Titled: NHS could refuse patients who will not mend ways

Patients who refuse to change their unhealthy lifestyles could be refused medical treatment, under proposals from the Government's NHS watchdog.

The controversial suggestion from the National Institute of Healthcare and Clinical Excellence would mean that a smoker in need of heart surgery might be denied the operation unless he or she promised to give up the habit.

The proposal is contained in a document which sets out for the first time the social values that should underpin decisions by the institute on which treatments to provide on the NHS.

It says all patients should be treated equally regardless of their age or social responsibilities and rules out discrimination on the grounds of gender, race or socio-economic status.

The only exception should be where a patient's age might affect the chances of success of the treatment. "Health should not be valued more highly in some age groups rather than others," it says. On self inflicted illness - that caused by "unhealthy lifestyles", such as casual sex, smoking, drinking or dangerous sports - it rejects the idea of "deservedness" in deciding who should receive treatment and says it would be impossible in many cases to determine which illnesses were self-inflicted.

It adds: "If the self-inflicted causes of the condition influence the likely outcome ... of an intervention, it may be appropriate to take this into account." A spokesman admitted there was a "grey area" between denying treatment on clinical grounds, because a patient might not benefit from it, and "blackmailing" them to change their behaviour in line with medically accepted health norms.

Let this serve as a warning for Americans. This is what national health care will get us. If or when it is put into place it will not take very long for the bureaucratic bean counters to determine that it is certain life styles that are driving up the costs of health care. Therefore anyone who doesn't live up to their standards of good health will be refused or forced to pay a very high premium. Some of you may be OK with that but I'm not. Those of us who take personal responsibility seriously better be able to opt out and have the option to make our own medical choices. And don't even get me started on the huge cost to taxpayers such a system will be.