Prime Minister Gordon Brown has promised a “groundbreaking” new screening programme for serious conditions such as heart disease, stroke, diabetes and kidney disease, which collectively affect the lives of 6.2 million people, cause 200,000 deaths each year, and account for 20% of all hospital admissions.

The move, which is part of a new programme of "deeper and wider" reform of the National Health Service to help it meet the challenges of the 21st century, signifies a big step towards a mantra of prevention rather than cure to help boost the health of the nation.

Addressing healthcare professionals at King’s College London yesterday, Brown stated: “The NHS of the future will do more than just provide the best technologies to cure: it will also - as our population ages and long-term conditions become more prevalent - be an NHS that emphasises care too. The NHS of the future will do more than just treat patients who are ill - it will be an NHS offering prevention as well. The NHS of the future will be more than a universal service - it will be a personal service too.”

According to Brown, the Service will also place a much greater emphasis on better management of long-term illnesses such as asthma and diabetes, as well as reigning in certain ‘lifestyle’ diseases such as obesity. A frightening 60% of the population are expected to be clinically obese by 2050, and new measures, such as activity-based prescriptions and at least five hours of sport a week for schoolchildren, are being put in place to help battle the snowballing epidemic, the PM said.

He also promised a new NHS constitution that will clearly lay out “the level of service patients can expect as well as their own responsibilities for their treatment”, and, in return, patients will be given more choice on their care, including better access to out-of-hours GP services and the potential of self-managing treatment at home.

Response mixed
Response to the government’s third stage of NHS reform, the first arm of which kicked off in 1997, have been somewhat mixed. Focusing on prevention is “a positive move” and could improve patient care, the British Medical Association conceded, but, commenting on the planned screening programme, Dr Laurence Buckman, chairman of the BMA GPs Committee, said “the practical considerations have not been properly thought through”, and that there had been “no attempt to talk to GPs about how these proposals might work”.

“Patients will clearly benefit from earlier detection of disease and GPs have been participating in national programmes to screen patients for illnesses such as diabetes and kidney disease for many years,” he said, but also drew attention to the current shortage of staff for carrying out diagnostic scans, “so an expanded screening programme would also require a significant expansion of both personnel and scanning equipment”.

The NHS Alliance, an independent body representing NHS primary care, said new screening tests for common diseases will “gladden the hearts of many health professionals who for years have called for the NHS to become a health service rather than a sickness service”.

But its chairman Dr Michael Dixon warned against a one-size-fits-all approach to screening, and stressed: “We must guard against creating a health system that regards its patients and its professionals as mere machines: sets of parts that can be switched on or off, with a plethora of different ports of call for different diseases and different parts of the body”.

The proposals may be a taster of what Professor Sir Ara Darzi, who is currently looking into the state of the NHS and how the reform programme should progress, may recommend in his report later this year, which is due before the Service celebrates its 60th birthday in July.