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Johnson’s crazy screening plan

Alan JohnsonIn an effort to outdo his predecessors and aim a policy so firmly at middle England that it almost hurts, Alan Johnson is planning to introduce vascular health screening for all 40 to 74 year olds. Frankly, the only conceivable policy which would satisfy the Daily Mail more would be a knighthood for Paul Dacre.

Mr Johnson wants to write to every person in the country between the given ages and invite them to attend their GP surgery for screening. The screening method will be very simple, involving only measurements of BMI, gender, family history, blood pressure, and cholesterol. Essentially, it will let overweight Mr Goggins know that he’s at risk of having a heart attack, just like his father and his father before him. It doesn’t add an awful lot of anything over and above the existing QoF targets, but Mr Johnson maintains that these simple measures this will save 2,000 lives per year. And that’s not a bad soundbite.

He’s a very clever man, Mr Johnson: He must be, because he hasn’t yet decided who will do this screening nor where it will be done, yet he already knows its exact cost – £250m per year. I’m not entirely sure where it is he’s found this figure. Perhaps it came to him in a dream.

Perhaps, in his dream world, the inverse care law does not exist. He admits that only 75% of people will come to his screening appointments (indeed, that’s the percentage on which his mystery funding figure is apparently based), but perhaps in his world this won’t be made up of the worried well. In contrast to any other health intervention ever introduced in the UK, the people who will attend his screening appointments are the ones who really need to attend.

The clinically obese will beat a path to their GP’s door for the experience of being told they’re fat. Those living on the minimum wage will take a day off work and pay for the bus ride to their local pharmacy between 9am and 5pm to be told their cholesterol is high. And those at greatest risk of vascular events – men – will suddenly have an overwhelming desire to engage with health services. Or not.

Instead, this will turn out to be another ill-conceived plan pitched to the worried well of the middle classes, helpfully providing the promise of a new ‘life-saving service’ to the age and class demographic most likely to vote in the upcoming local elections. Not only will it add little of clinical value, but it will divert a vast amount of money from parts of the NHS which desperately need it – particularly those parts which have a less ‘sexy’, populist image.

This is one case where I’m very happy to be proved to be a cynical political blogger rather than a realist. I’d like nothing more than for this plan to turn out to be a vascular panacea. Unfortunately, I can’t see that happening – and the one thing worse than an ineffective NHS is one which squanders money pandering to the worried well, for such an NHS cannot survive for very long.

» Image Credit: Original photo by Catch 21 Productions, modified under licence.

This post was filed under: Health, News and Comment, Politics.

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Comments and responses

Comment from Mort Karman

    23.39, 02/04/2008

Say what you want to, Simon, about the failings of the National Health Care Service. Having lived with the Canadian version, I agree, there are some, nay many, shortcomings.
But at least yo have SOMETHING.
On this side of the pond we have medical coverage for those on Social Security, mostly those over 65 or disabled. It is limited, but at least there is coverage.
For all the others, including the young children here in the USA
there is MOTHING.
If a person works at a company which has medical insurance for its employee there is some protection.
But the fees are massive and the deductibles can bankrupt most normal wage earners.
I knoow this well.
I had a nice small news agency and public relations business in Denver, Colorado.
When I got heart problems and diabetes I had no medical insurance because I could not afford the several hundred dollars a month it cost.
I wound up bankrupt.
Then I went on Social Security Disability so I at least got medical coverage from the government.
As this recession the President will not call a recession goes on more and more people loose their jobs and medical insurance.If you get a serious medical problem while you are uninsured, no insurance company will accept youas a client.
So with all the shortfalls of your medical service, most of us on this side of the pond would gladly accept it as at least SOMETHING.
We send billions to countries which hate us, yet we can not, say the politicans, give our own people a national medical plan.

Comment from sjhoward (author of the post)

    23.51, 02/04/2008

I quite agree that we’re better off with what we have rather than nothing. My personal fear is that politicians will continue to add on politically convenient functions to the NHS, such that the whole thing becomes financially unsustainable, and the baby is thrown out with the bathwater so-to-speak. That would leave all of Britain with a system probably less able to adequately deal with medical problems that the US’s.

It’s precisely because I value the NHS that I think silly plans like Alan Johnson’s should be nipped in the bud.

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