Is a check-up on your health such a good thing for your wealth?

Choose carefully where you go for your health assessment says Thea Jourdan. Some will charge for tests that are unnecessary

As Britons become more conscious of health, a growing number are undergoing regular body MOTs to make sure their engines are still ticking over nicely. But an annual overhaul can be an expensive business. Free yearly health checks on the NHS are available to patients only over 75. Everyone else has to pay to have their cholesterol profile and haemoglobin levels monitored.

As Britons become more conscious of health, a growing number are undergoing regular body MOTs to make sure their engines are still ticking over nicely. But an annual overhaul can be an expensive business. Free yearly health checks on the NHS are available to patients only over 75. Everyone else has to pay to have their cholesterol profile and haemoglobin levels monitored.

Bupa's most popular assessment, which takes 90 minutes, costs £365 for men and £395 for women. Their top of the range check-up comes in at a staggering £810, £860 if you include a mammography. Despite the expense, Bupa, the largest private health-provider in the UK, estimates that demand for assessments rose by 16 per cent from 2001 to 2002.

So, is a body MOT a wise investment? The Scottish Executive thinks so. Plans for a national network of health checks for men were unveiled last year in a drive to reduce the number of Scots who die prematurely from stroke, cancer and heart disease.

Employers are also keen on the idea, and many offer regular health checks as perks. Duncan Littlefair, the human resources operations manager with the construction giant, Taylor Woodrow, says all 4,000 of their full-time workers get free regular checks. "Our employees' wellbeing at home and at work is crucial to our business success." he says. "These tests are proactive and if there is a problem, they can make sure the problem does not worsen. They find these checks very reassuring."

Dr Johan du Plessis, clinical director of the private health walk-in centre Casualty Plus, agrees most patients are seeking reassurance that all is well. "Most of our clients want to make sure. They may know someone who has had a health scare or just read about something in a paper. They are happy to pay for peace of mind."

As demand grows, the choice grows. Basic tests which check height and weight, cholesterol levels and blood pressure, cost £100. The most expensive tests, which including X-rays, scans, and electron beam tomography to check heart function can cost ten times as much. Complementary diagnostic tests are also becoming more popular. Dozens of alternative health clinics now offer a full range of screens including bio-resonance tests to check energy levels, and hair analysis to reveal vitamin deficiencies. In some centres, it is even possible to have orthodox investigations alongside alternative diagnostic tests.

Dr Rajendra Sharma is the medical director of the Diagnostic Clinic, which is one of the few centres to offer orthodox and complementary screens together. "We find that many people want to get a complete picture of their health," he says. "Orthodox screens can tell you where you are now, but complementary medicine can pick up problems that may develop in the future." This kind of overview does not come cheap, at £330.

Many clients complain that they have found it difficult to make an appointment with their GP. In fact, family doctors are not obliged to perform diagnostic tests on demand, although they can order specific tests if a patient has developed worrying symptoms. The average appointment time is just 6.2 minutes, according to the Patients Association, so lengthy examinations are out of the question.

A worthwhile health check should always start with a full patient profile and medical examination. A doctor should be on hand to answer questions that may arise from the assessment. The vast majority of people should only need the "core tests" which include resting blood pressure tests, blood and urine analysis and check of lung function. Cholesterol tests should always be differential, because there are good and bad forms of cholesterol. Older people or those with previous health problems or genetic predisposition to a specific disease may need further tests and this should be explained to them. Test results should be analysed by a doctor and a written report should be sent to a physician.

At least, if you pay, you can expect quick results. Casualty Plus, based in London but soon to open nation wide has a laboratory on site, so most of the test results can be reported the same day. BUPA Wellness, with 32 assessment centres in the UK, also offers same day results. Over stretched NHS laboratories can take six weeks.

There are some caveats, however. When it comes to private health screening, pick your centre carefully. Some clinics may put profit before good practice and suggest a battery of unnecessary tests and scans. It is easy to waste hundreds of pounds on inconclusive tests, which require even much more expensive and fruitless investigations. "It is a case of buyer beware," says Alex Oaks, founder of the Diagnostic Clinic in London. "We reckon that around one percent of our patients need a scan and we don't push unnecessary tests on people. If people have any concerns at all, they should always run things past their own GP."

Oaks would eventually like to see a symbiotic relationship developing between NHS family doctors and private diagnostic clinics. "We are not competing with GPs. They are specialists in their area and we are specialists in ours. The fact is that the NHS cannot afford to be proactive, so people will always have to pay for this kind of service. I would like to see the day when every surgery has a diagnostic clinic next door." He believes that prices will come down as the market picks up momentum. "We have already reduced our rates since we opened last May, due to greater demand. It is all to do with economies of scale. When we open out own lab and roll out our product on the high street, costs will drop considerably."

But for a basic health check with minimum fuss, you can always test yourself. Over-the-counter kits measure choles- terol levels, glucose levels and dipstick tests for urine. These tests are quick and confidential and as reliable as clinic tests . Blood pressure monitors cost between £30 and £60. If the home kits suggest you have a problem, make an appointment to see your GP

'If free tests started at 65, NHS would save money'

Chris Shirley, 52, is a company director based in London."I went for my first check-up six years ago," he says. "A good friend had been diagnosed with bowel cancer and six months later he was dead. It brought it home that you could appear to be fit, but be really ill. We used to go running together and he always beat me."

Mr Shirley is clear about how a check-up fitted his needs. "I lead a healthy life. I have four children so I run all over the place. I don't smoke and I drink the equivalent of two glasses of wine a day. I also manage an under-12s football team called the Kensington Dragons, which keeps me very active.

"For my last check-up, I decided to pay extra for the Premier health assessment. I was given the results immediately and they were all fine. I don't regard it as a waste of money.

"I don't spend much time thinking about my health, so this was a good way to focus my mind on nutrition and healthy lifestyle. The doctor examined me and a nutritionist gave me advice about my eating habits. Bupa offers a speedy, reliable service and I am lucky to be able to afford it.

He does have views about what the state should do. "I think people over 65 should be able to have check-ups on the NHS. The limit of 75 is too high. If the Government brought in free health checks for this age group, they would probably save money in the long run."

'I'd Rather Take A Break At A Health Farm'

Dr Fay Wilson, a GP working in a busy practice in Birmingham, says: "Most of my patients usually see me when they have a specific problem.

"I will order appropriate tests after I have been told the symptoms. If someone wants a full health overview, I will usually refer them to the practice nurse.

"Even then, they are likely to have only their blood pressure taken, their weight and height recorded and a urine test." NHS surgeries are not obliged to do a battery of tests on request and most do not have the time. You cannot even offer your GP money to do the tests because GPs are not allowed to charge their NHS patients.

Dr Wilson points out that the best your doctor can do is refer you to a private clinic or a private doctor who can perform a health check-up.

"A better option is to visit a NHS walk-in centre. There are more than 50 around the country and you do not need an appointment. The doctors there give lifestyle advice. Otherwise, I advise people to ring NHS Direct if they want reassurance. They can tell you if you need to be screened".

Dr Wilson is sceptical about tailor-made health check-ups: "I do not think that they are necessary. If you are a relatively fit and well person, a bucket-load of blood tests and an ECG is highly unlikely to uncover some underlying problem. These tests can be very expensive and the costs can quickly mount if you are told results need further investigation. People should be careful that they don't waste their money.

"Complementary diagnostic tests can also be expensive and there is no scientific evidence that they work.

"If someone is happy to spend the money, fair enough, but I would much rather have a relaxing break at a health farm."

FACT FILE WHAT'S ON OFFER

BUPA: Patients do not have to be BUPA members. Core tests include cholesterol profile blood test, urine analysis and diabetes blood test. A same day report is issued for the majority of tests.

Premier Health Assessment: £495. (£535 for women.) Takes two to three hours. Includes 37/8 core tests.

Classic Health Assessment: Takes one- and-a-half hours. Includes 36 core tests.

Key Health Assessment: £250. Takes one hour.

Wellwoman Health Assessment: £190. Takes one hour. Includes 32 core tests and a cervical smear. www.bupa.co.uk Tel: 0208 901 5505.

CASUALTY PLUS: This walk-in centre treats 1,000 patients a month. People who want diagnostic tests need an appointment, but can usually be seen on the same day.

Basic Health Assessment: £150.

Full Health Assessment: £350.

Wellman: Basic charge of £140.

Wellwoman: Basic charge of £145.

www.casualtyplus.co.uk. Tel: 08456 777999

THE DIAGNOSTIC CLINIC: Offers orthodox and complimentary diagnostic tests. Choose either or mix the two.

Orthodox screen: £330. Takes one-and-a-quarter hours. Includes physical examination,blood, urine and stool tests. Women can have a cervical smear and breast examination. Men a rectal and testicular examination.

Complementary and alternative screen: £330. Takes one-and-a- quarter hours. Includes blood analysis and tests internal organ energy levels. Also tongue and pulse diagnosis and an assessment by an osteopath and hair analysis to measure mineral levels.

Integrated screen: £595. Takes two-and-a-half hours. This is a combination of the above screens.

www.thediagnosticclinic.com Tel: 0207009 4650