According to government proposals published yesterday, from April next year everyone aged 40 to 74 will have the right to a free health check every five years. Is this a good idea? A GP writes . . .
I believe that offering a blanket, one-size-fits-all health check to the entire population is a waste of time and money. An individual's risk of developing a disease depends on age, gender, genetics and lifestyle. To be of any use, a health check must be tailored to the individual, taking all those factors into account.
We could encourage everyone to find out as much as possible about their family's medical history. Sadly, the current craze for exploring our ancestors rarely includes medical details. People often tell me "cancer runs in the family". That doesn't help to identify their risk. We almost all die from heart disease or cancer. But knowing that two or more close relatives developed melanoma, breast, bowel, or prostate cancer below the age of 60 may be significant. Individuals with a family history of a particular cancer or disease can be referred for genetics counselling or screening.
Money and effort could also usefully be deployed in schools and health education campaigns, to persuade the public to overcome their abiding reluctance to report worrying symptoms. A significant factor in our poor cancer survival rates compared to other developed countries is that people still leave it too long if they see blood in the toilet, feel a lump, or develop a new unexplained symptom such as weight loss or cough.
You don't need a doctor to tell you you're too fat, shouldn't smoke or need to exercise. You can check your blood pressure and cholesterol at a pharmacist or buy a DIY kit. Your local GP surgery will also gladly do it. In the absence of any symptoms, a health check may reveal little.
Given that demand for health services is infinite, and supply limited, shouldn't nurses and doctors be deployed in caring for the sick and identifying and intervening in those most at risk? The inverse care law still applies in the UK, whereby those most in need of medical resources access them least. The "worried well" may welcome this government initiative, but the "unworried unwell" will remain untreated.
