Intended for healthcare professionals


Private health screening: NHS must not be left to “pick up the pieces,” say LMCs

BMJ 2019; 364 doi: (Published 20 March 2019) Cite this as: BMJ 2019;364:l1289
  1. Gareth Iacobucci
  1. The BMJ

Private screening providers should be mandated to provide follow-up appointments with patients to discuss abnormal results and should not offload responsibility to the NHS, local medical committees (LMCs) have argued.

The annual conference of LMCs, held in Belfast on 19 March, carried a motion arguing that GPs should be empowered to invoice private screening providers directly for their time if, as NHS GPs, they provide follow-up appointments to patients who had undergone privately funded scans.

The conference also voted on a separate stem of the motion saying it believed that health screening should not take place in the NHS without the approval of the UK National Screening Committee.

Ciaran Kelly of North and North East Lincolnshire LMC, who proposed the motion, highlighted that screening tests must satisfy a strict set of criteria before they can be recommended for use in the NHS.

“Private companies don’t care about these strict criteria,” he argued. “They are in it for the money, pure and simple. Should they find something untoward [in the private scan], then the patient is immediately forwarded on to the NHS to pick up the pieces, including explaining tests that were not ordered by their GP and should never have been organised in the first place.

“They want to offload that responsibility as quickly as possible to us.”

Kelly added that, in some cases, private screening exposed patients to “unacceptable risk.” He cited examples such as full body CT scans with radiation risk, “poorly evidenced” screening tests for cancer and food allergies, and “pseudo-genetic” screening tests.

“Surely this is the antithesis of what properly done health screening should achieve,” he said. “It just represents another example of private medicine skimming the cream and leaving the dishwater for the already stretched primary care services.”

He added, “I send letters to hospital consultants all the time saying, ‘If you want this test doing, you should order it and follow it up.’ I don’t see why we should give private industry a free pass.”

Ansar Hayat, of Wakefield LMC, spoke against the call for health screening not to take place in the NHS without the approval of the UK National Screening Committee, arguing that some screening not approved by the committee was already available on the NHS and could provide benefit. “We should let the patients do what they want to do,” he said.

Sam Creaving, of Avon LMC, urged the BMA’s GP committee to work with public health agencies and guideline development groups to ensure that GPs are resourced and protected for the work they do. “We want to make sure that we can deliver a high quality standard of care in a way which we are involved with,” he said.

The motion was passed in full.

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