Public health expert calls on MSPs to axe universal breast screening

Universal breast cancer screening should be scrapped in favour of a targeted programme, a leading public health expert has told MSPs as she also advocated a tax on junk food and subsidies for healthier options.

Dr Helene Irvine called for more investment in GP services rather than in the screening programme and said she believes the "entire NHS is at risk because of the progressive disinvestment" in GPs, questioning how they could be expected to detect cancer early due to lack of funds.

Giving evidence to Holyrood's Health and Sport Committee on breast screening and other health initiatives, she said: "It should be looked at, and anybody who looked at it objectively would conclude that it wasn't a good idea to do it at a universal level.

"So targeted screening should be considered for high-risk women where the return for the effort and the risks incurred are lower, therefore the cost-benefit ratio is better.

"The idea that we spend vast sums of money on something like breast screening that exposes all the women age 50-70 to radiation every three years generates a huge false-positive rate, has a very high screening-to-life-saved ratio, and yet we dis-invest progressively in the GPs seems to me a bizarre approach."

Dr Irvine said legislation rather than education is key to preventing people developing health problems, and she said she would legislate on salt, sugar, fat and junk food and would "regulate the amount of salt that's allowed to come out the salt shaker in the chippy".

She added: "I think we should be taxing junk food and subsidising fruit and vegetables and wholewheat bread. Imagine if it was 15 pence and white bread was £1.20 - a lot of people would eat the wholewheat bread."

GP Dr Margaret McCartney also called for targeted breast screening, saying over-diagnosis causes "harm" to patients.

She said: "I'm really interested in putting resources where they work. I think if we don't have evidenced-based policy making we are absolutely sunk in the NHS. I'm really worried that we are throwing good money after bad again and again and again."

The committee also heard concerns over the Scottish Government's four-hour accident and emergency target.

Ms Irvine said she supported the target when it was introduced but now feels it has "outlived its usefulness" and a redirection policy would encourage less "abuse" of A&E services.

Consultant paediatrician Dr Una MacFadyen told the committee the target "seems illogical on its own".