Screening for the masses

The UK government is planning to introduce health screening for everyone in England aged between 40 and 74. The announcement was made on 1 April, but it is not - much to the chagrin of many doctors - an April Fool's hoax.

Although prevention is without doubt better than cure, it is questionable whether this sort of mass screening is the best use of limited public health resources that are already stretched to breaking point.

The UK government already stands accused of interfering by trying to educate the population regarding the dangers of smoking, excessive drinking, poor diet and lack of exercise, all of which are key factors in causing the conditions - heart disease, stroke, diabetes and kidney disease - targeted by the screening. The fact is, people know what they should and should not be doing but are failing to change their lifestyles accordingly.

And why target the 40-74 age group? Wouldn't it be more effective to focus on the obese, binge-drinking smokers under 25, while the habits are easier to break and before too much damage has been done.

Furthermore, consider who is most likely to take up this "offer" - and there is no suggestion that screening will be compulsory. Rather than the most vulnerable members of society or the hardened smokers and drinkers, those beating a path to the GP's door will probably be the fit forty-somethings with hypochondriac tendencies.

There are great benefits to be had from screening programmes and from preventative measures. There are few who would argue against routine immunisations, mammograms or cervical smears. But these are all carefully targeted schemes and the preventative effects are well documented.

A number of retail outlets in UK High Streets already offer tests for high blood pressure, cholesterol level, blood sugar and body mass index, and rumour has it that one of the major supermarkets is about to start offering similar services. Perhaps they could select customers on the basis of what they have in their trolley - more than a couple of packs of beer or one multipack of crisps on the conveyor belt will immediately summon a screening assistant.

The benefit for the pharmaceutical industry is that statin prescriptions could rocket. The drugs already cost the National Health Service an estimated £500m a year, and this latest government scheme could see up to 4 million more people taking them as a preventative measure.

But in a system with finite resources, surely the money would be better spent on the most modern medicines for those with recognised, life-threatening conditions than on making patients out of healthy people.