Intended for healthcare professionals

Rapid response to:

Feature Medicalisation

Preventing overdiagnosis: how to stop harming the healthy

BMJ 2012; 344 doi: (Published 29 May 2012) Cite this as: BMJ 2012;344:e3502

Rapid Response:

Re: Preventing overdiagnosis: how to stop harming the healthy

There is an unrealistic societal preference for reducing risks irrespective of costs. The absurd interpretation of health and safety regulations is a manifestation of this societal attitude. For example, Whitehall staff, who are competent enough to run the country, apparently could not be trusted to put up jubilee decorations safely! (1)

When this ‘societal risk aversion’ meets ‘fee for service’ model, over-investigation and over-diagnosis occurs due to commercial interests and defensive medicine. (2) Hence, the new ‘Health and Social Care Bill’ in England has the potential to make the problem of over-diagnosis much more acute. (3)

1. Ahmed K. The Queen’s Diamond Jubilee: Whitehall told to remove bunting over H&S fears. [Internet]. 2012 Jun 1 [cited 2012 Jun 2]; Available from:

2. Brody H. Medicine’s Ethical Responsibility for Health Care Reform — The Top Five List. New England Journal of Medicine. 2010 Jan 28;362(4):283–5.

3. Ham C. What will the Health and Social Care Bill mean for the NHS in England? BMJ. 2012 Mar 20;344(mar20 2):e2159–e2159.

Competing interests: No competing interests

04 June 2012
Santhanam Sundar
Consultant Oncologist
Nottingham University Hospitals NHS Trust
Dept of Oncology, City Hospital campus, Hucknall road, Nottingham. NG5 1PB