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Last Updated: Sunday, 29 January 2006, 18:49 GMT
Head-to-head: Voluntary health checks
While government plans for voluntary health MoTs have been welcomed in some quarters, others have called it a headline-grabbing stunt which will serve little medical use.

A GP and a patient give their views on the proposal to the BBC News website.

THE DOCTOR

The GP, who works in Sussex and Surrey, told BBC News website that while hospitals were being closed, while district nurses were in short supply following restructuring and the wait to see a counsellor was six months in his area, money would be better spent elsewhere.

Stethoscope
The 'worried well' are most likely to take up the offer of health checks

"It has been presented in a very populist way," he said.

"If we had infinite resources and we weren't suffering, if my patients didn't come to me and say 'did you know they have just cancelled my operation again' I would probably think this was not such a bad thing," he said.

But there were real questions over how much you would actually gain by such screening, people needed more information about it, and in the end the people most likely to take up the voluntary checks were the "worried well", he said.

It just shows a lack any real understanding of healthcare

One example was the PSA test for prostate cancer.

"The vast majority of people who have a positive test do not have prostate cancer," he said.

"The test also has a high 'false negative' rate, which means it doesn't pick up all the ones with cancer either."

Also the progression of prostate cancer was very slow and treatment could lead to impotence and incontinence. A very old man was likely to die of something else first, so it begged the question would this be best.

"Patricia Hewitt must be, in medical terms, almost like a child armed with a gun, making pronouncements. She should come and see what happens at local level," he said.

"It just shows a lack any real understanding of healthcare."

Instead of 'choice' forced on us, my patients say they'd prefer good local services

In the meantime, GPs were still routinely checking people, whether it was "opportunistically" such as taking blood pressure when prescribing the contraceptive pill, if people requested a check and it was non-invasive, or whether the surgery was holding a specific health programme.

At the same time smear tests for women were routine, as was breast screening for women over 50.

"Where there is a high need for screening, the high need is currently covered. These resources could be put into something more important.

"Instead of 'choice' forced on us, my patients say they'd prefer good local services."

THE PATIENT

Unhappy at the treatment his asthmatic wife was getting from their GP, Carl Thomson decided to change the family doctor.

It was a decision which changed the 35-year-old's life.

As a new patient he was given a health check, part of which was a blood test.

He was diagnosed with Type 2 diabetes, and all his health worries of the past few years fell into place.

Two years previously he had complained to his then GP he was feeling depressed, exhausted and was having trouble concentrating.

It has really turned my life around, I am back on top of my game again.

It was diagnosed as depression.

"I was off work for six months and having all sorts of pills and potions thrown at me to cure depression," he said.

After six months he knew the medication was making no difference, so decided to "pick himself up" and return to work, but was still plagued by health worries

"My new GPs are great believers that prevention is better than cure," he said.

"It has really turned my life around, I am back on top of my game again. I am so much in their debt."

And because his diabetes was diagnosed fairly early on, he is able to control it through medication and diet, without having to resort to insulin injections.

I have a six-year-old son, and I am going to see him grow up

"They have saved me a great deal of problems and health troubles," he said.

If left undiagnosed he would have faced an uncertain future, while his condition would have been far more costly to the NHS, he said.

"If I had had a heart attack I would have 'bed blocked' for several months, there would have been all sorts of complications and problems.

"It would have been far more expensive for the NHS than it is treating it now.

"These checks will save us the tax payer a lot more money in the long-term and also get people's health back on track."

But there are other things far more important.

"I have a six-year-old son, and I am going to see him grow up. If this hadn't been diagnosed then there would have been a serious risk that I would not have seen him grow up long-term."




BBC NEWS: VIDEO AND AUDIO
Doctors give their opinions on 'health MoTs'



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