Mr. Neil Johnson:

My understanding is that very little is carried out. There is not a formal strategy for testing. In fact, one can question what tests would be done if, for example, a person was presenting to their GP and what is covered under the GP contract. There is a clear lack of opportunity for some holistic cardiovascular assessment.

It might be a bit of a cliché to say that we refer to the health system or health service, but, actually, it is a sick system. I do not mean that disparagingly. The focus is on treating the sick. What is missing is a preventative healthcare system. That needs to permeate across primary and secondary care. I referred to the idea, which could perhaps be evaluated from a cost-effectiveness point of view, that there would be significant value in carrying out annual mini-cardiac checks on those aged 60 or older, although that might to be too late. I am not talking about comprehensive, heavy diagnostic equipment. Matters such as atrial fibrillation, heart valve disease, heart failure and hypertension can be detected through low-cost intervention. One will not be able to prevent the condition if it has been detected, but if it is caught at the right time, one can halt or slow its progression and thereby reduce the health impact on the individual and the economic impact on society and, potentially, a more active and healthy ageing population with people living longer.