Isabel Oakeshott Deputy Political Editor
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PATIENTS who are overweight or smoke should be denied operations until they are fitter, the health secretary has declared.
Patricia Hewitt says it is right for doctors to order individuals to lose weight or give up cigarettes before they are treated.
In an interview with The Sunday Times she described the move as “best practice” because operations are less likely to succeed on people who are very fat or smoke heavily.
It is the first time the health secretary has explicitly endorsed the policy, which has been adopted by some health trusts.
Hewitt said the government wanted to see people taking greater personal responsibility for their health. But patients turned down for surgery because ofunhealthy habits should immediately be offered help to change their lifestyle.
Doctors are concerned that the policy could be exploited by some NHS trusts to save money. They also question the criteria that will be used to judge an appropriate weight for surgery. About one in five adults and 16% of children have a body mass index (BMI) of over 30, the level considered clinically obese.
Hewitt said she supported thetrend of GPs and surgeons to make decisions about whether it is appropriate, and safe, to operate on smokers or patients who were so overweight.
She said: “What I’ve been seeing . . . is more and more health centres and GP practices focusing on that kind of support. They will say to patients, you shouldn’t have this operation until you’ve lost a bit of weight and stopped smoking.”
Her comments are in line withguidelines published a year ago by the government’s drug rationing body, the National Institute for Health and Clinical Excellence (Nice). However, Nice emphasised that doctors should not discriminate on the grounds that a disease was self-inflicted.
Hewitt said it would be “dreadful” to deny treatment on the grounds that patients were to blame for their condition.
The type of operations likely to be refused to the overweightare hip and knee replacements, while smokers could be denied heart bypasses.
The British Medical Association described a BMI of 30 as a “rather low” threshold and warned that hospitals must not make judgments on financial grounds. A spokeswoman said: “We would not want to see blanket rules. What about people who diet down from a BMI of 40 to a BMI of 30 would they still be denied surgery?”
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Why is it that people harp on about their right to free health care, and do nothing to maintain their own health. Surely it is firstly the responsiblity of each individual to look after themselves. You cannot smoke in moderation as with eating and alcohol, because the safe limit of smoking is zero. I am fed up with smokers bouncing in and out of hospital expecting to be offered heart bypasses and other cardiac treatment just to be discharged to carry on with the habit that brought them in in the frist place and will continue to bring them in - what a waste of NHS money.
I don't think first treatments should be refused, but if smokers refuse to quit, the situation should be reviewed.
LJ, bristol, uk
At a mere 15 years old, even I find this completely ridiculous; out of interest, what gave her the ability and the right to want to play God?
What about in a life or death situation? This whole idea is just going to snowball; the NHS are most probably going to take advantage of the idea to save money and people are going to end up dying...
Did she come up with this statement because obesity and smoke-inflicted illnesses are self-inflicted? I'd bet that she wouldn't deny drunk drivers an operation to save their life.
Aaaargh this makes me really mad...
Kryssy, Bedford, UK
This is disgusting- not only that but by extorting so much from smokers!! And soon from the overweight with fatty food tax!
Now dictating lifestyle choices! Nu Labour need to go as soon as possible!
Charles, London,
I was absolutely disgusted when I read this and immediately one of my siblings came to mind. Her husband has had severe depression for many years and she has looked after him and brought up a family. She has also worked as a carer for over 20 years looking after the vunerable in society. She is overweight and smokes to relieve the stress she is often under. Hewitt and her kind would deny her treatment because of the latter, despite the fact that she has paid tax, NI contributions, and saved this government thousands by caring for her husband. These people realy are dispicable and want removing from office as soon as possible. When did Doctors ditch their oath in favour of PC fads, I assume that the above dictate will also apply to drinkers, sports injuries and anyone else that takes a risk. The word facist springs to mind - Hewitt should be renamed Cruella
Disgusted, Derby, UK
Ms Hewitt should be congratulated on her moral stand but surely the principle she embraces can be extended further. Others have rightly mentioned drug users. What about refusing treatment to those suffering from sexually transmitted diseases contracted outside of marriage? Those infected with tropical diseases acquired during needless foreign travel? Those suffering from injuries obtained from dangerous sports & pass times? More to the point, those evidently needing mental health care indicated by their being members of the Labour Party?
pj, london, england,
That is outright theft. I have paid my contributions over the years like everyone else (not to mention excessive tobacco tax to boot which have been used to subsidise the health care of others). Please send me a cheque by return so that I can make my own health care arrangements. Do it tomorrow please, before you resign and return home to Australia taking your fundamentally amoral socialist ideas with you.
Alan, Devizes, Wiltshire
This is a travesty when will politician and GP's get off their high horses they are paid for by both smokers and non-smokers alike and therefore should not dictate to people about legal choices.
In fact if one considers the amount of tax that smokers pay you could actually argue that smokers subsidise both MP's and GP's for the rest of the population and therefore deserve a better level of care.
Would anyone want to have to make up the difference in Tax of everybody stopped smoking?
James , Surrey, UK
I believe there are about 60 million people in the British Isles, give or take a few. How many of these actually smoke? Are smokers really to blame for the ill's of the world? How about giving the drinkers a good kicking for a change. I am sure A and E would be a lot quieter at the weekends if they didn't have to deal with the fall out from most town centres. Also, the thousands of Police officers who patrol the town centres at the weekend aren't there incase someone sparks up a Malboro light are they. Sort the binge drinkers out and you may even get a Policeman walking past your home once in a while what with the town centre being so quiet and all......
Glyn Young, Bolton, England
Do government ministers not realise that the HIPPOCRATIC OATH states that all persons will be treated regardless of how they carry out their lives.
Doctors should be well aware of this oath as they swear it on graduation.
D. W. Kerr, Den Haag, Holland
"Hewitt said it would be dreadful to deny treatment on the grounds that patients were to blame for their condition."
She had to say that just incase someone suggested that those who take part in sporting activities were refused treatment. Way back in the late 1990s estimates of the costs to the NHS for sports injuries were close to those for treating smokers yet they do not provide any extra taxes to fund Government's excesses.
It's about time this Governmnet stopped listening to its highly paid 'experts' and listened to job-experienced experts such as E Burgess from Slough.
Hewitt is advocating a possible sanctioning of euthanasia for smokers and the obese. Their risk of death through a delay of medical intervention is far greater than any risk of harm from her exaggerated claims for second hand smoke.
The smoking Bill will only kill Community whereas the policies above are sure to kill people.
cdb, Cornwall, UK