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Screening committee calls for tighter regulation of ‘unethical’ private MOTs

Exclusive Government advisors have warned that private companies are promoting non-NHS health screening checks in an unethical way, after Pulse revealed that GPs are increasingly faced with counselling patients who have paid to undergo the bogus and in some cases potentially harmful tests.

The UK National Screening Committee told Pulse that some private screening - which includes PSA testing and non-referred MRI scans - are unnecessary and can lead to patient harm.

It was responding to a survey by Pulse of 1,170 GPs, which found that nearly half of GPs reported their workload has gone up in the past year due to patients wanting to discuss results from non-evidenced based health screening tests they have paid for privately.

Private healthcare analysts LaingBuisson estimated growth in private health screening revenues at '5% to 7% in 2014 and 2015, which was an acceleration on previous years'.

GP leaders said this reflected their own experience - particularly in more affluent areas and with middle-aged patients increasingly directly targeted with adverts promoting the benefits of screening - and called for tighter regulation of private testing.

Dr Anne Mackie, director of screening programmes at the UK National Screening Committee (NSC) – the body which evaluates population screening tests and advises the Government on which ones should be adopted - said ‘Some of the conditions screened for by private companies are not recommended by the UK NSC and there are concerns that the potential harms of this screening are not clearly presented to the patient.

‘Offering screening without explaining fully the risks relating to false positives, which can lead to raised anxiety and further unnecessary diagnostic tests, and false negatives, which provide false reassurance, is unethical.’

Pulse's survey also indicated that some patients are clearly coming to harm, with GPs widely reporting patients being caused unnecessary anxiety as well as investigations and treatment for ‘incidentalomas’ – in one case a patient had a kidney and tumour removed, which was found to be benign.

Professor Helen Stokes-Lampard, chair of the RCGP, said: 'We have heard anecdotally that GPs are seeing an increasing number of patients making appointments to discuss the findings of private testing because they are worried, or they think they need treatment as a result, that might be of dubious value.

‘At a time when general practice is facing such intense resource and workforce pressures, this additional demand is unhelpful for everyone concerned, particularly patients who genuinely need to see a GP but are struggling to make a GP appointment.’

Glasgow GP and broadcaster Dr Margaret McCartney has held ‘informal talks’ with the House of Commons Health Committee about potential measures, which she said could involve a levy on private companies to pay the NHS for the work their tests create.

However, she added: 'Fundamentally we need some sort of legislation to underscore the principle that these tests are not evidence-based – perhaps an "anti-quackery" clause that all customers must sign before consenting to go through screening.'

The Department of Health declined to respond to the findings and the demands for action on private testing.

Have you seen an increase in the past 12 months in patients attending general practice after undergoing private screening?

Yes – 43%

No – 50%

Don't know – 7%

The survey was launched on 9 November 2016, collating responses using the SurveyMonkey tool. The 29 questions covered a wide range of GP topics, to avoid selection bias on one issue. A total of 1,170 GPs answered the question above.

Readers' comments (12)

  • Doctor McDoctor Face

    Why not make the screening companies liable for the private costs of further investigating any asymptomatic findings?

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  • As both an NHS GP and Medical Director for a private screening company I am keen to address the points made in this piece in addition to those of my GP colleagues. My next book 'Better Value Health Checks' is due out later this year and I hope this will serve as a useful guide to all those seeking to design and deliver health checks (private and public)

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  • @x. ray 9;19
    I fully agree with this approach.
    The evidence for much screening is poor, if not non-existant.
    Private screening (just like other private medicine in this country) is a massive parasite which would not exist if it had to develop the means to support itself.

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  • Nick Summerton? The one who professed that JDs need to shut up and do as they are told?
    Do you really think this is an appropriate platform for advertising your next book?

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  • IT IS THE GOVERNMENT WHICH IS "IN LOVE" WITH THESE PRIVATE COMPANIES TOGETHER WITH "STRANGLING" UK GENERAL PRACTICE...THEY ARE RESPONSIBLE FOR CULTIVATING THIS ENVIRONMENT...SO WHY ARE YOU TELLING US??? TALK TO HUNT...

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  • Look there is some one doing free publicity of their books !

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  • The ten principle considerations required for Screening by Wilson and Jungner (WHO) may have been set out nearly fifty years ago but apply today as much as ever.

    I work in NHS Scotland an the Chief Medical Officer has introduced "Realistic Medicine". I wonder if these 'MOTs' will be "realistic"?*

    * http://www.bmj.com/content/356/bmj.j1058/rr

    Dr Peter J Gordon

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  • I would consider that the Achilles heel of these private screening companies must be their failure to follow up on their duty of care by counselling and acting upon the results THEY generate. It surely must be possible to strike a few off the GMC register on this basis alone.

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