With the NHS facing budget issues and rising costs to ensure it has the necessary resources and staff in place to efficiently care for its patients, it should be no surprise that cuts to treatment are being proposed. Among the more radical proposals put forward is stopping NHS treatment for conditions that are considered to be caused by lifestyle choices, with smoking being the main target.
In the UK around 16% of adults smoke, a figure that is gradually falling thanks to growing awareness of the risks. Smoking puts a huge amount of pressure on NHS resources with the potential health risks. Tobacco is linked to almost a fifth of cancer cases alone, as well as being related to other medical conditions that require treatment.
So, with the impact of smoking on the NHS considered, what are the arguments against treating or charging smokers who need access to medical services?
Arguments against treating smokers
A study from 2015 reveals that this is an issue that splits the general public right down the middle. Some 52% of people think the NHS should not fund treatment if an illness is the direct consequence of smoking. The key reason behind this is that many people already feel that the NHS is already too stretched to deal with health issues that have been ‘self-inflicted’. It’s this sentiment that forms the basis of the against treating smokers’ argument.
Arguments for treating smokers
In favour of treating smokers, advocates of this side of the debate state that the healthcare system has a duty of care to all patients, whether they smoke or not. As a medical professional, it can create an ethical dilemma should rules change on where the NHS stands. It is not a doctor’s role to judge patients but to encourage healthy lifestyle choices where possible and to treat illness regardless of cause.
One of the challenges that comes from not treating smokers comes from determining whether smoking has been the cause of the health issue. For some problems, such as lung cancer, it’s found in a significantly higher percentage of smokers than non-smokers, but it doesn’t prove the exact cause. It creates an issue of where the line is drawn.
It’s also worth noting that numerous other lifestyle choices have an influence on our health. If the NHS refuses treatment for smokers, it’s just another small step to begin excluding other patient segments, such as those patients that are considered to drink heavily or have a BMI above average.
What’s your opinion, should the NHS start turning away or charging people based on their lifestyle choices, including smoking?