We’re all aware of the massive cost of obesity and smoking on society – both financially and to our health and quality of life. Both smoking and obesity pose some of the biggest risks to public health; causing increased risks of a multitude of illnesses including cancer, heart disease, strokes, diabetes and lung disease. It’s estimated that smoking can reduce life expectancy by up to 9 years, while obesity can shorten lives by up to a massive 14 years.
As well as the huge health risks, both smoking and obesity put extra financial strain on overstretched health services. It’s estimated that the NHS in the UK spends an estimated £16 billion a year on obesity related illnesses. That’s more than the country spends on police and fire services combined. With pressure on the NHS to save money, is it right that they should cut services for obese patients and smokers? Or are the plans putting the public at risk?
Cuts to NHS Services
Following all the recent cuts to NHS Services, the health service in Hertfordshire has now announced a new policy which aims to “to support patients whose health is at risk from smoking or being very overweight.” Under these plans, obese patients and smokers would no longer be eligible for routine or non urgent surgery on the NHS. However the NHS also claims that “exceptional clinical circumstances (will) be taken into account on a case-by-case basis.”
Patients using the NHS in Hertfordshire are being advised that in order to qualify for surgery, they will have to improve their health by reducing their BMI or stopping smoking. Patients will have 9 months to reduce their BMI by 15% if it’s over 40, or by 10% if it’s between 30 and 40. Smokers will have to go 8 weeks without smoking, which will be checked by health professionals by a breath test.
Effects on Patient Care
With an increasing need to improve public health, are these plans reasonable? Or are they putting patients at risk? A recent survey showed that 85% of the public agreed that those with high BMIs should be encouraged to lose weight, and that smoker’s should be asked to stop. Government figures also show that 63% of adults in Hertfordshire are overweight or obese, and 15% are smokers. It’s thought that these plans will encourage healthier life choices in patients.
Hertfordshire practitioner and Chairman Dr. Hari Pathmanathan claims that “The consultation proposals were developed by local (general practitioners) and public health doctors, with the best interests of the whole patient population of our area in mind. We understand that some of our patients will have to make changes and they will be supported to do so, for example with the free weight-loss and stop-smoking advice sessions already on offer,”
Opinions are split amongst professionals however, with the senior vice president at the Royal College of Surgeons in the UK, Ian Eardley stating in a recent interview that “Singling out patients in this way goes against the principles of the NHS, “This goes against clinical guidance and leaves patients waiting long periods of time in pain and discomfort. It can even lead to worse outcomes following surgery in some cases.”