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30.04.12

‘Lifestyle rationing’ supported by doctors

The majority of doctors believe the NHS should have the right to withhold non-emergency treatment for smokers and obese people who do not alter their lifestyles, according to a new survey.

Of 1,096 doctors who took part in the doctors.net.uk survey, 54% supported measures to deny treatment to patients in these groups; something that has been strongly opposed by patient groups and other healthcare professionals.

Unhealthy behaviours such as smoking and obesity can make certain procedures less likely to work, and the magazine Pulse found that 25 out of 91 PCTs have introduced treatment bans for these people since April 2011.

Dr Tim Ringrose, Doctors.net.uk’s chief executive, said: “This might appear to be only a slim majority of doctors in favour of limiting treatment to some patients who fail to look after themselves, but it represents a tectonic shift for a profession that has always sought to provide free healthcare from the cradle to the grave.”

Dr Clare Gerada, chair of the Royal College of General Practitioners, said “It’s the deserving and undeserving sick idea. The NHS should deliver care according to need. There was no medical justification for such restrictions on smokers, as giving up nicotine would not necessarily enhance an operation’s chances of success.”

However, she admitted that obesity can make operations more dangerous, making it ‘medically legitimate’ to withhold treatment from some very overweight people. She reiterated that this “should not be done for social reasons”.

A spokesperson for the Department of Health agreed that in some circumstances there are clinical reasons to ask a patient to take action before surgery, but added: “There is no excuse to deny care on the basis of arbitrary blanket bans – the individual needs of patients must be taken into account.”

Tam Fry, spokesman for the National Obesity Forum, said: “There’s no way that someone who is obese can be denied initial treatment by the NHS – that would be totally unjustified. There are many reasons why people are fat and gluttony is only one of them. The NHS should not be discriminating against fat people purely on the grounds of their fatness. That would be a denial of their basic human rights.”

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