Is a private health MOT for men really worth the money?
This is all a bit different to the last health assessment I had nine years ago. Back then it was just a couple of blood tests and a weigh-in. Now I am in Bupa’s flagship West End health centre, going hell for leather on a watt bike, while a nurse with a clipboard demands to know how exhausted I feel on a scale of one to 10. I am attached to a heart monitor and there is a jumbo television screen upon which my cardiovascular performance data flickers and fluctuates before my eyes. Meanwhile, The Telegraph’s photographer points his lens into my big, red, sweaty face. I tell the nurse I’m at level 5. But she can tell I’m lying. The truth is, I feel like I’m going to throw up.
Like many men, I was rocked enough by the King’s recent cancer diagnosis to start reflecting more carefully on my own health. My last health MOT was in spring 2015, just after I turned 40. It was simple, straightforward and didn’t involve me having to change into a tracksuit. Mind you, the results weren’t great. My blood pressure had shot up, my cholesterol was high, I was overweight and I was pretty miserable. The only good thing about the whole sorry episode was that it helped me to discover the single culprit for all of my woes: alcohol. I was drinking about four times the recommended weekly units of booze at the time. The nurse told me that cutting down would go a long way to solving all of my problems. I went one better and quit booze completely and – she was right – everything did get better.
Now I am almost 50 – still sober but starting to drift back into the sort of health anxiety I thought I had conquered. As a middle-aged bloke, there are numerous reminders of exactly why and how you might be about to get sick: not least the stats. Men between the age of 50 and 67 are more than three times more likely to die from heart disease than women. Men are 60 per cent more likely to develop cancer in their lifetime and 70 per cent more likely to die from it. Men are more likely to develop both type 1 and type 2 diabetes than women. Type 2 diabetes most often develops in people over 45.
It’s a bleak picture and one I am reminded of daily. The algorithm bombards me, via social media feeds, with reminders to take out life insurance, to talk to my mates about mental health, to get my prostate checked, to take vitamins and sign up for a ParkRun. All good advice, but often accompanied by commercially driven reminders of just how perilous it is to be a middle-aged man.
With all this in mind I signed up for Bupa’s Be.Ahead health assessment: which features 14 “core tests” covering fitness and mental health, as well as standard blood tests and examinations. The price is steep £1,069 (full disclosure: my test was arranged by Bupa’s press office free of charge). For that I will have 120 minutes of tests and consultations with a health adviser plus an hour with a GP who will review my results in detail. Plus, I will walk away with a detailed health plan, and get continuing online and phone support from Bupa experts for a year. Not included are blood tests for kidney function or testosterone levels, both of which Bupa were happy to arrange as extras (at a theoretical extra cost of £49.50 each).
The day starts with a range of tests with the charming and personable health adviser, Marila, who asks a series of lifestyle questions – around diet, exercise, vices, etc – and a bit of family health history. She takes my blood pressure on both arms and connects me to a heart monitor. My weight, height and body fat are measured and I am taken through a few light flexibility, strength and balance exercises.
After a half-hour break, I am invited to sit down and discuss my results with a GP, Dr Michael Hefferon. One of the advantages of undergoing private tests is the speed with which the blood results come through: Dr Hefferon is able to talk me through them in great detail, less than an hour after the needle left my arm.
If anything, there is too much detail for me to take in, but the summary seems to be pretty good: my blood tests come back normal, my blood pressure is fine, my heart rhythm is nothing to worry about. My body mass index (BMI: weight divided by height) is high but my waist-to-height ratio and body-fat levels are normal.
I undergo quick, uncomfortable but painless prostate and testicular exams, both of which give me the all-clear (as does a PSA blood test, a measure of prostate cancer risk). I also undergo an HbA1c blood test, which finds my blood sugars to be normal. Compared to others in my age range, my results suggest a 2.7 per cent chance of developing type 2 diabetes in the next 10 years. I am given a kit with which to collect a stool sample back at home, which is then submitted by post and assessed for signs of colon cancer. A few days after the MOT I get an online update giving me the all-clear.
Further blood tests aimed at identifying other specific cancers do not come as part of this general MOT, but Bupa does offer separate cancer-screening packages.
Dr Hefferon is part doctor, part mate at the pub, part Instagram fitness influencer: he fuses all of his clinical dialogue with practical tips on building strength, burning fat and eating better. The health report he sends me afterwards includes a huge amount of useful apps, articles and YouTube videos on all of these subjects and more. It’s fascinating and pretty entertaining stuff – certainly more engaging than a dreary leaflet on how to get your five-a-day.
Finally, I climb onto the watt bike and do my VO2 max test (the “V” stands for volume, the “O2” for oxygen). It’s a progressively difficult cycle session that assesses the maximum amount of oxygen consumed during extreme exercise. It’s considered the gold standard in measuring endurance and an indicator of a person’s longevity. As someone who exercises regularly, I have high hopes that I will smash all expectations and wow the assessment team but, disappointingly, my results were just “good” rather than “brilliant”. Oh well. All of my results seemed to say the same thing: “no red flag yet, but don’t get cocky”.
I am due another NHS health test with my GP, which will of course be free. This will assess many but not all of the risks covered by the Bupa MOT. There are fitness tests, heart-rate variability tests, mental-health assessments and even sleep-pattern assessments with the Bupa package that give a more rounded picture of my overall health and lifestyle.
So is it really worth it? Not all doctors think so. “You don’t need an expensive health assessment to get a sense of your fitness,” says Dr Maragret McCartney, a GP and academic at the University of St Andrews. “You can just get a heart-rate monitor of your own. The truth is that some of these tests can cause more harm than good, such as patient anxiety or even despondency.”
The NHS provides free screenings throughout a patient’s life. Decisions about what tests are carried out, when and on whom are made by the UK National Screening Committee (UK NSC), the independent scientific committee that advises the NHS and government about all aspects of screening.
The NHS website explains: “The UK NSC only recommends a screening programme if it is confident that high-quality, peer-reviewed published evidence shows that its benefits would outweigh any harms. It assesses the evidence for screening against internationally recognised criteria.”
The question is whether all of the tests included in Bupa’s £1,069 mega-package are strictly necessary. False negatives are possible; so too are false positives, which often pass the burden of further investigations on to the NHS.
“I think private providers should carry the cost of any treatment once they’ve discovered a problem,” says Dr McCartney. “Extensive screening is always likely to throw up some small problem that might not necessarily have become a serious issue but nevertheless becomes a cost for the NHS to deal with.”
She uses the example of the prostate-specific antigen (PSA) blood test, which Bupa uses to check for possible prostate cancer. The NHS does not routinely use the tests as it is regarded as unreliable (raised levels can often be a sign of a urine infection or benign enlarged prostate).
My score comes back fine, but Dr Hefferon took care to warn me in advance of seeing my results that a raised PSA is not necessarily anything to worry about. Nevertheless, had my tests results been more worrying, I would have gone back to my NHS GP for further investigation. Similarly, Bupa tested my heart for atrial fibrillation, a condition that causes your heart to beat in an irregular way. At present, the UK National Screening Committee does not recommend a national screening programme for atrial fibrillation (AF) because – according to its website – “there are different types of AF and it is not clear if these all have the same risk for stroke; it is not known how effective treatment for AF is in people found through screening. It is not known if screening is more beneficial for people with AF than the current approach to detection and management.”
While this context is explained to me at Bupa, I would have certainly sought further investigation had my results been irregular. It could be argued that this might have put unnecessary strain on the NHS but also caused me unwarranted anxiety.
Dr Hefferon (who works with both the NHS and Bupa) says they are careful to avoid unnecessary treatment. “We try to be very measured and discourage our patients running back to the NHS to swamp them,” he says. “We always communicate the scale of any problem very carefully.”
Having spent all of those hours under Bupa’s microscope, I suppose I felt slightly short-changed to be told there was nothing wrong with me. But what I was really seeking was reassurance and convenience, both of which the Be.Ahead tests provided. Just by spending a day reflecting upon and discussing my health with professionals, I came away feeling somewhat more positive about life. They say you can’t put a price on peace of mind. Well, Bupa has, and it’s just over a grand.
