Doctors who ban surgery for smokers are right, says nanny Hewitt

Patricia Hewitt, the Health Secretary, has given her blessing to the policy of denying operations to smokers until they kick the habit. Endorsing a position adopted by some health trusts, the minister also voiced support for doctors who order patients to lose weight before treatment.

Mrs Hewitt said she backed the increasing number of doctors who make decisions about whether it is appropriate and safe to operate on smokers, or patients who are significantly overweight.

"What I've been seeing. . . is more and more health centres and GP practices focussing on that kind of support," she told The Sunday Times. "They will say to patients, you shouldn't have this operation until you've lost a bit of weight and stopped smoking."

However, she added that it would be "dreadful" to deny treatment on the basis that patients were to blame for their condition. Hip and knee replacements are among the operations likely to be denied to those who are overweight, while smokers could miss out on heart bypasses.

The Health Minister's views on the issue, which mirror those of a growing number of medical experts, are based on what she describes as "best practice" – because operations are less likely to be successful when the patient is very fat or a heavy smoker.

However, some doctors have expressed concern that the stance could be used by some NHS trusts as a means of saving money, while others have questioned the criteria that will be used to judge an appropriate weight for surgery.

The two sides of the argument were outlined in a debate published last month in the British Medical Journal.

Prof Matthew Peters, the head of thoracic medicine at the Concord Repatriation General Hospital, Sydney, Australia, claimed that five non-smokers could be operated on for the cost of four smokers, and that their outcomes would be better.

However, Prof Leonard Glantz, of Boston University School of Public Health, in Massachusetts, said: "It is shameful for doctors to be willing to treat everybody but smokers in a society that is supposed to be pluralistic and tolerant."

A policy of encouraging smokers to give up the habit before they are granted operations was put forward last year by hospital managers in Norfolk and Newcastle-under-Lyme, Staffordshire, where Health Service trusts are millions of pounds in debt.

The Norfolk trust explained the move by saying that smokers are at increased risk of complications and take more time to recover from surgery, meaning they have longer and more expensive stays in hospital.

Smokers, however, described the policy as blackmail, pointing out that they pay taxes along with non-smoking citizens.

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/02/12/nsmoke12.xml
(If anyone is reading from the Times, your website update last week is painfully slow and content updates lost.)

The intrusion by the politically correct nanny Hewitt to find more ways of rationing NHS services had an unusual result last year.

Health Direct posted on Wed 30 Aug 06 in Call for IVF ban for obese, but young, smoking lesbians may win IVF postcode lottery when very obese women should be denied IVF fertility treatment, experts say. The British Fertility Society is recommending women with a body mass index of 36 and over should not be allowed access to fertility treatment.

Underweight women and those classed just as obese (BMI over 29) should be forced to address their weight before starting treatment, the society said. NHS guidelines say overweight women should be warned of the health risks, but do not impose any ban on treatment.