letter to GMC and Health Committee

Dear Sir Terence and Dr Wollaston

 

I note that the GMC does not just offer private healthcare insurance to its’ staff, but also BMI Healthcare Health Screening.

 

My concerns are

 

1) BMI Health Screening offers screening for diabetes, urinalysis, breast and testicular awareness, renal  and liver function tests, ‘gout’ test (a misnomer in the asymptomatic) , Chest xrays, lung function tests, resting ECGs, breast examination, PSA, bowel FOB testing outwith the UK National Screening programme, etc.

 

2) These are not offered by the NHS because they are not evidence based screening programmes.

 

3) The cost of dealing with the false positives falls to the NHS. The Govermental response to the Science Committee’s report on Health Screening has shown no willingness to deal with this issue more generally.

 

4) The costs are therefore to the NHS, but also to the doctors who pay for the GMC. I do not wish to pay for anyone to receive harmful, non evidence based interventions , yet I am forced to do so if I wish to practice medicine in the UK.

 

5) Furthermore, over the last decade I have repeatedly raised concerns about the misleading advertising for screening tests in the private sector whose services are directed or owned by GMC registered doctors. I have been told that only if I can prove harm will you take action. In screening it is very difficult to prove harm outwith RCTs.

 

6) I am concerned that these decisions have been biased by the perceptions of non medically trained GMC staff who have made decisions about who to refer for FTP investigations, because these lay assessors may not have had the information that the screening they have received was ineffective and with potential harms.

 

7) I therefore am calling on the GMC to review this practice and their previous decisions not to investigate some doctors whose advertising for private health screening, run outwith the UK NSC guidelines, has been questionable, or where their adverts have been banned by the ASA.

 

8) I would also like the Health Committee to consider this problem when the GMC is next held to account.

 

I would be grateful for your response.

 

yours sincerely

Margaret McCartney

 

Reply from the GMC, missing the point really

 

Dear Dr McCartney

 

Thank you for your e-mail about healthcare screening which is offered to staff who chose to take private insurance sent to Professor Terence Stephenson. I have been asked to reply on his behalf.

 

The provision of BMI Healthcare screening for our employees is part of a range of benefits that help us recruit and retain high quality staff  and support their wellbeing.

 

The screenings do provide an opportunity for health promotion, disease prevention and access to appropriate screening that our staff may not normally consider undertaking.  BMI are clear that the testing undertaken is done on the basis of clinical assessments, with doctors taking decisions on removing or adding tests on a case by case basis. We regularly review the benefits we offer and BMI advise that they are currently undergoing a thorough review and we expect that what they offer will change over the next year. This includes for example an intention to bring intervals for mammography in line with national screening guidelines.

 

I do agree that it is very important to ensure that what we offer as an employer in this area is in line with good practice and your e-mail was a helpful reminder of the importance of this. We are considering how to enhance our arrangements for monitoring and reviewing the arrangements we have in place.

 

With regard to the provision of private medical screening and complaints to us, I can assure you that we do not have a pre-determined position on any complaint we might receive. Where complaints are made that reach our threshold for investigation, we will investigate and our senior decision makers, lay and medically qualified, work within our statutory process and with clear guidance in reaching decisions on these complaints. We are confident that the provision of health benefits does not in any way affect the impartiality of our staff.

 

Yours sincerely

 

Neil Roberts

 

 

 

5 Responses to “letter to GMC and Health Committee”

  1. Samir Dawlatly March 5, 2015 at 2:35 pm #

    Well said!

  2. Keith Walker March 7, 2015 at 4:45 pm #

    To me, what is really dumb is using “normal” ranges for screening tests that 1 in 20 people will fall outside. As shown by the population data on which the ranges are based.

    Do a number of tests and the chance is you’re “abnormal” on one of them.

    Seems to be leading to a lot of unjustified intervention. We would never do this in industrial testing, where pointless interventions are costly and may make things worse. But that’s because we would go bust quickly. Without a government bail out. Enough said really.

  3. Andy Finucane March 7, 2015 at 7:47 pm #

    Well said Margaret! Every week I am dealing with some “abnormality” from one of these private health care “checks”. Yesterday a 78 year old with a borderline low creatine and the week before an appointment was made by a 45year old with a borderline low urea! Both clinically irrelevant, but nevertheless both took up an NHS appointment. And GP colleagues report similar appropriation of NHS appointments to discuss spurious biochemical results. By definition even if every test was 100% accurate, “abnormal” results will be generated for patients whose result falls 2 standard deviation from the mean and thus 4.2% of results will be in this range (assuming a normal distribution).
    Health screening companies MUST take responsibility for the auctioning of these results, including the expertise to help patients understand the clinical significance of the result. If this means writing to the NHS GP for a background medical report, then GPs must charge for this “service”; otherwise this is an inappropriate appropriation of NHS resources.

  4. Dr sue milroy March 21, 2015 at 3:08 pm #

    I have become very angry that all g m c posts come advertised with inclusive axa PPP health insurance. Why should I pay for this…. Angry doctor of London….

  5. Dr sue milroy March 21, 2015 at 3:10 pm #

    Look into why all gmc posts come with Axa PPP health insurance……I’m really angry about that…

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