joining weight management or smoking cessation programmes to the prescription of medicines, the DH explained.

Commenting on the move, Health Secretary Alan Johnson said the NHS is evolving to become “more personal and responsive to individual needs; becoming as good at prevention and keeping people healthy as it is at providing care and cures; and able to offer the information and support people need to make healthy choices”.

And announcing the plans, he said the case for a national screening programme is “compelling”, particularly as it could save around 2,000 lives a year. But the British Medical Association has warned that such a screening programme might actually lead to “the healthy being seen at the expense of the sick”.

‘Serious’ concerns
“While we would like to welcome this, as prevention is undoubtedly better than cure, we have serious concerns about the pressure this will put on an already overstretched general practice,” said Dr Laurence Buckman, chairman of the BMA’s GP Committee.

“Over a third of the population fall into this age range which for an average practice means two thousand patients. It could work out at 40 extra appointments a week – and that’s if they only need one appointment...Whether it is nurses, GPs, healthcare assistants or pharmacists who do these checks, there is not currently the workforce, the time in the day, or even the space in our surgeries to carry out this number of consultations,” he stressed.

On a separate note, Buckman questioned the decision to proceed with such a programme given the lack of “scientific evidence” behind the plans. “To justify healthcare spending on this scale there would need to be very clear evidence that this is both cost and clinically effective, [but] there have been no pilot schemes and the models the government is using are theoretical”, he argues.