Medical Matters: Imagine combining your late night shopping in Tesco with a visit to a doctor in the shopping centre.
Or getting off the bus or train on your way from work and calling into a health service commuter centre which offers treatment for minor illness.
These were just some of the proposals put forward by British Health Secretary Patricia Hewitt last week when she published a white paper, New Direction for Community Services for the National Health Service (NHS).
As part of a general shift of healthcare to the community and away from hospitals, consultants in specialities such as dermatology and orthopaedics will be expected to conduct outpatient clinics in community hospitals and clinics.
But perhaps the most radical proposal is for the NHS to offer patients a human version of the NCT at five different points throughout their lives.
People will be asked to fill in a questionnaire about their lifestyle and their family's medical history.
If the self-assessment shows that they are at high risk of heart disease, diabetes or other health problems, they will be invited to a face-to-face consultation with a personal health trainer.
This NHS Life Check will enable the health trainer to set goals for improving patients' diet and increasing the exercise they take. It will initially focus on children and people approaching their 50s and will be piloted in the most disadvantaged communities to begin with.
So is this an idea the health service here should consider? Would we all benefit from a health check to assess our fitness at five different points in our lives?
Assuming the personal health trainer offered specific help with diet and exercise, what evidence is there that this would benefit our health? We know that obesity levels are rising, with almost one in five of us clinically obese and many more people overweight.
Obesity doubles the risk of coronary heart disease, stroke and type 2 diabetes mellitus. It increases the risk of developing certain cancers, musculoskeletal problems and contributes to loss of function and mobility. So tackling obesity by means of exercise and improved diet makes sense.
In my experience it is the exercise component of this equation that gets neglected when a patient resolves to do something about their weight.
A skilled personal trainer could make the difference between success and failure.
Thirty minutes of at least moderate intensity physical activity a day on at least five days a week significantly reduces the risk of heart disease, stroke and diabetes. It helps to improve a number of risk factors for cardiovascular disease, including raised blood pressure, "bad" cholesterol and insulin resistance. Regular physical activity also prevents falls in older people.
Nor do you have to wait long for the benefits of exercise to kick in. A recent study in the department of physiology at Trinity College Dublin found that cycling at a moderate rate of 30 minutes three to four times a week produced a significant drop in blood pressure after only two weeks of activity.
Physical activity is also associated with a reduction in the overall risk of cancer and offers definite protection against developing colon cancer. Certain exercises can alleviate low back pain and physical activity in later life can delay the progression of osteoporosis.
Exercise is even good for our mental health. A recent report by the UK Mental Health Foundation said: "Exercise has been associated with reduced anxiety, decreased depression, enhanced mood, improved self-esteem and body image, as well as improved cognitive functioning."
With such strong evidence for the general benefits of exercise and lifestyle change, why does last week's proposal for the introduction of health checks in Britain make me uneasy?
Firstly, I am concerned with the nature of the research quoted by Ms Hewitt to back the proposal. Apparently more than three-quarters of 1,000 people who took part in a citizens summit in Birmingham last year said they would like a regular health check. This does not represent scientific evidence; rather it smacks of a pop-psychology approach to healthcare. Where is the evidence for the cost-effectiveness of this particular idea?
The nanny-state aspect of the proposal also rankles. Admittedly, the health check or subsequent appointment with a personal trainer will not be compulsory. But some subtle pressure will be put on people who are obese.
They are not causing harm to anyone other than themselves; should we not respect their autonomy? And will the scheme risk creating a large group of worried well who will become dependant on the health system?
Lack of exercise, poor diet and obesity are probably better dealt with at a public health level. The Department of Health should wait for evidence of the effectiveness of the UK scheme before introducing any similar proposals here.
Dr Muiris Houston is pleased to hear from readers but regrets that he cannot answer individual queries.