Announcing a flagship health policy in 2008, the then Prime Minister Gordon Brown claimed that the way the NHS diagnosed and treated deadly diseases was set for a ‘transformation’.
He promised that, from 2009, everyone aged 40 to 74 would be offered an NHS health check to spot the early signs of an array of serious conditions, including heart disease, diabetes, kidney disease and Alzheimer’s.
The check, later nicknamed the midlife MOT, would be offered every five years and carried out by a GP or nurse.
At the time, the Government claimed catching these diseases early would prevent thousands of hospitalisations and deaths every year. More than 16 years on, the high hopes of the health check scheme have not been achieved.
Heart disease cases are at an all-time high, killing more than 170,000 Britons every year. The number of people diagnosed with diabetes has doubled since 2008, with more than five million now living with the life-threatening condition.
Kidney disease cases have also doubled over that period and are expected to continue rising – it’s predicted that treating this condition alone could cost the NHS upwards of £13 billion a year by the end of this decade.
These are all conditions which are considered preventable if caught early. And while experts say this rise in debilitating diseases is, in part, due to poor lifestyle habits and an ageing population, one thing is clear: the NHS health check has failed.
Retired surgeon Phil Hollow calls on those between 40 and 74 to get the vital health check-up
Last month, the National Audit Office published a damning report which concluded that fewer than half of those eligible for the midlife MOT are taking up the offer.
At the time, doctors blamed the public’s ‘lack of engagement’ with the scheme for the poor attendance figures, and accused patients of simply ‘not turning up’ to appointments.
But a Mail on Sunday investigation has learned that not only have thousands of patients not been invited for their midlife MOT – many have never even heard of it.
Last week, our GP columnist Dr Ellie Cannon wrote that she was ‘astonished’ people do not show up for their health check because ‘it’s such an easy thing to do’.
In response we received hundreds of emails and letters from readers who complained they had never been offered one.
One 73-year-old from Sussex said she has never received an invitation for the health screening and was now desperately trying to get one booked before she became too old to be eligible.
Another woman, 67, said she learned about the midlife MOT only two years ago. When she then asked her GP if she could have one, she was told it was not available.
And one 43-year-old man from London said he had been trying for several years to get the health check. When he was finally offered one, it revealed that he had dangerously high blood pressure.
However, NHS insiders claim that GPs are not to blame for this crisis. Instead, they argue the fault lies with local councils which are now responsible for organising them.
This newspaper has uncovered the shocking extent to which local bureaucrats are endangering lives. We have identified 12 councils in England and Wales that have provided health checks to less than ten per cent of residents over the past five years, meaning millions are going without one.
We have also discovered that some councils have abandoned the scheme altogether.
These authorities are now offering the health check only to ‘high risk’ groups. Another council has denied that the midlife MOT is its duty at all. Shockingly, not one council in the past five years has met its responsibility to invite 100 per cent of eligible residents for the health check.
Experts have accused councils of putting lives at risk and are calling on the Government to step in to fix the crisis.
Shockingly, not one council in the past five years has met its responsibility to invite 100 per cent of eligible residents for the health check
‘The system is not effective – money is being thrown out the window and thousands of preventable deaths will be missed as a result,’ says Professor Francesco Cappuccio, an expert in cardiovascular health at Warwick University.
‘This is a big problem. With local authorities not carrying out these tests, health inequalities will worsen and the burden of disease will be greater on patients, and it will all end up costing more for the health service down the line.’
So what does the health check involve? And how can you get one?
The check is offered to anyone in England and Wales aged between 40 and 74 who does not have an underlying health condition.
Until 2017, over-18s in Scotland were offered a similar check, known as Keep Well Clinics, however the funding was eventually pulled. Northern Ireland has never offered such a scheme.
During the appointment, a GP or nurse will check blood pressure, weight, cholesterol and calculate diabetes risk. These measurements can give a good indication of the risk of developing life-threatening conditions such as heart attacks and strokes.
A study by the University of Oxford, which analysed 140,000 people of whom 48,000 had a health check, concluded the appointment can cut the risk of death or diagnosis of heart disease by nearly a quarter, meaning the scheme has saved thousands of lives.
Until 2013, GP surgeries were tasked with inviting their patients for the midlife MOT. At the time, about 90 per cent of eligible people were invited. However, due to worries that organising the scheme was creating too much work for GPs, the Government decided that it should be up to local councils to organise the check-ups.
In theory, councils identify the eligible patients and send invites every five years.
Crucially, councils are also meant to commission GPs and nurses to carry out the midlife MOT, which means they have to find clinicians and pay them.
Experts argue that the policy change has been an unmitigated disaster. The latest figures suggest that about 60 per cent of those who are eligible are offered a health check – but this hides the poor performances of certain councils.
Sefton Council in Merseyside has managed to provide check-ups to only three per cent of residents. NHS data suggests that the area has the highest rate of heart failure in the country.
Other poor-performing councils include East Riding of Yorkshire, at four per cent, Wokingham in Berkshire, at five per cent, Enfield in North London at six per cent, and Sheffield at eight per cent.
When Sheffield Council was approached for comment, it claimed it was an issue for ‘the NHS and not the city council’.
Some experts suggest that local councils are unable to organise the checks because they are not getting enough funding from the Government.
‘For many councils, NHS health checks are a key part of their health improvement programmes,’ says David Fothergill from the Local Government Association. ‘However since 2015, the public health grant has been reduced by £858 million, limiting councils’ ability to fund these crucial services.’
Not all local councils are failing, though. Newham Council in east London has provided a health check to 80 per cent of its eligible residents thanks to a tracking system, created in partnership with Queen Mary University and which all local GPs use, which identifies eligible patients.
‘This digital approach, in combination with getting all of our GPs on board, has enabled us to get these results and improve thousands of lives,’ says Simon Reid, who runs the programme.
While councils are failing to invite eligible people, many people who are offered one do not take it up. Government figures suggest of those who are offered a test, 44 per cent do not book an appointment.
However, experts say that if the Government spent more money raising awareness of the benefits of the scheme, many more people would come forwards.
‘The whole idea of the check ups is that we find worrying things early,’ says Prof Kausik Ray, cardiologist and public health expert at Imperial College London.
‘Heart disease does not happen overnight, and there are steps we can take to protect patients from complications if we can find them before they get sick. So it is really concerning that people are not getting the check-up.’
Retired surgeon Philip Hollows, 66, from Nottingham, is one of those who regrets ignoring his invitation.
‘It is very easy to ignore yourself and think you are healthy,’ Dr Hollows says, ‘but these things can turn around and bite you’
The doctor says he was ‘too busy’ to go for his check-up when he had the opportunity in 2018 – he also felt fit and healthy, enjoyed hiking and staying active. But three years later he suffered a heart attack, and during his stay in hospital was diagnosed with type 2 diabetes.
‘How on earth did I let that happen? I am a doctor,’ he says, adding that he only ever received one invite, ‘certainly not every five years’.
‘It is very easy to ignore yourself and think you are healthy,’ he says, ‘but these things can turn around and bite you.
‘I don’t know if having the check would have affected my outcome, but it may have done and that’s a hard lesson to learn.
‘In life, you need to look after yourself and take some responsibility. So you should really make a point of asking for the check-up.’
Campaigners are now calling on the Government to take action to fix the system.
‘The Government has an opportunity to think more radically about how we can better detect and prevent cardiovascular disease,’ says John Maingay, director of policy and influencing at the British Heart Foundation. ‘This could help countless more people to live longer, healthier lives, while simultaneously boosting the economy.’
Former civil servant Diane Reeve, 73, has been trying to get an appointment for months after her husband had to have a triple heart bypass. She says: ‘I have never been invited for a check-up, but my husband’s condition focused my mind so I sought one out.’
She first tried her GP, who said no, then the NHS directly, followed by her local council but was still unable to get one.
‘It has been really disappointing that I have not been able to get an appointment, and it really shouldn’t take this much effort to get one,’ she adds.
She was told by Lincolnshire County Council that her GP surgery, Hawthorn Medical Practice, ‘does not currently hold a [health check] contract with the council’ and so she wouldn’t be able to get an appointment.
Less than two miles away, patients at another GP surgery, Beacon Medical Practice, are offered the health check. Data shows the council has signed up only half of the local GP practices to the health check scheme.
After The Mail on Sunday approached Lincolnshire County Council for comment, a spokesman said: ‘Under future arrangements we will be able to offer NHS health checks to everyone eligible.’
A Department of Health and Social Care spokesman said: ‘We recognise that there is more to do to improve this programme.
‘This Government is committed to taking action on preventable, deadly diseases. We have begun to pilot comprehensive heart health checks in workplaces, and we are developing a digital version of the check to provide an even more accessible and convenient service for people.’
