Health checks in general practice

Time to review their role

The NHS has changed a lot since the late Denis Burkitt (who linked high fibre diets with preventing bowel disease) compared illness to an overflowing bath and suggested that doctors and nurses might be better employed turning off taps than mopping the floor. Increasingly, general practice has been considered to be the right place for turning off taps,1 2 and in 1990 health promotion was made a contractual requirement for general practitioners.3 Does prevention of illness in primary care work? Three papers in this week's journal consider different aspects of that question.4 5 6 Unsurprisingly, the answer is not straightforward.

One group based in Oxford, testing strategies to reduce the risks of cardiovascular disease and cancer in general practice populations, has greatly influenced British health policy. It is to the OXCHECK researchers' credit, therefore, that evangelistic fervour has not clouded their evaluative judgment. In their latest report they conclude that health checks for unselected middle aged people achieve little or no reduction in smoking and excessive drinking (p …