"I just don’t know what to do anymore, I’m scared that if I do end things he will actually make himself sick so as to not let it end sort of thing?"
Wow! You think he will refuse to let you end the relationship. Refuse. 'Not let it end' is the words you used but what you mean is REFUSE.
It's not his call. If you want to end this relationship you can. If he wanted to end the relationship and you didn't, he could. A relationship needs the agreement of both parties. If you don't agree any more, it is over. Let's face it - it is already over, you just haven't told him yet
.
You care enough about him to not want him to make himself sick but - give that some thought. What kind of sickness would he deliberately inflict on himself in order to control you? Because that's what we're talking about - control. Would you actually care as much about him if he went to that extreme to maintain control over you? And any 'sickness' - well it'll just be words, same as now.
Look at what else you've said, about YOUR life -
"sometimes I stay out all day or try and stay over at friends houses because I can’t be arsed coming home to listen to how sick he feels or watch him lie there with a hot water bottle but then if his friends ring him he will spring right up to the pub!"
Your life, any any enjoyment of it, is being curtailed by his behaviour. His enjoyment of his life - I'm not seeing any curtailment there. He springs right up and embraces it. Whilst you avoid your own home.
There is a saying, 'If you do what you've always done, you'll get what you've always got'. You've tried being sympathetic (in the first year). You've tried not offering sympathy since. You've tried crying. None has brought any change to his behaviour. If you stay with him, this is him - this behaviour of his is what you will ALWAYS get. So you now have to do something different if you don't want that. And I think you already know what it is, and it is to split up. It is entirely reasonable to do so. Whether or not he agrees makes no difference. You absolutely would be right to end this relationship. It has become downright harmful to your mental health.
Oh, and as for "apart from his many ailments he is a good man, loving affectionate loyal" - well, no - he isn't a good man. A good man does not damage his partner's mental health. A good man does not make his partner dread going home. A good man does not respond to his partner crying with continuing to claim he's sick whilst mysteriously never going to the doctor. He is NOT a good man. He is a manipulative drain on your mental resources. A parasite, if you will.
"Would the ultimatum of counselling & or blood tests at the gp or It’s over be fair enough here or would that make me a horrible bitch"
Absolutely fair enough. Not horrible in the slightest. You haven't tried this before and it might work. But be prepared for him still to weasel out of anything, and to carry through ending it with him. He's driving you down, you can't let that continue.