'Midlife MOT' NHS Health Check wastes £450m a year, according to report

Health checks offered to hundreds of thousands of people over 40 are ineffective and currently waste £450 million a year, a report suggests.

Experts from the London School of Economics and the University of Liverpool, said that, at best, 1,000 lives a year are saved - equating to £450,000 per life saved.

The NHS Health Check aims to help prevent heart disease, stroke, diabetes, kidney disease and certain types of dementia.

People aged 40 to 74 are invited once every five years for a free check at their GP surgery.

But the "midlife MOT", launched in 2009, has faced criticism for failing to show it improves health or saves substantial numbers of lives.

The NHS has predicted it will save 650 lives a year, prevent 1,600 heart attacks and strokes, prevent 4,000 people from developing Type 2 diabetes and detect at least 20,000 cases of Type 2 diabetes or kidney disease earlier.

The new study, published in the Journal of Public Health, said the programme "relies on weak concepts" and "denies strong scientific counter-evidence".

It said "health checks have been repeatedly shown to be ineffective", including several reviews examining all available evidence.

The authors, including Professor Simon Capewell, from the department of public health and policy at the University of Liverpool and Professor Walter Holland, from the London School of Economics, said health workers, services and local authorities were all forced to promote the health checks.

"In spite of austerity policies, they are required to commit time and scarce resources to activities of debatable effectiveness and cost-effectiveness.

"This saps morale, particularly considering the substantial opportunity costs of failing to invest those scarce resources in alternative, more effective interventions."

The authors said the money could be better spent in areas such as child health or promoting healthy food, which could halve early deaths for heart disease.

"Many such policies are powerful, rapid, equitable and cost saving, for example, legislation supporting smoke-free public spaces or plain packs, alcohol minimum unit pricing, banning dietary trans-fats or slashing the daily dietary intake of salt or sugar."

The experts said adherence to the checks showed the dominance of "political obedience" over scientific objectivity.

"We believe that many of our colleagues in the Department of Health, Public Health England and NHS England privately agree that NHS Health Checks are costly and ineffective," they said.

"However, as civil servants they are obliged in public to 'toe the party line'.

"Lacking an independent voice, they must be seen to support ministers even when the scientific evidence points in the opposite direction - they are obliged to see the Emperor's clothes where none exist."

The researchers said the UK "urgently needs" an independent Institute of Public Health, as found in Finland and the Netherlands.

The report said the way a person's risk of disease is calculated during a health check is imprecise.

The scoring system has "frustratingly low sensitivity and specificity for the individual patient", the experts said.

Most current risk calculators miss more than one-third of people who go on to have a heart attack or stroke. In some cases the mismatch may be as high as 50%.

In other cases, some patients may be given medication they do not need, the authors wrote.

A further weakness in the health check programme is that only around half of eligible people take up the offer of screening, they added.

Furthermore, giving people advice coupled with short-term behaviour changes "generally have little medium or long-term benefits".

Preventive medications for blood pressure have only modest benefits, while statins to lower cholesterol "only have minimal mortality benefits in low-risk individuals", they said.