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Heavy drinkers, smokers and obese people could be denied hospital treatment
The chair of the National Institute for Health and Clinical Excellence (NICE), Sir Michael Rawlins, has said that doctors could be issued with new guidance permitting them to refuse to treat patients with illnesses deemed to be ‘self-inflicted’.
Heavy drinkers, smokers and the obese could be denied treatment but there is also concern that the definition of self-inflicted illness could stretch to conditions such as sport injuries if not clearly outlined.
Speaking to The Sunday Times, Sir Michael said that the new NICE guidance would ensure that the limited National Health Service (NHS) budget was well spent.
Using alcoholics as an example, Sir Michael said that NICE’s new social value judgements would make it clear that, if a patient continued to drink, they would not be given a liver transplant as it would not be “a sensible use of resources”. He further asserted that this would not be punishing alcoholics, rather that it was “pointless spending all that money and using a liver that could be used for someone else”.
NICE, which merged with the Health Development Agency earlier this year and exists to provide national guidance on promoting good health and treating illness, published a draft set of code guidelines in September.
According to the draft, care cannot be withheld simply on the grounds that a condition is self-inflicted. The draft states: “NICE and its advisory bodies should avoid denying care to patients with conditions that are, or may be, self-inflicted. If, however, self-inflicted cause(s) of the condition influence the clinical or cost effectiveness of the use as an intervention, it may be appropriate to take this into account.”
The draft of the report is due to be debated next week while the final NICE report should be published within a couple of weeks. Today, NICE would not comment further on Sir Michael’s interview and declined to offer any further information about self-inflicted illness guidelines.
Sir Michael’s comments follow last week’s announcement by the East Suffolk Primary Care Trust (PCT) that obese patients would be no longer be able to have knee and hip replacement operations on the NHS. Consultants and GPs agreed not to refer anyone with a body mass index of more than 30 to a specialist until they have lost weight.
According to a recent poll of more than 400 doctors by Doctors.net.uk, one in five doctors admitted that he or she has already denied patients treatment because they are obese, smoke or drink heavily. Details: www.nice.org.uk or www.patients-association.org.uk