Health rationing 'imposed on lifestyle deviants': Doctors are withholding treatment from smokers unless they quit, Equal Treatment group claims at campaign launch

DOCTORS are withholding treatment from growing numbers of smokers and other 'lifestyle deviants' unless they promise to give up cigarettes and change to a healthier way of living, it was claimed yesterday.

At a press conference held at the House of Lords to launch a campaign for equal treatment in the National Health Service regardless of whether people smoked, drank or had other unhealthy habits, Lord Harris of High Cross, chairman of Forest (Freedom Organisation for the Right to Enjoy Smoking Tobacco), said that some medical procedures were now 'subject to a doctor's opinion of the patient's lifestyle.'

He said that doctors were urged to delve into every aspect of a person's life, suggest programmes to 'correct' what was wrong, and set up at-risk registers which could be used to decide who 'is worthy of treatment.'

Last August a man died after he was refused treatment for a heart condition because he was a heavy smoker. Harry Elphick, 47, had a heart attack in February but was told by consultants at Wythenshawe hospital in Manchester that tests to show if he needed a by-pass operation were not carried out on smokers. Mr Elphick quit his 25-a-day habit but died a week before he was due to see doctors again.

Other cases have since emerged as some hospitals and consultants formalise a policy that many have had in operation for several years. The introduction of the NHS internal market has highlighted rationing of health care, and raised fears that some patients will lose out because of lifestyle factors that may affect the success of treatment.

Speaking yesterday at a rally organised at the Department of Health in London by the group Equal Treatment in the NHS, Antoine Clarke, a campaigner, said that drug addicts got better treatment than smokers. Harry Chathli, one of the rally organisers, said he knew of eight cases of people discriminated against because they or their relatives smoked.

In a letter to the Secretary of State for Health, the group called on Virginia Bottomley to condemn this form of discrimination as a 'fundamental breach of the principle of the NHS which promises free and equal access at the point of need.' Signatories to the letter included John Belcher, a former president of the Association of Cardio-Thoracic Surgeons of England and Wales, the NHS Patients' Campaign and smokers' support groups.

The campaigners said: 'the freely chosen lifestyle of a patient is an unacceptable means of determining eligibility for medical tests and treatment.' Many illnesses could seen as self-inflicted, they argued: 'Would you countenance the refusal of treatment for patients with Aids, or venereal diseases? Or illnesses caused by too much alcohol or over-eating? Or those with injuries sustained during sporting activities?' The cost of treating sportrelated injuries is pounds 590m compared with around pounds 440m for smokingrelated illnesses, they said.

Dr Kenneth Calman, the chief medical officer, last night rejected the claim that smokers face discrimination but said doctors needed to take into account whether or not a patient smoked when deciding the best course of treatment. In a statement, Mrs Bottomley said 'It is, always has been, and will remain, a matter for the professional judgement of the clinician involved, how and when to treat his or her patient.'

Passive smoking may cause 4,000 deaths from lung cancer in the European Community each year, scientists warned yesterday at the launch of European Week Against Cancer.