Revised health checks ‘could exclude Asians’

RISK MANAGEMENT: Some doctors are concerned about the impact the review of the NHS Health Check could have on ethnic minority patients

by LAUREN CODLING

SENIOR doctors have spoken of their concern for British Asian patients after the government decided to reconsider NHS health checks last Friday (16).

The checks are currently offered to UK patients aged between 40 and 74 to spot the early signs of life-threatening conditions such as kidney and heart disease and Type 2 diabetes.

However, the Department of Health and Social Care said the scheme pays little attention to people’s individual risks or needs.

Now the government is set to review the personalised health checks, with promises to introduce online checks and more “targeted” advice.

The checks are currently offered to everyone aged between 40 and 74 to spot the early signs of major conditions that cause early death

According to ministers, the latest review will focus on offering personalised interventions based on factors such as age, where people live and their DNA.

Health secretary Matt Hancock said the review would be an “important step” to move away from the “one-size-fits-all approach of the past”.

“(The review will help) us to find data-led, evidenced-based ways to support people to spot, manage and prevent risks to their health through targeted intervention,” Hancock said.

Speaking to Eastern Eye on Monday (19), Professor Mayur Lakhani welcomed the review,
but admitted he worried about how the changes could affect Asian patients.

Lakhani, who is the president of the Royal College of General Practitioners (RCGP), said he was particularly concerned about the notion of introducing online checks.

“Some Asian patients have language barriers and they also have lower usage of the internet, so inadvertently this could lead to inequalities,” he said.

Professor Mayur Lakhani raised concerns that a targeted approach may inadvertently lead to inequalities 

Lakhani, who chaired the health secretary’s inquiry into primary care access for BAME patients in 2007, noted the importance of health care for Asian patients, referring to increased risks of heart problems and diabetes. If the care was primarily online, he worried that it could create a “two-tiered system”.

Although he stressed he did not believe that was the review’s intention, he hoped there would be further moves made to ensure some patients were not excluded.

“Let (patients) have a voice in this issue and for the review,” Lakhani said. “If British Asians experts or patient groups could be represented, then I think that would make it much more positive.”

In response to the news, the honorary vice-president of the British Medical Association (BMA), Dr Kailash Chand, revealed his cynicism relating to the health checks.

“Politicians love the idea because the thought of doing something ‘good’ has populist appeal, but most or all doctors believe that these ‘health checks’ are scientifically flawed while also being a bad idea,” Dr Chand told Eastern Eye.

“My experience of 30 years in general practice tells me you always find something
‘false positive’ or a ‘false negative’ that you can’t explain – then you do more tests.” He added: “An individual may end up with diagnoses of diseases or risk factors which wouldn’t have caused any symptoms in his lifetime. The screening results in over-diagnosis, over-treatment, benefiting pharmaceutical and insurance companies and not patients at all.”

Dr Kailash Chand believes that funding should instead be delegated to local health initiatives 

Stressing his belief that “prevention is better than a cure”, Dr Chand suggested that funding be delegated to local initiatives which could make a difference.

“Asians who have lot more prevalence of diabetes and heart diseases could benefit from tailored lifestyle advice and access to local services, such as stop smoking services, and/or clinical management to help them reduce their heart disease and diabetes risk,” he said.

In response to Eastern Eye, the BMA GP committee chair, Dr Richard Vautrey, said the trade union welcomed the review.

However, he stressed that the government had to ensure that any future preventative care plans were tailored so that those population groups who were at most risk of preventable ill health got the care they needed as a priority.

Dr Vautrey added: “If the responsibility to carry out more advanced health checks lies within general practice, which we believe it should be, then the government must ensure that the appropriate resources and investment is in place so GPs can effectively oversee the delivery of this care.”