Gordon Brown's New Year commitment to cardiovascular screening is a firm step in the right direction - upstream towards prevention - and although we've heard this kind of thing from government before, this time I get the feeling they really mean it.

But are they merely proposing to extend and diversify the opportunistic risk assessments already undertaken in general practice and increasingly in high street pharmacies (perhaps through a personal voucher scheme), or are they intending to establish a full national cardiovascular screening programme with all the quality assurance that would imply?

Either way, the new set-up must not increase health inequalities and must ensure accessible services are in place to support people found to be at high risk. Telling someone they've got high cholesterol, blood sugar or blood pressure without proper lifestyle advice, ongoing support and preventive treatment is bordering on the unethical.

Doing the tests is easy - providing effective ongoing management much less so, and doesn't come cheap. We need many more practice nurses, community dietitians and exercise co-ordinators. Dietary advice and exercise schemes must be greatly expanded and sustainably funded to have any meaningful impact and reach those who most need it - which means clear directives to commissioners, robust performance assessment and quite a big chunk of funding diverted from acute services.

I can't wait to hear what Alan Johnson has to say about all this later in the year.

Alan Maryon-Davis is president of the Faculty of Public Health.