He said he wanted a more “personalised” NHS with a bigger focus on prevention.

Doctors’ representatives accused the PM of “inconsistency” because of recent cuts to funding for such conditions.

The plan comes as Mr Brown seeks to regain the political initiative and counter David Cameron’s bid to claim the Tories are the party of the NHS.

In a speech in London Mr Brown outlined plans for more diagnostic tests in GP surgeries, such as blood tests, electro-cardiograms and ultrasounds to cut waiting times.

It remains one of the most trusted organisations in British society, its doctors, nurses and staff recognised by everyone as a force for good in our country. Gordon Brown Analysis: Brown’s blitz Will screening work?

Mr Brown said: “There are 200,000 deaths a year from heart and stroke disease.

“Many of them, indeed probably most of them, avoidable if we did the right things.”

He said screening for those was “only the start” with extended screening for breast cancer for women, preventative vaccines against cervical cancer and “far more” being done in relation to aneurysms.

“The whole nature of this is that the health service has really got to change in its next 60 years from being the curative service – where it’s done so much good – to being also a preventative service and one that’s not simply a uniform service, but personal to people’s needs,” said Mr Brown.

“So you get to see the doctor you want at the time you want and the hospital you want, but also a health service organised around your needs and at the same time, of course, the preventative work.”

Take up

Initially the tests will be available to the most “vulnerable”, and money has been set aside to pay for the procedures in the health budget for 2008-11, said Mr Brown.

No-one can argue against a greater focus on prevention but this smacks of tinkering Nick Clegg Lib Dem leader In full: Brown’s NHS speech

He said the government planned to use advertising to “persuade people” to take the tests.

In his speech, Mr Brown said: “The next stage is offering men over 65 a simple ultrasound test to detect early abdominal aortic aneurysm… the weakening of the main artery from heart to abdomen which kills over 3,000 men a year – and this will eventually save more than 1,600 lives each year.”

He said Health Secretary Alan Johnson would set up plans to introduce a series of tests to identify vulnerability to heart and circulation problems.

Vascular screening, to be introduced this year or early in 2009, would include a series of blood, fat and sugar tests in GP surgeries.

Reform

The prime minister said “renewal” of the NHS would be the government’s highest priority, adding that the aim was “deeper and wider reform” to create an NHS “that is here for all of us but personal to each of us”.

And he said patients could be given taxpayers’ money to choose their own health care, by committing himself to the principle of “personal health budgets”.

Government officials said it was initially only likely to cover patients suffering from long-term conditions – to allow them to choose the right treatment for them.

Dr Richard Vautrey, deputy chairman of the GPs committee at the British Medical Association, said: “What I do find extraordinary is just two or three weeks ago the prime minister insisted that funding be taken away from the treatment of patients with heart failure, hardening of the arteries and kidney disease – the very conditions that he’s now proposing to screen for.”

And for the Conservatives, shadow health secretary Andrew Lansley accused Mr Brown of “chasing headlines”.

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“There is no proper timetable for delivery; we don’t know where the money’s coming from but we do know that Brown has raided public health budgets,” he said.

Liberal Democrat leader Nick Clegg said evidence was needed that “this is more than just another expensive political gimmick from this government”.

“Gordon Brown is ducking the fundamental issue of overall reform of the health service. No-one can argue against a greater focus on prevention but this smacks of tinkering,” he said.

Mr Brown’s decision to make his first big speech of the year on health follows Conservative leader David Cameron’s speech last week in which he set out proposals which he hoped would lead to the Tories becoming the party of the NHS.

Firefighters and volunteer rescuers who toiled at ground zero for months after the Sept. 11 attacks will be eligible for a long-term health screening program paid for by an $81-million federal grant, officials announced Tuesday.

“Those individuals who selflessly dedicated themselves in the days and months after September 11th can rest assured that we will be able to identify any signs of symptoms that may indicate long-term illness as a result of their work,” Fire Commissioner Nicholas Scoppetta said at the news conference, held at Fire Department headquarters.

The department will get $25 million of the U.S. Department of Health and Human Services’ grant funds, which will be available to current and retired firefighters and EMS workers.

Officials said there is a pressing need to screen retirees because more than 2,000 firefighters retired after the attacks, nearly 10 times the average for a two-year period.

The screening program “is evidence that America has not forgotten,” said Sen. Hillary Rodham Clinton (D-N.Y.).

The rest of the money will be distributed to area hospitals to screen and monitor volunteers at ground zero.

Health screening can play an important role in managing your health so we are delighted to give you greater control over your health by introducing an annual health screen as part of your plan.

A health screen will assess your risk of developing cardiac problems by checking your body mass index and testing your cholesterol levels and blood pressure. It will also assess your kidney, liver and lung functions as well as provide you with advice on cancer awareness, diet and weight management, stress management and osteoporosis prevention.

Whether you need an NCT or a full service will depend on your age and general state of health, the staff at the screening centre will be able to advise you on the best type of health screen for you. For more information on the types of tests available, how they are carried out and how to understand the results please visit Health Screens – The Tests.

After your health screen you will have a health and lifestyle consultation to discuss your health, follow up on any recommendations and to develop a plan for staying healthy and in control of your health in the future.

Here are the options available with EHA:

Medixine Growth Screen

Medixine Growth Screen offers state-of the-art growth screening and consultation services to nurses working at well baby clinics and schools, to primary health care physicians, and municipal and central hospital pediatricians. These services are offered location independently and near real-time and they are supported by sophisticated auxology (growth analysis) software capable of detecting even minor abnormalities in growth. Primary health care workers will get a prompt reply from pediatric endocrinologists (using Virtual Growth Center) who are familiar with growth disorders, via a network.
The system ensures a constant high quality of assessment of growth, eliminates unnecessary examinations and speeds up diagnostic processes.

The first project, run during 2008 in the city of Espoo, is covering 60.000 children and adolescents. Nurses enter the growth and weight measurements  into the Espoo City patient management system and are then automatically transferred to the Growth Screen.  The pilot is conducted in cooperation between social and health services of Espoo city, the Helsinki University Hospital for children and Professor Leo Dunkel, providing the scientific background and growth algorithms for the project.

Benefits

• Early detection of growth problems; essential for treatment ‘on-time’
• Uniform quality of care and comprehensive screening of all children in a district
• Only real potential growth disorders are investigated further
• The automation facilitates nurses’ and consultants’ work
• Significant health cost savings expected through automation and early detection and treatment of growth disorders

OBJECTIVE: Jails have a substantial legal obligation to provide health and mental health care for inmates; yet screening procedures across American jails are highly variable. Currently, no valid, practical, standardized tool is available. The study reported here sought to validate a revision of the Referral Decision Scale (RDS)—the Brief Jail Mental Health Screen (BJMHS)—which provides an even briefer and more practical tool for use in jails. METHODS: Valid BJMHS data were collected in four jails (two in Maryland and two in New York) from 10,330 detainees. A total of 357 detainees were also administered the Structured Clinical Interview for DSM-IV (SCID) for standardized clinical cross-validation: 125 detainees (74 men and 51 women) who were classified as referrals for further mental health assessment on the basis of BJMHS and 232 detainees (137 men and 95 women) who were not classified as referrals. RESULTS: The BJMHS takes an average of 2.5 minutes to administer. It correctly classified 73.5 percent of males but only 61.6 percent of females on the basis of SCID diagnoses. Overall, the BJMHS identified 11.3 percent of screened detainees for further mental health assessment. CONCLUSIONS: The BJMHS is a practical, efficient tool that jail correction officers can give male detainees on intake screening. However, the screen has an unacceptably high false-negative rate for female detainees.

(Which? is the UK Consumers’ Association)

Two experts in public health assessed screening services offered by the top three private health providers and two independent private clinics. They concluded there’s little evidence to back clinics’ claims that paying through the nose for a medical ‘MOT’ is key for future health.

While screening tests sometimes detect future problems, and sometimes people will benefit from early treatment, the danger lies with those that give inconsistent results and little useful information, and those that ‘detect’ non-existent disease.

The majority of people who get positive results from health screens wouldn’t actually go on to develop the disease. False results like this cause worry, more investigations, and even unnecessary treatment – at a cost to the individual or the NHS.

There’s no evidence, for example, that routine screening for prostate specific antigen (the main test for prostate cancer) leads to a longer or better quality of life. Two thirds of men with high PSA don’t have prostate cancer, and some men with prostate cancer don’t have high PSA.

Private clinics criticised

The Diagnostic Clinic in London and The London Clinic were strongly criticised for providing inadequate information. The Diagnostic Clinic didn’t give a balanced explanation of the huge range of conventional and complementary tests on offer, or tell patients there aren’t any recognised quality standards for many of these tests. Several have actually been proven unreliable, such as a test that uses an electro-dermal device banned in the US because of a lack of scientific evidence.

Information provided by The London Clinic about the likely benefits, harms and limitations of its tests was, again, ‘totally inadequate’. There’s no evidence to support its screening procedures, and it was sketchy about how tests can actually reduce the risk of disease. It states, for example, that the pelvic examination is ‘looking for liver/ovarian or colon disease’. In fact, evidence shows this is an inappropriate method of finding such diseases.

Bupa was the best of the bunch for customer information, said to be ‘as good as the NHS.’ But again, there was little strong evidence to back up the tests’ medical benefits, while others are available on the NHS. One expert said the only advantages of going to Bupa were pleasant surroundings and the fact you’d have more of the doctor’s time than during a normal visit to a GP.

It was a similar story at BMI; client information was judged ‘very misleading’, while the claims for the screening were ‘very vague.’ For example, it ignored the limitations for mammography in women under 50. Nuffield Hospitals offered the genuine benefit of a GP helpline, which customers can access for a year after screening. Otherwise, though, the experts thought that only some of the tests would be of benefit.

Malcolm Coles, editor, Which?, says:

“In some cases, screens can have a positive impact and provide reassurance, but our experts had major misgivings about the value of paying for full-body screens. Whatever the test, it’s important that enough information and support is given before, during and after testing, but some of the clinics we looked at are giving inadequate or misleading information.”

Dr Muir Gray, Programme Director for the NHS Screening Committee, says:

“The NHS offers various free screens and can also give advice and support on various health-related issues. A major benefit of NHS screening is that you receive full continuity of care – including follow-up treatment.”

Notes to editor

For further information, please contact Martin Chapman on 020 7770 7373 or e-mail martin.chapman@which.co.uk.

Research notes

Which?’s research shows the most comprehensive full-body check each service offers, together with its experts’ verdicts on the tests. Which? asked two screening experts give their verdict on the information and tests provided by five private full-body screening services. The services include basic health checks as well as screening for particular diseases.

While screening gaps between whites and minorities seem to be narrowing in surveys where people state when they last had specific procedures, the reality may be that such gaps are widening or remaining stagnant, suggests the study, which compared such self-reports by a large group of patients against the Medicare claims filed by their doctors.

“Our sense is that probably the claims data are giving us a better picture of the true disparities here in services than in simply asking people whether they’ve received a preventive service or not,” said Kevin Fiscella, the study’s lead researcher and an associate professor of family medicine and community and preventive medicine at the University of Rochester School of Medicine. The research, published online in BMC Health Services Research, was funded by the federal Agency for Healthcare Research and Quality.

The study “highlights the importance” of using different types of data — including insurance claims, self-reports and medical charts and records — to get a accurate picture of disparities, said Ernest Moy, a senior service fellow at AHRQ who did not take part in the study.

The research was prompted by other surveys indicating that black women were getting mammograms nearly as often as white women; such data suggested that efforts to reduce this disparity have paid off. Yet racial gaps in breast cancer mortality rates persist, Fiscella said.

“That made us wonder, ‘Is this [other] data really accurate?’ ” he said. “And if so, why are [black women] dying and being diagnosed at later stages?” There are many explanations, he said, “including that the [self-reported] data may not be accurate.”

The health-care community should take heed of the new study’s results, advised Jessie Gruman, president of the Center for the Advancement of Health, a group that encourages adoption of effective medical practices.

“I think it’s very important for the health-care system and for individual providers to be very clear about their expectations” of patients, she said. “People need the information” about recommended testing well in advance of when the test is due, “and getting the test needs to be facilitated for them.”

In the study, Medicare participants were asked to recall whether they’d had certain preventive services in the preceding year. Those responses were then verified against Medicare claims data.

The study looked at more than 7,000 patients eligible for prostate cancer screening, 18,300 eligible for flu shots, 4,700 eligible for Pap smears, 10,400 eligible for cholesterol testing, 7,400 eligible for mammograms and 1,400 eligible to be screened for colorectal cancer.

Respondents were 65 and older. Most were white, with minorities representing 9 to 13 percent of each test group.

Previous research shows that people often underestimate how much time has passed since they received preventive care, according to the study.

The study found that 52.5 percent of whites who were eligible for a mammogram reported having had one in the previous year, while claims data showed 45.1 percent had actually received the test. About 45 percent of eligible non-white Hispanic and African American women reported having had mammograms, yet claims data showed only 30.4 percent had had the test done.

Further research needs to be done to see why these differences exist.

“We think there’s more social pressure on minorities [to report having been screened] because the inaccurate stereotype is that minorities don’t care about their health like whites do,” Fiscella said. “And so when a [minority] person answers that question, they are answering in the context of existing social stereotypes, [and there is] more pressure to say, ‘I’m not like that. Of course I take care of my health.’ ”

But patients’ self-reports aren’t the only issue in tracking the delivery of preventive services. Minorities are more likely than other people to use community health centers and hospital clinics, which often underestimate the volume of screening they provide, the study states. ·

Comments: paynej@washpost.com.