There was a particular question on BBC’s Question Time last week (4th December) that especially caught my attention. The question was:

“Why should smokers and obese people be denied routine surgery because of their way of life?”

This refers to NHS Devon’s decision to restrict surgery for those who are obese and/or smoke. You can read a BBC report on this here. Essentially what is happening is that the NHS in Devon have a huge deficit (reportedly £14.5 million) and have to make cuts. Among these cuts is restricting surgery to those who are obese (a BMI of 35 or above) until they have lost 5% of their weight, and to smokers until they have given up for 8 weeks. This restriction does not apply to emergency surgery.

As we learn on level 2 and 3 fitness qualifications, muscle is heavier than fat, and someone with a well-developed musculature can easily have a high BMI but be perfectly healthy. I have a high BMI, but I also have a ‘normal’ fat percentage, a respectable hip:waist ratio and am otherwise fit and healthy – would I be denied surgery if I lived in this area? I am by no means muscle-bound, so what about finely-tuned athletes and those that devote much time to developing their musculature? Is this a ‘blanket’ policy applying to all, or are there exceptions?

I fully understand the additional risks and costs associated with obesity and smoking, and fully appreciate that savings have to be made. But still can’t help feeling this is a slippery slope – just my personal opinion. A friend of mine believes that these are self-inflicted and other people should not have to pay (through taxation) for their over-indulgence and personal habits. This may be true of some, but what about the inactive, for example? A sedentary lifestyle is also a risk factor for many conditions – what if there was a ruling there would be no treatment for those who didn’t meet the minimum guidelines for physical activity? He would certainly fit into this category, and a sedentary lifestyle is also self-inflicted.

I believe our NHS is an amazing institution and hate to say anything negative about it; but I do hope this restriction does not become the new ‘norm’ and adopted in all areas.