Private health companies urge pointless medicals



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Private health companies are acting unethically by encouraging patients to pay for pointless and occasionally damaging health screening, doctors claim.

A survey of GPs has found that those in affluent and middle class areas increasingly have to help worried patients who have undergone unnecessary and sometimes bogus tests, which have been carried out outside the NHS.

The tests, often promoted as part of a “health MoT”, can lead to high false readings, in particular with the prostate cancer “PSA” test. That test is not used for routine screening on the NHS because it picks out many healthy men as well as those with cancer. Experts have judged that the resulting invasive investigations, and worry, mean that unless it is highly targeted, the risks outweigh the benefits.

The survey was conducted by the healthcare magazine Pulse. It found that of more than 1,100 GPs more than half had extra work because of patients wanting to discuss the results from private screenings. Anne Mackie, director of screening programmes at the UK national screening committee (UK NSC), is responsible for advising the government on which tests are worthwhile.

She accused companies of negligence for leaving GPs with the job of reassuring patients. “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,” she said.

Many GPs said that the rise had meant that more of their patients ended up receiving unnecessary treatment, including one example in which a patient had a kidney removed, only to find that the tumour on it was benign.

Margaret McCartney, a GP and author of the book The State of Medicine: Keeping the Promise of the NHS , said that private companies should pay for any follow-on consultations. “There are numerous companies whose management seems to consist of handing the patient a 50-page dossier and highlighting supposedly ‘abnormal’ results, which they are told to discuss with their GP,” she said.

“As the NHS system cracks under pressure and private providers increasingly seek to take advantage of this I think we need a new method of ensuring that the NHS does not end up responsible for tests it didn’t order and that aren’t evidence-based.

“We also need much closer regulation of marketing materials by the Advertising Standards Authority, but 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.”