The electronic records already exist, although probably not in an interactive format. I am sure that such as Google could do it, and supply secure encryption through dedicated servers, for say £5billion. No, make that £5.5 billion, to include my 10%

Keith R. Jones, Nottingham, UK

As someone who has enjoyed smoking a pipe for 36 years, partaking in a perfectly legal activity, and paying a great deal of tax for the privilege – I am heartily sick and tired of being bullied by self-righteous zealots! This onslaught has been quite relentless. Now Patricia Hewitt dares to suggest that it might be all right for a doctor to refuse treatment if I do not give up smoking. Smoking is a choice as an adult, that I have decided to make, and since I pay NI tax then I am perfectly entitled to help from my doctor.

Should we refuse to treat people who have been convicted of a variety of crimes, allowing our doctor to make a judgment on which people to treat or not. Will our doctors’ and dentists’ become our moral arbiters? Shall we then start to report people that we have seen smoking in their own homes to dentists, doctors and our local police superintendent?

You can see where all this is leading can’t you? Perhaps we can ban breathing more than so many times per minute. Anyone found breathing more than their allotted share will be prosecuted!

Chris F J Cyrnik, Notts, england

At Last! Somebody with the courage and sense to state the "unspeakable" obvious. When the Managers are left to do the managing, and the politicians stick to the strategies, then MY NHS, for which I pay and is not Free, just no Extra charge at the point of delivery, then our NHS will recover from its own terminal disease.....if allowed to afford its own drug regime.

Keith R. Jones, Nottingham, UK

If a system that is costing that amount of money is not working then there must be serious planning errors. With that sum involved an immediate investigation should take place to find out if any one person or group of persons have not done their jobs properly.
The fact that this sum is equivalent to over £100 per person in the UK, makes it a far worse debacle that the original Dome programme.

Alan Challoner, Llanerchymedd, UK

Ok I smoke, I also pay a lot of tax, never claimed a benefit and served my country for 23 years as a soldier. If Ms Hewitt can choose to deny me treatment, I reserve the right to choose not to pay my taxes. By the way, is a drunk on a Saturday night not to be treated, a drug addict who overdoses. A fortune is spent on the NHS, for what? So we can turn people away because of their habits, diseases and failings.
When the government stop stressing me out with costly policies I will give up smoking.

Marcus Moosa, Winchester, Hants

This government are doing a grand job of social engineering - you have to hand it to them!! I have 2 children aged 11 and 13 - they basically eat the same things and exercise the same amount - One is about 2 stone overweight, the other is average for her height. When will HMG and the other health zealots realise that we are not just what we eat, our genetics probably have just as much to do with it. The Labour Party seems hell bent on making us into health freaks, leading lives with no risk attached. Doesn't sound like much of a life to me.
As for smoking - I could write a book about all the lies and hypocrisy surrounding this subject! Suffice it to say that if the dangers of smoking, both passive and actual, were anywhere near what their propaganda machines spurt out, HMG would have banned the product long ago!! But no - they won't do that will they? No prizes for guessing why though.

Loraine Gostling, London,

Why is it that people harp on about their right to free health care, and do nothing to maintain their own health. Surely it is firstly the responsiblity of each individual to look after themselves. You cannot smoke in moderation as with eating and alcohol, because the safe limit of smoking is zero. I am fed up with smokers bouncing in and out of hospital expecting to be offered heart bypasses and other cardiac treatment just to be discharged to carry on with the habit that brought them in in the frist place and will continue to bring them in - what a waste of NHS money.
I don't think first treatments should be refused, but if smokers refuse to quit, the situation should be reviewed.

LJ, bristol, uk

At a mere 15 years old, even I find this completely ridiculous; out of interest, what gave her the ability and the right to want to play God?

What about in a life or death situation? This whole idea is just going to snowball; the NHS are most probably going to take advantage of the idea to save money and people are going to end up dying...

Did she come up with this statement because obesity and smoke-inflicted illnesses are self-inflicted? I'd bet that she wouldn't deny drunk drivers an operation to save their life.

Aaaargh this makes me really mad...

Kryssy, Bedford, UK

This is disgusting- not only that but by extorting so much from smokers!! And soon from the overweight with fatty food tax!

Now dictating lifestyle choices! Nu Labour need to go as soon as possible!

Charles, London,

I was absolutely disgusted when I read this and immediately one of my siblings came to mind. Her husband has had severe depression for many years and she has looked after him and brought up a family. She has also worked as a carer for over 20 years looking after the vunerable in society. She is overweight and smokes to relieve the stress she is often under. Hewitt and her kind would deny her treatment because of the latter, despite the fact that she has paid tax, NI contributions, and saved this government thousands by caring for her husband. These people realy are dispicable and want removing from office as soon as possible. When did Doctors ditch their oath in favour of PC fads, I assume that the above dictate will also apply to drinkers, sports injuries and anyone else that takes a risk. The word facist springs to mind - Hewitt should be renamed Cruella

Disgusted, Derby, UK

Ms Hewitt should be congratulated on her moral stand but surely the principle she embraces can be extended further. Others have rightly mentioned drug users. What about refusing treatment to those suffering from sexually transmitted diseases contracted outside of marriage? Those infected with tropical diseases acquired during needless foreign travel? Those suffering from injuries obtained from dangerous sports & pass times? More to the point, those evidently needing mental health care indicated by their being members of the Labour Party?

pj, london, england,

That is outright theft. I have paid my contributions over the years like everyone else (not to mention excessive tobacco tax to boot which have been used to subsidise the health care of others). Please send me a cheque by return so that I can make my own health care arrangements. Do it tomorrow please, before you resign and return home to Australia taking your fundamentally amoral socialist ideas with you.

Alan, Devizes, Wiltshire

This is a travesty when will politician and GP's get off their high horses they are paid for by both smokers and non-smokers alike and therefore should not dictate to people about legal choices.

In fact if one considers the amount of tax that smokers pay you could actually argue that smokers subsidise both MP's and GP's for the rest of the population and therefore deserve a better level of care.

Would anyone want to have to make up the difference in Tax of everybody stopped smoking?

James , Surrey, UK

I believe there are about 60 million people in the British Isles, give or take a few. How many of these actually smoke? Are smokers really to blame for the ill's of the world? How about giving the drinkers a good kicking for a change. I am sure A and E would be a lot quieter at the weekends if they didn't have to deal with the fall out from most town centres. Also, the thousands of Police officers who patrol the town centres at the weekend aren't there incase someone sparks up a Malboro light are they. Sort the binge drinkers out and you may even get a Policeman walking past your home once in a while what with the town centre being so quiet and all......

Glyn Young, Bolton, England

Do government ministers not realise that the HIPPOCRATIC OATH states that all persons will be treated regardless of how they carry out their lives.

Doctors should be well aware of this oath as they swear it on graduation.

D. W. Kerr, Den Haag, Holland

"Hewitt said it would be “dreadful” to deny treatment on the grounds that patients were to blame for their condition."
She had to say that just incase someone suggested that those who take part in sporting activities were refused treatment. Way back in the late 1990s estimates of the costs to the NHS for sports injuries were close to those for treating smokers yet they do not provide any extra taxes to fund Government's excesses.
It's about time this Governmnet stopped listening to its highly paid 'experts' and listened to job-experienced experts such as E Burgess from Slough.
Hewitt is advocating a possible sanctioning of euthanasia for smokers and the obese. Their risk of death through a delay of medical intervention is far greater than any risk of harm from her exaggerated claims for second hand smoke.
The smoking Bill will only kill Community whereas the policies above are sure to kill people.

cdb, Cornwall, UK

I am absolutely disgusted by Ms. Hewitts stance. Does she plan on prounouncing other perameters as to who & when people should receive (or not) necessary medical treatments? How about those who are alcoholics - no surgeries until they have been dry for say....one year? Alcohol is as much if not bigger killer - worldwide- than smoking. So why not outlaw ALL liquors, wines and beer? After all you never know when one will become addicted. I guess it is OK to pander to certain groups with specilised wards, etc but not to the average sick British citizen. I don't smoke but I seen the self considered "morally superior" anti smoking donuts repeatedly be all out rude to smokers who are following current laws. There are many behaviours that can cause physical harms to oneself. Great Britain is becoming the PC capitol of the world - in MANY areas - few of which seem to have benefitted the British (now unbelievably having to be referred to as "indigenous" population). Thanks to the Hewitt types.

M. Lawlor, Florida, USA

My husband used to be a pack-a-day smoker, until he snapped his Achilles tendon seven years ago. Needless to say, he wasn't denied treatment and the tendon was surgically repaired. The surgeon advised stopping smoking for ten days to promote healing. For my husband, quitting for ten days was equivalent to stopping forever, and he hasn't smoked since. Apart from this happy secondary outcome of treatment, I cannot imagine anyone living in a supposed democracy being forced to spend their life with a calf muscle bunched up to the rear knee, because they have been deemed "irresponsible" and consequently denied treatment....

Nicola Will, Montreal, Canada

I am overwieght and smoke. I pay VAT, Duty on fuel, Income tax, National insurance and Council Tax. If I am not going to receive the same benefits as other people in society then I think I should get some money back.

The government have lost the plot. I think they are becoming dangerous and should certainly not serve a third term.

Andy Leonard, Leics, UK

Medical decisions should be left with medical experts, not cabinet ministers, surely?

Bewildered, Cardiff, wales

Ms Hewitt said she supported the trend of GPs and surgeons to make decisions about whether it is appropriate to operate. Thats great, thats how it should be.

But whats actually happening is that the PCT becomes involved in that decision & gives a blanket ban on patients who have a BMI of 30. This is not based on the clinicians decision or clinical need.

Steve, Stoke-on-Trent,

In principle this is a reasonable idea, but the reality is that most Primary Care Trusts do not have appropriate treatment services to offer support to people giving up smoking or trying to loose weight.
Yes, these conditions are "self-inflicted", but the research evidence shows that few people can make successful lifestyle change without support.
As someone who is trying to "build a fence at the top of the cliff" as part of my NHS role, rather than waiting at the bottom of the cliff with the ambulance, I challenge the Government to put its money where its mouth is - in prevention, in education and in support for lifestyle change programmes.

Helen , Cambridge,

The Nationalised Health Service isn't working: anything which has a captive audience that cannot vote with its feet never will. All that happens is that taxes soar, endless bureaucrats and bean counters are appointed - but services decline.

Let's have the courage to scrap the NHS and replace it with compulsory health insurance.

Gerry, Sevenoaks,

If national insurance contributions were replaced by health insurance premiums people would soon start to take notice. The healthier you are the lower your premium! fail to work and contribute to society would exculde you from the services available to hard working and contributing members of society -seems fair to me!
It's about time people took responsibility for their own lives!

peterj, aberdeen, scotland

I once weighed 18 stones which would be described as obese, given my height of 5 foot 4 inches. However, over a number of years I worked hard to lose weight and for some time now have been within my ideal weight range at around 10 stones. What a difference this has made to my daily life and never more than last year when I had to undergo an abdominal hysterectomy. My operation went smoothly and I was up and walking about the day after the operation. On day two, I was fit enough to go home. Several other women in my ward (ranging from overweight to obese) who had undergone surgery before me, were still lying in bed unable to do very much at all. Now, I know surgery is very different for individuals but I have no doubt that excess weight made their suregry more difficult, more dangerous and difficult to recover from.

People for their own sake should do whatever it takes to make successful medical treatment easier.

Angela Kilpatrick, Glasgow,

So in that case we smokers shall withhold PAYE payments to the NHS and use the money go private.

The NHS is not FREE - we have ALREADY PAID FOR IT !!!!!!

Jane, timbuktu, england

Alcohol abusers, drug abusers andpeople driving like maniacs causing accidents. They will be denied as well, I assume. Nothing wrong with promoting good lifestyle and not pouring money down the drain, but consistency will need to be applied.

Rob Pickett, Nanning, PR China

This is just another way for the government to save money, whether people are overweight or smoke should not matter if they need treatment which they have indirectly paid for via income-tax, national insurance contributions and excise duty. The government have reduced the NHS to a shambles by their mis-management of funds and incompetent re-structuring of the system.

Les, Soutport, England

i think that these medical mubo jumbo talkers think they know what they are on about when actually they are murdering people needlessly. i mean imagine a nervous family with there son in intensive care waiting for an operation which could save his life. then all of a sudden a doctor comes in and says,
'im very sorry but your son is to fat and hasnt stopped smoking yet, he is going to be refused treatment". RIDICULOUS.

Alex Novadnieks, beijing, china

Should car drivers who are involved in traffic accidents have to hand back their driving licences and sell their cars before doctors agree to treat them? How ridiculous!

Shaun, London, UK

In line with this logic sportsmen who break a limb or suffer serious injury ,due to participating in their sport, will be compelled to sign an affidavit to cease such dangerous practices before they are operated on. Just as ridiculous soldiers injured in battle will not be operated on unless they resign from the forces. This has nothing to do with good practise, it is more to do with finding scapegoats for the appalling financial mess the NHS is in under Hewitt's and New Labour's governance.

jim hendry, Slatina, Romania

I am on overweight person, struggling with obesity and a current BMI of 40. With the wonderful help and understanding of practice nurses, I have managed to reduce my BMI from 43. I read Ms. Hewitt's proposals that I may denied medical treatment with alarm and sadness, espeically given that I passionately believe in the principle of socialised medicine and the NHS and that my taxes have funded the NHS for many years. If I am to be denied an operation or other treatment, because of being obese, can I please have a proportionate refund of the taxes I have paid for the treatment of others without question. Obesity is a problem and it is concentrated in poorer socio-econmic groups, it seems Labour is condemning them to further health inequalites in this facade of a socialised health service.

Dr. David Craik, Kidderminster, UK

Do any of these smokers have a brain? They complain they pay too much tax, they complain when doctors think it is a waste of time trying to fix their self-inflicted illnesses.... JUST STOP SMOKING and become superior and self satisfied like me!! And the obese think diets don't work........oh really.....excess food which is not burned off by exercise is stored as fat....end of story!

sue, swansea, uk

refusing to treat smokers would create an overwhelming prejudice within the system. To suggest that smokers take ressources away from the NHS is not valid, not least as they more than pay for the annual cost of the service with the high level of duty placed on the purchase of suc products. This money saving scheme merely targets the socially easier target. The extent to which a complaint is caused by such behaviour is also doubtful. A patient who, albeit drinks more than recommended should not be told to stop drinking should he develop problems related to drink. There may be no direct causal link. Hewitt agrees, seemingly by not going so far as to include drinkers in her list of social groups "not worth treating". It is abunantly clear that the greater popularity of drinking is the reason for this.

James, Cambridge,

Oh, splendid idea! Let's have a Health Service which only caters for the fit and healthy and the rest of us can go hang!

Irene, Shaftesbury, UK

Yet another joke from the Carry On Killing crew who 'manage' the NHS. Britain continues to suffer a 'health service' that is managed by ..........government! (The proven, single most effective way to make a complete pig's ear of any service delivery.)

John A Blackley, Austin, Texas

I'm not sure smokers would be pleased with the outcome of an analysis of whether the costs of delivering health care to them is balanced by the taxes they pay for cigarettes. I'll bet it doesn't even come close, that even with those taxes, the societal economic burden of smoking is vastly greater, especially if you include the health costs of second-hand smoke. So if you want to go down that road of comparing costs and benefits, be prepared to see data justifying a large increase in the taxes.

Pete Myers, White Hall, VA/USA

This government’s obsession with ‘encouraging’ a healthy lifestyle is contradictory and hypocritical.

They like to threaten the tax-paying smoker, and those whose body weight doesn’t comply with Labour’s idea of a politicised normality. But when it comes to lifestyles that encourage the spread of sexually transmitted diseases, then this government throws large sums of public money ‘educating’ children and adolescents on how to engage in the spread of STDs and unwanted pregnancies, and all this requires vast some of NHS public money to ‘fix’. It is amazing hypocrisy.

David, Somerset,

What about people who drink alcohol to excess? Or take drugs? Or drive fast? Or do dangerous sports such as rock climbing?

Neil Graham, Chorley, Lancs, England

So no more orthopaedic surgery for horse-riders, rugby players, skiers or motor cyclists? No more STD clinics? No more ante-natal care for women with high blood pressure or a history of miscarriages? No more tropical medicine for people who take holidays in exotic places? No more A&E on Friday and Saturday nights?

This is a VERY slippery slope, Patricia Hewitt. Be very careful before you set off down it.

Bob Doney, Camberley, UK

Fine Ms Hewitt, so then should drug addicts and alcoholics many of who I come into contact with make no useful contribution to Society yet we do not turn our back on them. Even though people around them suffer physical, mental and verbal abuse at their hands, lack of food due to lack of money. Perhaps you would be prepared to look across the Chamber and tell Charles Kennedy he could not have an operation or treatment until he had dealt with his addiction? Smokers appear to have been turned into Social Pariahs should we do the same of all other addicts?

Andy, Worthing, Sussex

Totally agree with Hewitt principle. It should be extended. Sunbathers should be denied treatment as should players of dangerous contact sports. Politicians who make us the passive victims of misleading spin, sometimes causing death, should undergo truth therapy before receiving treatment for other ailments.

paul, hastings, sussex

I'm currently visiting a hospital on a regular basis. There are notices everywhere indicating that the hospital has a strictly no smoking policy. Every time I arrive I have to weave my way between obese men and women in dressing gowns who are smoking at the entrance to the hospital. I imagine this is a scene repeated all over the country. Of course doctors ought to be able to make judgements about the value of treating people who can't or won't help themselves.

D Fence de Fumer, Cheltenham,

Discrimination and the removal of Human Rights seems to be the only remedy in the UK for all of our problems.
A smoker is taxed heavily and probably suffers many less health problems than a heavy drinker, but now smokers and larger people have there Human Rights to treatment withheld to balance the books.
Human rights are being removed from the British and passed to economic and illegal immigrants as usual the British are the only second class citizens in their own country.

Louis Cannell, Northampton, UK

Ms Hewitt is a highly patronising, matriarchal individual, so there's nothing surprising in her suggestion. However, it has become rather standard to attack smokers and the fat. Taken collectively, that's well over half the population who could be denied treatment. Presumably, they can have their National Insurance and Income Tax refunded (fat chance! - no pun intended). If her proposal is to become reality, then why not deny treatment to lunatic drivers who smash themselves up, those engaging in dangerous sports, people who get HIV through unprotected sex, asylum seekers who've never contributed a penny etc etc. Or perhaps that would be too politically incorrect?

Steve Davidson, Bromley, Kent, England

This is interfering with clinical managememt and encouraging NHS managers to do the same.

Tom Fallowfield, Braemar,

As a former surgeon it is hard to express my disgust at Ms. Hewitt's suggestion too strongly. She obviously has not the slightest inkling of how a decision whether or not to operate on a particular patient is made by a conscientious surgeon. One operates where the balance of risks and benefits to a particular patient of operating are greater than not operating. Suggesting a blanket ban on operating on particular groups of patients, completely ignoring the downside to those patients of not operating is bad, not good, medical practice.

Will Ms. Hewitt be the one to be sued when a patient denied a heart bypass because of her decision dies from their untreated condition, and where the medical probabilities are that operating would have been less risky? If Ms. Hewitt wants to start making clinical decisions that impact individual patients, then let her retrain as a doctor and actually start to understand the complexity of the clinical decision in which she is trying to meddle.

E Burgess, Slough,

If the concept of "fairness" is applied, then it should be those individuals who look after their health who should be entitled to tax refunds. Currently we subsidise the enormous cost of health care for those who smoke and are obese.

Cliff, Birmingham,

The exhorbitant taxes that smokers pay should place them at the top of the waiting list. How about drug addicts whose habit is not taxed and are a great strain on the NHS, where are they in Hewitts view? I am a non-smoker nor a drug user.

Gordon Perrygrove, Birmingham, England

By the time a smoker has smoked sufficient cigarettes to damage their health (S)He has paid enough tax for any treatment many times over when purchasing their cigarettes.

Edwin Thornber, Chichester, Sussex

They always state platitudes like this when money is tight.
Wrap up what is really going on in a piece of medical flannel!

They are happy with the tax from smokers.

Jimmy, York, England

It's sad to see it come to pass, for those not sufficiently 'capable' to self-regulate, but as with all other behaviour - self-inflicted ill health MUST become a determining factor in provision of medical services as costs rise.
We in the USA, where medical care IS rationed according to one's ability to pay, are lobbying for a national healthcare policy wherein ALL persons receive appropriate treatment if and (most importantly) WHEN it is justified. No, we don't advocate cosmetic surgery to 'correct' physical characteristics to convert 'plain Janes' into 'Barbie dolls (as some countries do).
Unfortunately our efforts towards implementation of 'Socialized Medicine', as those who oppose such a plan address schemes practised in the UK/EU nations, are regularly defeated due to the very same 'Cult of Irresponsibility' which drives up costs in these nations.
By, finally, taking a stand (such as UK GPs are) the 50 million denied treatment in the USA stand to gain. We thank you.

Lawrence Pines, Middletown, USA/NY

Presumably those who smoke or are overweight will be premitted to withhold their taxes then. Or doesn't the concept of 'fairness' extend to the right to a service for which a person has been forced to pay?

Mike Routhorn, Weston, UK

This government is beginning to disgust me with its addiction to meaningless soundbites. BMI is a very rough guide to an individuals fat ratio. BMI takes no account of muscle mass (many body builders for example have high BMI but low body fat) nor of general physique (short, stocky, broad).
BMI is an imperfect measure, it should NOT be used as an excuse for denial of treatment.

Piers, Liverpool, UK

How are doctors going to help people lose weigh when they need a hip or knee replacement? They won't be able to exercise much due to the pain of the hip/knee and if they offer them diet advice, well, 95% of diets fail. Will they say that you must lose weigh before you have a hip operation so you must have stomach stapling first? Having said all this I do believe people have to take responsibility for themselves. What I would very much like to see is a study to find out why people are overweight/obese and what is the most effective way to help people be healthy. How many people overeat due to emotional problems (could CBT help?), how many people would benefit from healthy cooking lessons like the government supports adult computer classes. Do people have access to supported exercise programs? You can get GP referrals to the gym to classes specially tailored to help the very overweight. But, only inside of 9-5. Not much help. Giving up excess food/smoking is hard, I admire people who do.

Ann Harper, Edinburgh,

i'm not sure how much the tax is on a packet of cigarettes, but judging by prices in other countries, i imagine that it must be around £3 on a packet of twenty. smoking 20 a day, that makes £1095 in extra tax an ordinary smoker pays each year. even if we are to blame for our own illnesses, surely we have paid in advance for our treatment, unlike everyone else who needs nhs care.......

george wood, hove, east sussex