Invited debate: response to Waterall et al.

The Public Health England (PHE) paper by Waterall et al. is strong on good intentions but weak on evidence. In truth, the NHS Health Checks programme is a failure. We respond to each substantive point raised by Waterall et al. Introduction We agree that the burden of premature cardiovascular disease and death is enormous, inequitable and potentially preventable. We also strongly agree that population-wide measures can be powerful, rapid, equitable and cost saving. We therefore commend the PHE emphasis on policies such as salt reduction, five a day, smoke-free legislation, plain packaging, alcohol MUP and inequalities. Sadly, these aims are effectively upstaged by the continuing PHE emphasis on NHS Health Checks (NHSHC). That downstream strategy fails conceptually, scientifically, economically and practically. The NHSHC programme was launched in 2009, yet visible gains remain absent. …