Kerre Woodham: Fatties and smokers get medical bum's rush

Obese people and smokers are being denied some treatments. Photo / Thinkstock

It was revealed this week that one in four NHS health trusts in Britain are denying "undeserving" patients certain operations and procedures.

If you have a BMI (that's a measure of body fat called the body mass index) of 35 or above you'll be turned away from a quarter of Britain's public hospitals if you want a knee or hip replacement.

Obese women are refused IVF treatments in nine of the trusts unless they lose weight and smokers are pretty much denied every operation, unless it's lifesaving, because they're considered too much of a risk under general anaesthetic.

It seems that in New Zealand much the same thing has been going on, although in an ad hoc, informal kind of way.

When I mentioned the story on radio, a number of callers said they'd been told to lose weight before the surgeons would operate. Another, whose wife had breast implants after a double mastectomy, was told it was just as well she didn't smoke. The surgeon wouldn't waste his time on smokers - apparently they take far longer to heal and there is a far greater risk of complications.

One caller's dad, a pack-a-day smoker who needed hernia surgery, was dismissed by his surgeon. Why on earth would I bother to operate when you'll be dead in a couple of years, he said he was told. He gave up smoking that day, went back to the specialist a month later and is as healthy as a buck rat.

I can understand doctors wanting to give their patients tough love but dividing the sick and suffering into deserving and undeserving strikes me as problematic.

Sure, it's galling that millions of our health dollars are spent on P cooks and their third-degree burns, and drink drivers and their spinal injuries. In an ideal world, criminals would pay for their medical care. Smokers and the obese are easy targets - but what about rugby players, horse riders, even middle-aged marathon runners? If they break their necks or need their hips replaced after wearing them out on kilometres of footpath, do they deserve to be looked after? They've damaged themselves doing what they love to do; smokers and overeaters are doing what they love to do.

Both groups, deserving and undeserving, incur enormous medical expenses, so is there any reason why those with sports injuries get sympathy while fatties and smokers are vilified? Other than prejudice?