'Health MOT' for every patient in Britain

The National Health Service is to offer every patient in Britain a personal diet and fitness regime among its radical measures to force individuals to take greater responsibility for their own health.

The National Health Service is to offer every patient in Britain a personal diet and fitness regime among its radical measures to force individuals to take greater responsibility for their own health.

"Personal health plans", which could also offer advice on sexual activity, are the centrepiece of the Government's forthcoming White Paper on public health, details of which have been leaked to The Independent on Sunday. Far-reaching proposals will include plans to screen children to identify those at risk of becoming obese.

The controversial measures amount to an unprecedented intervention by the state into private individual's lifestyle choices and are sure to revive the charge of government "nannying". Ministers stress, however, that the individual health improvement programmes will be voluntary.

Patients will be set specific goals monitored by their GP only if they volunteer for what has been dubbed a "health MOT", say officials. Theyenvisage family doctors setting goals and giving guidance on weight loss, fitness and sex as part of plans due to be fully in force by 2008.

Progress will be monitored by email, where possible, to reduce the pressures on GPs. A new telephone service, Health Direct, will offer specific health promotion advice.

Ministers plan to use the launch of the document on 10 November to signal a sea-change in NHS priorities. "From now on we are going to see a "national service for health", not just a National Health Service," said one source. "Everything is going to be geared towards preventing illness."

Officials envisage family doctors setting goals and giving guidance on weight loss, fitness and even sexual activity as part of the plans. Still to be decided, however, are measures allowing local authorities to ban smoking in the work place in the White Paper, scheduled for publication on 10 November. John Reid, Secretary of State for Health, is understood to be resisting pressure led by Matthew Taylor, head of the No 10 policy unit, to include a ban.

Speaking to The Independent on Sunday, Mr Reid signalled that he would resist any move to replicate bans already imposed in Ireland or New York.

He said: "I have to try to balance the health questions with lifestyle, cultural and learn from others, what we can't do is just transpose others' legislation."

Tony Blair has made public health the focus of NHS policy because of the spiralling cost to the taxpayer of so-called lifestyle diseases such as cancer, heart disease and some forms of diabetes.

An official report by Sir Derek Wanless warned that such conditions would cost the NHS an additional £30bn a year unless people became "fully engaged" in their own health. Sir Derek recommended that the Government help individuals to take more responsibility and that it do more to educate people about the consequences of their lifestyles.

However, doctors' leaders last night warned that the "personal health plans" could be "gimmicky" and ineffective. Dr Hamish Meldrum, chairman of the BMA's GP committee, said: "We will want to study any plans very closely. It could be that these plans are of limited effectiveness, they could be a little gimmicky."

Dr Margaret McCartney, a GP in Glasgow, said: "The only people you are going to get wanting these plans are the worried well. Those that most need a chat about lifestyles are the least likely to volunteer."