Health police to urge couch potato Scots to visit GP

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Key points

• Health minister to announce new policies recommended by report

• Health boards will have to identify people at risk and get them to clinics

• Policies criticised for cost and ‘Big Brother’ attitude

Key quote

"If we are going to take the public with us on this there needs to be very sensitive implementation around these changes" - Shona Robison, SNP health spokeswoman

Story in full A "NO-ESCAPE" plan, which will see unhealthy Scots in deprived areas face door-step pressure to visit their GP is to be at the centre of the Executive's moves to improve the nation's health within two decades, ministers are set to announce today.

Andy Kerr, the health minister, will accept the key recommendations of cancer specialist David Kerr for the future of the NHS in Scotland.

Central to the report is the idea of "anticipatory care", or searching out the nation's couch potatoes before they end up in hospital. Health boards will be asked to identify "at risk" members of the community and ensure they attend a clinic if they have not done so. This is likely to be through sending out "health police" to identify those at risk.

Mr Kerr will also endorse the report's emphasis on community-based care, especially for the chronically sick and elderly, and more safe and sustainable local services.

However, the report also recommends centralising certain specialisms, such as neurosurgery, in order to improve training possibilities.

Doctors have welcomed the Kerr report. However, there are concerns about cost, training enough staff to carry out the ambitious plans and a "Big Brother" attitude to patients.

Prof Kerr's report came after a spate of protests over the closures of local hospitals.

Shona Robison, the SNP health spokeswoman, said the Executive must take on board a key part of the report - which is to consult fully with the public. "If we are going to take the public with us on this there needs to be very sensitive implementation around these changes," she said.

Perhaps the most likely target for protests will be any changes to emergency services in Scotland. Prof Kerr recommended minor injuries be treated in the community instead of having large A&E units, effectively downgrading many units.

He will call for more preventative health measures for all, but especially in deprived areas such as Shettleston, in Glasgow, where people's life expectancy is up to ten years shorter.

At present it is unclear how the plan will work, although Prof Kerr has talked about a new breed of health workers going into the community to persuade people whose lifestyle could lead to high cholesterol and blood pressure to visit a doctor.

Andrew Walker, a health economist at Glasgow University, was more cautious about anticipatory care. He said anti-smoking services had worked but other methods, such as sending health workers into the community, have not been tested.

The Executive has insisted that implementing the Kerr report will be cost neutral, but Mr Walker, who advised the report, added: "I would strongly suggest this is going to put additional cost pressures on the NHS not lead to cost savings."

Mairi Scott, head of the Royal College of GPs, welcomed the idea of targeting people in poor areas, but said doctors would need more resources.