There is a huge fuss in the UK about the NHS refusing treatment to fatties and smokers:

The NHS has been accused of trying to save money by blocking access to surgery for smokers and obese patients as new figures show how they are routinely being denied treatments.

Data shows that more than a quarter of Primary Care Trusts in England have brought in new restrictions based on patients’ lifestyle criteria in the last year.

It reveals that people are being denied IVF treatment, breast reductions and fat-loss operations based on their weight and whether they smoke.

In the case of one trust, NHS Hertfordshire, a controversial ban imposed last year on knee and hip operations for anyone with a body mass index (BMI) over 30 as well as smokers, has been extended to cover all routine surgery.

The new Hertfordshire policy, introduced in January, makes exceptions only for neurology, cardiac and cancer operations.

Freedom of Information responses from 91 PCTs, obtained by doctors’ magazine Pulse, show 25 have brought in new restrictions on treating obese patients or smokers since April 2011.

Good, this is called consequences to actions. No one forces you to smoke or stuff food in your gob to excess, it is only right that precious health resources should be given to  people who don’t deliberately poison themselves or eat themselves into oblivion.


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  • Jonlynn

    hmmmm I do agree that we should all be aware of consequences and try to be responsible for our actions however,  this is a slippery slope………… What next? Whites before blacks perhaps? Vegetarians over carnivores? Blondes before brunettes?   Ahhhh shades of Nazi Germany I fear! As we know there are many kids brought up on poor diets surrounded by drugs, alcohol etc  and they are really being set up to a life of ill health. Was it their choice? Was it their choice to be conceived in a vat of alcohol which predisposes them to drink later. We now know that things the mother is exposed to get through to the growing fetus. Tobacco, marajuana, alcohol, coffee, junk food, spicy foods etc, priming them to find them ‘attractive’ if not addictive, later in life. Why is it ok for us to have our bodies polluted by chemicals prescribed or pumped into buildings(so called air-fresheners)? I am not a smoker or over weight but I feel that treating people who do and are, like criminals, not deserving of health treatment, is so hypocritical and inhumane. Look at the numbers of people who suffer from the side effects of prescribed drugs and surgery/medical treatments gone wrong. !!!!!  If they want to save money they could start by charging an insurance payment to visitors and making it impossible for people to fly there just to have babies and get free treatment.
    Worth some ‘healthy’ debate ;-)))
    Cheers, Lynn

  • Blokeintakapuna

    Totally agree WO – it’s called personal responsibility!

    As for Lynn above – children don’t smoke and as adults they still have self determination and the ability to decline putting excess foods into their mouth’s.

    It’s not rocket science!

  • Andrei

    Going to apply the same criteria to homosexuals anal fistulas and stds?

    And what about the money that is spent on curing “unplanned pregnancy”? 

    Oh no these are sacred cows – the lefty rulers only are going to punish people who do things they disapprove of.


    • Auto_immune

      Lefty rulers? Last time I checked it was the tories who were driving cost efficiencies in the NHS.

    • You seem to have a weird fixation on homosexuals Andrei

  • Mark

    I find the attitiude rather suprising. While we’re about it I assume we are to refuse medical treatment to those suffering from depression or any mental illnesses on the basis they tend to have much higher health costs. And after all they should just snap out of it and get on with their lives. The trouble with socialised mediciine is you always run out of money and end up rationing. So there is always going to be pressure on like this. In this country the additional taxes paid by smokers more than cover there additional health costs, and maybe for obese people a better solution would be to provide bariatric surgery before they get too obese and can’t work anymore and before they are too obese to have the operation?

  • AnonWgtn

    Nothing new actually – it’s been policy of many hospitals for many years.

    • Richard McGrath

      Dead right there. Individual DHBs tend to fix their own thresholds for treatment, often excluding people from waiting lists. Then they crow about the shorter waiting lists!

  • mara

    So no abortions then; unsafe sex. No skin cancer removals; too much sunbathing. No alcohol related illness or accident treatment; obviously a boozer. I could go on.

    • Richard McGrath

      No reason why the patients shouldn’t be able to purchase these services in the private sector.

  • James

    Fine….then the NHS should refund these peoples tax component. No service no pay.

    • Richard McGrath

      I agree. Give everyone the chance to purchase health care outside the one-size-fits-all NHS.

    • Mr_Blobby

      You’re assuming that these morbidly obese people are in paid employment. My guess is most if not all are on a sickness benefit.

  • Lesterpk

    While I generally agree, a BMI of above 30 would exclude most of the All Blacks from qualifying for surgery there, hardly example of bad unhealthy living.  Richie McCaw at 106kg and 187cm + BMI of 30.3  Methinks something around a BMI of 35 would be a better cut off level.

    • Richard McGrath

      Measuring skin fold thickness and % body fat is better than BMI.

  • Kthxbai

    Obese patients and smokers are vastly higher anaesthetic risks, the obese especially.  People who are obese and smoke have compounded risk.

    IVF is pretty fruitless in significantly overweight and obese women – the success rates frankly suck compared to perfomring IVF in women in the normal weight range.

    So if you are weighing risks and benefits of a procedure for an individual patient, the risk/benefit ratio is vastly tilted if the person is obese and also if they smoke.  General health is also taken into account in assessing the potential benefit a person could get from a procedure.

    So it’s not discrimination, just good medicine.

    And as for the All Blacks having a high BMI, no-one would regard them as obese.  BMI is a blunt instrument and needs to be backed up by examination.

  • Richard McGrath

    Privatising healthcare would solve many objections to the NHS policies. Having people purchase medical insurance with premiums based on individual risk, or having people band together as a co-operative and purchase group medical insurance, as some iwi groups have done (and as friendly societies used to do, and still do, for their members) are solutions that will work for many. In a free market there will also be charity and low cost health care. The answer is to remove politicians from the equation.

  • ConwayCaptain

    Make health insurance compulsory and tax deductable.

    • Lesterpk

      It virtually is that way in Aussie.  If you earn over $80K IIRC correctly and dont have private insurance you get charged an extra %age on top of the Medicare levy.
      Also, if you dont have private insurance by age 30, when you do join you pay a loading based on age at joining.  Having just moved here at age 39 it sucked.

  • Blam

    One may argue that Smokers have been subsidising beds to keep old people alive through added tax

    • Mr_Blobby

      Agree smokers are taxed $2 for every $1 they cost in healthcare plus they die earlier saving on super. Unless they all give up smoking then the rest of us will have to pay. Smoke them if you got them I say.

  • Steve P

    If – if – there is some justification for the denial of medical treatment on etiological grounds, then it is not a decision to be made by medical personnel (which seems to me to be unethical anyway), and certainly not on an ad hoc or region-by-region basis.

  • Boss Hogg

    Have a talk to an Anaesthetist about obese people.  The risks in surgery go through the roof from what I understand and they don’t like killing people – makes a lot of paper work.

    Healthy people make better patients – strange that.

  • Steve p

    How many patients have there been in the Otara Spinal Unit as a result of rugby?

    So should we: ban rugby, or deny treatment to those who are injured playing rugby; “You knew the risks!”

    • Gazzaw

      Steve, rugby and most sports have very significant health benefits. How many deaths per year from rugby? One maybe two? How many serious spinal injuries? Ten, twenty, thirty?

      The annual death toll from smoking related diseases is 4300-4600 and you can bet your bottom dollar that every one spends a lengthy time occupying a hospital bed & not just once either.   

      What sort of fucktard knowingly inhales lethal toxins and then expects the other 80% of the population to wait in line for a hospital bed or theatre space while we wait for them to die.

      • Steve P

        So medical personnel (or someone) has to come up with some calculus that weighs up the aggregate health benefits of an activity against the negatives before deciding whether an individual “deserves” health treatment?

        A few thousand people are somewhat fitter as a result of playing rugby, does that make those severe injuries “worth” it? How on earth would you calculate that? Actually, people get fit *in order* to play rugby (and it’s mostly social rugby, so people booze up after the match – what about the social cost of that?), wouldn’t we all would be better off if people just did the getting fit part and left out the playing rugby part? The “benefits” of rugby to NZ are more social than health related.Someone walking to the dairy to get some ciggies is hit by a car as they cross the road – does walking (good) cancel out smoking (bad)? You see how ridiculous this gets?As others above (and even Cullen) have pointed out, smokers pay more in tax than they cost the health system – plus they do us all a favour by dying younger and not being superannuitant burdens – doesn’t that entitle them to even a little bit of healthcare?And what about other costs to society. If everyone rode motorbikes instead of driving cars the country would save billions in buying oil from overseas, so the gummint should be encouraging everyone onto motorbikes – but motorcyclists have to pay many times more in “user pays” ACC than car drivers. AFAIK amateur rugby players don’t pay anything in ACC.