Comments for en-gb 30 Wed 22 Oct 2014 03:40:32 GMT+1 A feed of user comments from the page found at Mark_in_Wilts MrSBaldrick wrote:The tax levied on cigarettes and alcohol nowhere near covers the extra cost to the NHS of the increased treatments many of these people need. -----------------If you research the NHS and HMRC websites you'll find that the opposite is true - £~2bn cost to the NHS for treating smoking-related problems; £~10bn raised through Duty and VAT on tobacco.The problem with the proposed scheme is that it is over-simplistic - if you smoke, drink, eat "unhealthy" food, then you are unhealthy; if you don't then you are healthy. Which is not always the case.I've smoked for over 35 years yet in that time I've run numerous half-marathons, regular 20+ mile hikes, and 15-mile per day cycle rides to/from work. Even now when I go out walking at lunch time my "healthy" non-smoking colleagues are breathing a lot heavier than me when we're going up steep hills. Also, I have a 97-year-old aunt who has smoked for 80+years whose only health problem is a dodgy hip (and another died a couple of years ago aged 96) - so much for smokers die younger!! Fri 21 May 2010 08:25:29 GMT+1 Simon Hill This whole issue revolves around the concept of 'free' nationalised universal healthcare. If we want to stick to the ideal, then all healthcare is free regardless of the cause of the illness. Unfortunately, this model leads to a healthcare system that costs more than we can afford to provide, so we are left with having to make choices about healthcare which are driven by financial constraints - in other words, cost-effectiveness (rather than just clinical effectiveness) of treatment strategies is a major factor in deciding which strategies are taken up.This means that when techniques such as 'bribing' people to improve their health turn out to be cheaper than treating the poor health that would otherwise arise from continuing unhealthy lifestyle choices then a perceived injustice is created - why should those who already choose to lead healthy lives without financial incentives pay taxes to 'bribe' less health conscious people ?The alternative, however, is to go down the road of judging illneses on the basis of which were 'self inflicted' and which were not. Not such a simple line to draw - some might suggest that smoking is a 'self inflicted' disease (at this stage I should point out that I am a life-long non-smoker but also a Ward Manager of a respiratory medicine ward almost exclusively populated by lung disease related to smoking) - but what about arguments that say people from deprived backgrounds are more likely to smoke because of their personal circumstances and upbringing - do we blame the child from a poor family who grew up surrounded by smoking when they become addicted at an early age and so brought about their own ill health ? Continuing such reasoning then leads us to denying the overweight treatment (especially those poor kids who grew up on chips), then what about joggers - people who partake in this type of high-impact activity have a massively higher chance of developing osteoarthritis in the knees and hips - why should couch potatoes pay for their knee replacements ? This avenue of reasoning is not sustainable, no clear line could ever be drawn as to what is permissible self infliction of illness and what is not - too much illness is ultimately related in some way to lifestyle (although the NHS would be massively cheaper to run if we only treated purely genetic diseases and fault-free accidents).Ultimately, if you accept that a socialist healthcare model is the correct one (and I don't) then you also accept that the healthy will pay for the unhealthy, whether this is in direct 'bribes' or healthcare later on when the effects of their unhealthy lifestyle manifest themselves. Accepting this fact then leads to the logical conclusoin that whichever option is the cheapest in the long run is the one to use, however unpalatable it may be to pay doley chavs to pretend they have given up smoking. Fri 21 May 2010 08:24:51 GMT+1 deleted #1 is wrong in a few respects - the NHS is there to prevent ill-health as well as cure it. And the tax from cigs DOESN'T go to the NHS. It goes to the government. That said - rewards are a daft idea and don't give anything to those of us that DO look after ourselves in the first place. If the proof that not smoking gives you a healthier longer life isn't enough, then I doubt paying people to quit will stop them in the long term. People will quit for the time it takes to be a 'quitter' on the stats, then most will start again to keep getting the reward every time they quit. Not fair at all and if it does happen, I won't be working for the NHS much longer after that. Fri 21 May 2010 08:08:56 GMT+1 makar - thread killer jono-been wrote:I think it's a stupid idea.The NHS is there to fix problems, not prevent them.-------Why shouldn't they try and help prevent them? Prevention is better than a cure. Better for the nhs (in the long run) and better for the people.But still, anything for a moan, I'm sure your system would be much better Fri 21 May 2010 08:07:08 GMT+1 basguy This is an absolute nonsense. The NHS needs to focus on its core business which is making people well not paying people to become healthier. How many operations and treatment would this incentive cost? If people don't have the willpower to do things for themselves then let them suffer. Fri 21 May 2010 07:47:59 GMT+1 Maximus I couldn't agree more with #9 sssmith, stress is the biggest cause of many illnesses in this country which the NHS is find difficult to cope with. With all the stealth taxes introduced by the last government, people are finding it nigh on impossible to make ends meet. Petrol and diesel taxes which leads to increases in food and other necessities, suppliers can't absorb every increase. The health service, try as they might can't cope with ailments as it is without diverting money to the 'be a good buy and give up smoking, I'll pay you'! Wrong wrong wrong, they chose to live like that so they should choose to give it up if not? Well, the wreaths were nice. Fri 21 May 2010 07:46:39 GMT+1 MrWonderfulReality What nonsense.At a time in our history when we can LEAST AFFORD ANYTHING DUE TO GOVERNMENT DEBT it is crazy to give money to people who make BAD CHOICES.There is ONLY ONE JUST & FAIR WAY to sort this out, and that is for those who actually MAKE THE WRONG/BAD CHOICES to pay MORE. If you drive your car continuously at high speed then your petrol costs will be higher than those who take more care. Thing is in the NHS, if you live your life at high speed then you dont have to pay extra. Its a nonsense. I thought this government was supposed to be about self and shared responsibility.I also doubt that any significant number will change their lifestyles and they will just CONTINUE their bad choces of lifestyle AT MY EXPENSE and at the expense of pensioners and cancer patients who could BETTER USE THE MONEY.ATTROCIOUS lifestyles cost the NHS MANY extra £BILLIONS each year and with obesity on the rise that amount will significantly grow. MAKE these people PAY MUCH MORE for their choices then that way by them CHANGING their choice to a better lifestyle they will be MUCH better and greater rewarded Fri 21 May 2010 07:36:20 GMT+1 Fencebound Did I miss the bit where we have a deficit? The need to maintain healthcare, free at the point of delivery, means treatments have to be prioritised, so this is ridiculous. On the matter of the lifestyle related issues: I can suggest a financial incentive - charge people for treatments relating to health issues which are self inflicted by persistent adherence to a damaging lifestyle (would note smoking, drinking, overeating, & drugs use specifically). Even a nominal charge would helpful. But back to the question: I think people need to stop being silly with the public purse now. Fri 21 May 2010 07:35:10 GMT+1 Stuart Why not simply limit people's benefits from the system if they smoke, or are over weight? That seems much simpler; a doctors gives you a target weight and if you wish to scoff cakes and burgers and become more rotund than is good for you, that's fine, but your benefits are cut in half if you go over a certain limit. Why should anyone else pay to help tubby do what he should be doing anyway? Sounds mad to me. Fri 21 May 2010 07:13:02 GMT+1 Laud Sprowston It opens the door to "Health Tourists" who will be chasing rewards.Why should I pay for some idots who choose to smoke after all the health warnings that have been given over the years.Have we gone completely mad.Cameron do something useful and put an end to this crase stupidity. Fri 21 May 2010 07:09:53 GMT+1 Human Cash Point Great idea... How about saying "if you abuse your body" you pay for your treatment. That should send shock waves through the minds of the drunks which fill the casualty departments on the weekends!!! Send them the BILL!!! Fri 21 May 2010 06:51:28 GMT+1 William Selka A free resource is an abused resource. If our taxes which fund the NHS are thought of as an insurance premium, why not have a lifestyle discount? It is also possible to charge the producer, such as in the case of tobacco, but in the case of food, it is more difficult to assess whether it is going to be eaten healthily or unhealthily. I much prefer pricing dis-incentives for unhealthy lifestyles than outright bans. Whether this is given as a cashback or lower tax code doesn't matter to me. If it reduces NHS costs and improves health, it is a better investment than more facilities. Fri 21 May 2010 06:08:29 GMT+1 Reasoned Rants I gave up alcohol voluntarily last year because I could see I was becoming dependent and it was damaging my life.I'd like to claim my money now please. Which form do I fill in? Fri 21 May 2010 05:15:27 GMT+1 Mark @ 142. At 6:46pm on 20 May 2010, MrSBaldrickFrom my previous posts it should be obvious that I am not a fan of smoking, drinking or unhealthy eating however life is seldom as black and white as we would like it to be. I consider myself to be a ‘victim’ to two of these.I don’t remember the exact figures but I believe that taxation on tobacco products (about 10 billion GBP a year) is almost 5 times that of the related costs to the NHS of tobacco related treatment (about 2 billion GBP a year). I would be more than happy if someone could correct me on these figures and prove me wrong.Tobacco (and to a lesser but more serious extent drinking) is an addiction which many of our older generations were trapped into when the adverse health effect were much less known and till recently these products were allowed to be advertised as lifestyle enhancing.I’m not saying that I like it or it’s just or fair....... It’s just the way it is otherwise these evils would have been eliminated from our society a long time ago. I would agree that there should be increased efforts at providing free help to kick bad habits as it’s the right thing to do, but there is no economic argument for it and to the contrary would cost the tax payer.To my mind the only way forward is to educate those not already in the traps. Unfortunately the ‘give it a go’ age group for tobacco products tends to be strong minded, hormone affected teens that believe they are indestructible and will live forever. Appealing to them on the basis of illness in what seems lifetimes away is pointless... I played the vanity card with my kids and pointed out that by their early 30’s (a time frame they can relate to) smoking could lead to yellow, wobbly teeth or even dentures.A move that I would like to see in the future, although probably unrealistic, is that the legal age of purchasing tobacco products be increased by one year once every other year until smoking dies of its own accord. This would also let the economy ease into the change of revenue. Fri 21 May 2010 04:35:05 GMT+1 charlie We are supposed to be adults. This "be good and you'll get sweets on Friday" approach is really patronising.I smoke and will not give up even if I am offered an incentive. It is the only thing I do wrong (I exercise, eat very well, and drink rarely). I need a habit, and smoking just happens to be it. Sign of weakness? Probably. But if something's worth doing, it should have incentives beyond those financially, and that's why I haven't given up.I really hope this goverment will not only see how stupid this proposal sounds, but publicly declare that doctors may be academic but lack common sense, chucking this report out the window. Only then will I believe we've seen real change. Fri 21 May 2010 03:16:08 GMT+1 claire lloyd No way!. The government shouldn't have to give out handouts or freebies to people because their too lazy, addicted, or reckless to care that their lifestyle is unhealthy or detrimental to their health. If the government does this than people will never learn to fix their own problems. They should offer people care for things such as cancer and obesity, but then what they should do is if after having the treatement they go back to their same old habits than I would leave them to rot. Its time the government started helping those who really need it as opposed to those selfish people who have no self control or discipline. Fri 21 May 2010 02:51:25 GMT+1 jeffers2 No, it is wrong. Instead doctors should be made to give better health care to patients. I have been overweight for years after damaging my leg and having to stop running.I went to my doctor twice for help and advice. The first time he sent me to the nurse who was more over weight than I was. The second time he said lack of exercise was nothing to do with being overweight and that I should take his diet sheet (circa 1970's) and go away. The NHS isn't free and isn't cheap. As a taxpayer a lot of my hard earned money goes into it so I don't want it doled out in stupid ideas such as this. Fri 21 May 2010 02:47:35 GMT+1 Mark In addition to my comments of 166. At 02:29am on 21 May 2010:The only financial incentives I would like to see to increase the health of the nation would be at the source...... i.e. the tills of our supermarkets.Subsidise fresh meat, fruit and vegetables so they are readily available to all funded by a higher tax rate on less healthy food products. It may not seem the case to many on a reasonable wage but if you’re on a tight budget it’s cheaper to head for the freezers. In my view this is real problem. Fri 21 May 2010 01:43:30 GMT+1 Mark NO NO NOIf anything take a hard line and penalise those people who have brought disease upon themselves through unhealthy life styles once admitted to hospital. Treat those that deserve the treatments first.In fact let’s see some reversal and give us some of our choices back. Send the smokers back into the smoking rooms and bars so the pavements outside of our offices, hospitals and pubs are once again free of smokers. Let the handful of passive smokers decide if they want to ‘take their chances’ rather than forcing it on everyone.This is most apparent on our high streets where casual shoppers, often with children in tow, now have to encounter intoxicated drinkers every few hundred meters. In my view it’s better for an individual that has chosen to enter a smoky environment to take a risk with passive smoke than stray ash flying in the face of a 3 year old that happens to be walking against the wind on return from the shops. Fri 21 May 2010 01:29:08 GMT+1 BLACK_PEARL Thats discrimination.If your going to pay fat people by the pound of weight they loose I want paying as well for not being fat and saving the NHS money.They should punish bad life style / behaviour not reward it.Typical twisted mentality of the do gooders.What people need is the 'Dirty Harry' approach, not the dotting mother mentality. Thu 20 May 2010 23:57:14 GMT+1 sparkles The NHS could find better ways of spending tax payers money. When will people accept that they are in charge of their own bodies and start looking after themselves? I'm fed up of the state, the NHS in this case, having to pick up the bill for those people who are never to blame for their addictions, be it food, smoking or drugs. Thu 20 May 2010 23:00:05 GMT+1 nine33 No. For once in recent times at least it should provide what it was originally conceived to - health care for all on an equal basis.It is currently a system riddled with waste from the top down. People that can not obtain the health care or the quality of health care they need should be able to seek it privately in the UK or indeed anywhere else worldwide, with the cost being met entirely from the NHS budget.And if we can't afford it then lets scrap it altogether, there is no point in keeping something going that does not deliver what it was set up to do, or which can not provide equal standards of care for all. The hidden policy of keeping people comfortable until they die, because it is cheaper than treating them makes the system in it's current form nothing short of a fraud. Thu 20 May 2010 22:38:56 GMT+1 Rebecca Thomas According to Sky News the NHS spend approximately £20m on smoking related illness, yet this initiative would only cost £1.5m. Remember this is tax payers money too, so the initiative begins to make sense.Yes, I am a smoker and have been since I was 15 years old. I have tried to quit several times, but just can't to find help that is right for me. It's one thing to have to see someone weekly for breath tests and a chat, after all we are talking about 23 years of addiction and, more recently, comfort during long term illness. But it would be another thing all together to receive a reward for your hard work that you can put towards a healthier life all round. An incentive like this would really help me to keep motivated. I suppose just like you'd give a child a few £1 for helping round the house, even though they really should anyway.As for only including pregnant women, I think this is disgrimanatory. They should have incentive enough in giving birth to a wonderful new life and wanting to protect it. Thu 20 May 2010 22:14:31 GMT+1 ruffled_feathers Why can we not take responsibility for ourselves....we need an incentive to look after ourselves??? Does anyone else not think it strange that we are viewed as so inept that we need an incentive to do such a thing? Thu 20 May 2010 22:04:12 GMT+1 Mrs Vee I've heard some really dumb things in my time, but this one truly takes the biscuit!If people want to smoke and drink themselves stupid whilst stuffing their faces with unhealthy amounts of food, then no amount of taxpayers money will stop them. If they can't see how brainless they are, I fail to see how a handout from the taxpayer will show them the error of their ways.Give me strength....! Thu 20 May 2010 21:15:20 GMT+1 squeezy No, why should MY hard earned taxes fund those who chose to be fat, smoke, drink to excess etc? Make these people fund their health care themselves and not expect us nor the NHS to give them the easy way out. Thu 20 May 2010 20:43:46 GMT+1 Jonathan This is a very dangerous idea, especially after all the furore about the idea of paying people to be organ donors. I propose charging people who ignore medical advice and continue to lead poor lifestyles. At present, drug addicts, alcoholics and the obese can claim incapacity benefit and free housing, so they are rewarded compared to genuine job seekers.Ultimately, we need to look at NHS expenditure. This money should not be used for tattoo removal (the patrient should pay) and should not be used to pay for cranes to lift 72 stone people onto reinforced ambulances. Once again, charge the patient (who currently pays little or nothing towards the NHS). Rewarding bad people is a dangerous idea. The NHS will pay people who lose weight. Many of these people will then put the weight back on again and then could be rewarded until death. Why do only good people seem to be penalised? Thu 20 May 2010 20:39:18 GMT+1 CladinBlack Who wants to live healthily in this country anyway - you do all the right things, eat healthy food, don't smoke, drink in moderation, exercise, live to a ripe old age...only to be abused in some dirty care home...I think I'd rather have a life, die early but happy!!! Thu 20 May 2010 20:35:35 GMT+1 Christine Stockley No they should not. There have been so many campaigns to get people to adopt healthy lifestyles, paying people would just go to those who look after themselves already. Surely we should be adopting money saving schemes now, and would it really save money in the long term. Unfortunately there are just too many ignorant people who think they are entitled to free healthcare whatever. Thu 20 May 2010 20:18:11 GMT+1 Chris If incentives mean less ill health then that is a gain for those concerned and a gain for the tax payer as there will be less ill health to pay for - why on earth would anyone be against that?Honestly, the reaction of some posters seems to be if i don't get the reward then nobody should - see the bigger picture ofr pity's sake. Thu 20 May 2010 20:06:22 GMT+1 righteoussasquatch "The NHS is exploring the possibility of using financial incentives to encourage healthier lifestyles. Is this a good idea?" Excuse me having just had 13 years of daft Labour policies, Liam has said there is no money left "Good Luck" and some intellectual wants to give money away. People will give up smoking etc when they are ready to no amount of money is going to bring that time forward. Save you money for things like surgery and outpatients appointments. This is a political move to reduce neasured efficiency in the NHS and to make the coalition look bad. Don't fall for it boys! Thu 20 May 2010 19:12:25 GMT+1 John Charlton The reward for giving up something harmful is better health. I see no reason why public money should go to the feckless and weak-willed. We should live with the consequences of our own decisions. By all means publish information about the harm of smoking but that's all.I also remain unconvinced by the economic case for, say, giving up smoking. The vast majority of NHS expenditure on all of us is in the final 18 months of our lives. So if a smoker dies at sixty, when he might have lived to eighty he will have saved the country 15 years of state pension and probably less NHS expenditure (think of all those free prescriptions he never got). Thu 20 May 2010 18:50:13 GMT+1 EdwinaTS Heavy financial penalty for smoking, drinking, and driving badly are already in force, so there is already heavy incentive for reducing these bad lifestyles, so how can incentives for good lifestyle possibly motivate?One thing will be for certain though, many people will be claiming good life style incentives without adopting it. Thu 20 May 2010 18:41:22 GMT+1 Bladesman30 yes the NHS should reward healthy lifestyle choices.A financial reward should also be given for blood donation and semen donation.I also think that those citizens who choose to take unhealthy lifestyle choices should be charged for treatment and in some cases they should be refused treatment.For example drunks who attend an outpatients for a second time should then be clearly warned that there will not be any assistance for them if they turn up drunk on the third ocassion.Hospitals should have a police presence and many of them.Initially,the policing costs may outweigh the savings made from the none treatment of reprobates,but after time people will be detered from unhealthy life choices. In addition,CAN WE PLEASE HAVE A HEALTHY DIET IMPOSED ON OUR CITIZENS/Get rid of all vending machines that dispense sugary drudge for example.When it comes to health,we need more dictat because it's the only way to prevent the rising tide of obesity.Why do we have a free Health Service.What a continual drain on the employed this god dam service is. Thu 20 May 2010 18:39:30 GMT+1 LongJumpKonan I think it should reward a healthy lifestyle for example with lower cost for people who try to live healthy. But actually, that cannot really be implemented considering that you cannot prove who lives unhealthy on purpose and who doesn't. Thu 20 May 2010 18:38:50 GMT+1 2feetontheground How much money is spent from tax payers money on their (smokers, drinkers and obese) healthcare? Why should the NHS have to pay more to these people to try and keep them alive. I agree with a previous statement:'It would be less controversial to penalise those who adopt a lifestyle which will cause ill health. Much higher taxes on tobacco, alcohol and unsuitable food for example.'Surely if this extra money from a tax on unhealthy living could be put towards heathcare, there wouldn't have to be so many job cuts within the NHS system and such a requirement to 'pinch pennies'. Those who have been injured without having damaged their own bodies could then get the benefits and attention they deserve. Thu 20 May 2010 18:37:44 GMT+1 Constanzead I'm 19 and have cancer. This idea is disgusting. People shouldn't need financial incentives to do things which will save their lives. It just goes to show the stupidity and immaturity of these lazy people.For further opinions and angeriness of mine on the matter, try my blog :) Thu 20 May 2010 18:34:25 GMT+1 topsail The NHS should whatever they judge to be most cost effective in saving lives. Rewards will probably save the NHS a lot of money. Thu 20 May 2010 18:29:31 GMT+1 5XX This is quite ridiculous. Whatever next? Dentists paying us not to eat rocks? A&E paying us not to slash our wrists? I think people who deliberately harm themselves should pay a proportion of their NHS costs or even go private. After all, this is our money they are giving away. Why should non-smokers subsidise smokers? They cause enough problems already. Thu 20 May 2010 18:25:59 GMT+1 stevek The best way of dealing with problems such as this is surely so simple.Smoking - put a price on the packet of the cost to the NHS in large print and add this to the cost. This money then goes directly to the NHS.Obesity - any product with fat or sugar above a reasonable level - same deal.Drink - yep you've guessed it sost to taxpayer on the label. add to the price.Then when you go to the shops you might think before paying extra for some crap product. If you don't who cares you're now paying your way -you fat out of breath drunk ! Thu 20 May 2010 18:23:47 GMT+1 druid2002 The way it seems so far is that is a fatty is deemed obese by the NHS then he or she will get free gym passes when the rest of us have to pay for it!IF they weren't so busy spending their hard earned cash on food then they would have enough for food!Another feckless idea for the stupid. Thu 20 May 2010 18:21:48 GMT+1 anglo-scot This is a terrible idea. I work in the NHS and believe me they could not control this type of scheme.The organisation is abysmal , management is poor and it would only result in our taxes being ripped of. Considering the very poor lifestyles of many NHS staff, the amount of staff obesity, and the extremely high level of sickness - perhaps they could start by rewarding their own staff. Thu 20 May 2010 17:53:34 GMT+1 MrSBaldrick 139. At 6:10pm on 20 May 2010, North Briton wrote:Smokers and drinkers should get preferential treatment on the NHS. They have paid a far larger proportion of their income in tax than non-smokers and drinkers. They are only going to die once in their lifetime so it is up to them to make a choice and not anyone else. Does it cost the NHS more if people die young compared at a greater age? No.It is not dying that is expensive, it is keeping people alive that costs a lot of money. If someone chooses to smoke and drink to excess, and dies of sudden heart failure, costs the NHS nothing, everyones happy. On the other hand, a person who is so moribundly obese they can barely walk will cost the NHS 10's of £1000'sThe tax levied on cigarettes and alcohol nowhere near covers the extra cost to the NHS of the increased treatments many of these people need. Thu 20 May 2010 17:46:50 GMT+1 FatPeace - A Promise to Heather Clad in Black (#136) so what do you propose? A ban on fat people working in the NHS? Disclosure of BMI on the application form? An amnesty of a year for existing staff to get skinny or get out? Why not extend it to people who work with kids, after all, they're now also forced by Govt policy to push the 'fat is evil' line and it could be construed as hypocritical, or that they're poor role models? Last year some so-called scientist claimed that all those thousands of fat celebrities clogging the airwaves and papers were encouraging teenagers to think it was OK to be fat (I mean, the thought of it, that some depressed chubby teen might be inspired to follow their dream by the sight of Katy Brand or James Corden instead of hiding in the house crying into their Pizza as the Govt seem to desire!) so do we say no more fat people on air or in public life unless they're being suitably humiliated on Fat Teens Can't Hunt or The Biggest Loser?And Graham Harris Graham (#138) the day they start frogmarching me to the doctor (who I avoid if at all possible because all they see is a fat person with all the stereotypes that carries and attribute any given issue I may have to that all-defining number on the BMI chart) is the day I emigrate, and I'm sure I wouldn't be alone. I'm sick and tired of the way that health and medical history are rapidly becoming viewed as perfectly acceptable grounds for gross discrimination (ie bans on fat people fostering, adopting or having IVF) in this country on the grounds that they might carry an extra risk of something or another or set someone too daft to think for themselves a baaad example. Life is inherently risky. That exemplary citizen who lives on greens and jogs 10 miles a day might get hit by a bus and die or become a severely disabled 'burden' and 'liability'. We're all going to die of something. Personally, I'd rather enjoy my years on this planet instead of obsessing about every calorie I consume or burn and every pound gained or lost as now apparently seems to be expected of us. The pursuit of perfect health really isn't a moral imperative, neither is it attainable by everyone, and the preoccupation with enforcing and mandating it risks creating a two-tier society which would benefit a privileged few but mean misery and frustration for most. Thu 20 May 2010 17:44:17 GMT+1 MrSBaldrick No, I thought we had perhaps seen the back of these ridiculous Labour tax and squander ideas. In case everyone has forgotten there is a huge multi £billion deficit to fill.A better idea would be to charge those who choose to abuse their bodies, be that through smoking, alcohol, bad food, excessive food etc. Maybe slap more tax on cigarettes, drink, junk food, fast food etc Thu 20 May 2010 17:40:25 GMT+1 North Briton Smokers and drinkers should get preferential treatment on the NHS. They have paid a far larger proportion of their income in tax than non-smokers and drinkers. They are only going to die once in their lifetime so it is up to them to make a choice and not anyone else. Does it cost the NHS more if people die young compared at a greater age? Thu 20 May 2010 17:10:39 GMT+1 Graham Harris Graham It's time to tax unhealthy people; each year every adult gets a mandatory health check at the doctors surgery and their taxes get adjusted depending on such criteria as % of belly fat, cholestorol, heart rate, blood pressure, flatness of feet etc.Those with lousy lifestyles will be economically coerced to give up fish & chips (which may come as a surprise to them but it isn't a balanced meal), cigarettes, tonic wine (which isn't a substitute for water), TV dinners, crisps (which aren't a vegetable) & pork pies (which may not contain much pork at all but do contain lots of gristle & a jelly that behaves like wallpaper paste).Simples! Thu 20 May 2010 17:07:18 GMT+1 CladinBlack They should promote death! as staying alive is going to cost everyone more money!______________________________________________________________________I think they've been pretty good at promoting death - like refusing life-saving drugs and treatments for cancer patients. Thu 20 May 2010 16:59:53 GMT+1 CladinBlack Maybe the NHS should look closer to home to start 'lifestyle changes'. I worked in a business park where most of the offices were various NHS helplines like NHS Direct and others. At lunch-time I had to pass so many of these NHS staff standing around, smoking and a large number were very overweight. I'm fed up of the times I have booked into a hospital where the receptionist is nearly always overweight. It's hypocritical to tell people to change their lifestyles and get fit - maybe they should try it out on their own staff first and if that works then it can be extended to the public. Thu 20 May 2010 16:56:34 GMT+1 SnoddersB So my money is to go to those who smoke and drink. How about less tax for those of us who do none of the above. This is a typical ill thought out Labour tyupe action. I surpose that thye will also reward drivers who stop speeding and parking on pavements. Thu 20 May 2010 16:52:50 GMT+1 mike ivybridge It's the wrong way round, isn't it ? People who do not live healthy lifestyles or who wilfully smoke, drink alcohol, take drugs or follow dangerous pursuits should have to give way to those who lives healthy lifestyles etc. when waiting for treatment. In any case, the NHS doesn't have the money for reward schemes. What an utterly ridiculous idea! Thu 20 May 2010 16:51:19 GMT+1 Artemesia 102. At 2:07pm on 20 May 2010, Toad In The Hole wrote: "Should the NHS reward lifestyle changes? No. As far as I'm concerned the NHS should not pay for the treatment of worthless junkies, smokers or alcoholics, it's their problem, they should pay for it. This would save billions each year"Would you say the same for DIY 'accidents', the majority of which are due to carelessness and also cost the NHS a great deal of money?It was their problem, they should pay for it?I don't know the exact number but I believe there are also many injuries caused by 'keeping fit' in one way or anotherWhere do we draw the line, people who go pot-holing and mountain-climbing without due care and have to be rescued and treated?I'm not sure that I agree with it anyway but the policy being considered is to reward 'lifestyle changes' not to punish 'wrong' lifestyles, there is a subtle differenceI just hope that 'punishment' ie refusal to treat as you suggest, never becomes policy because if it does then there's an awful lot of us besides 'useless junkies', smokers and alcoholics who might 'at fault' when it comes to 'causation' Thu 20 May 2010 16:42:49 GMT+1 tc There is a 'cut price ' pub nearby ...locals arrive 10 ish each morning buy a pint, cheap English breakfast, check out the dogs and the horses...(bookies directly across the road) sit there all day often in the sun and none seem to work........Naturally they do not look very healthy.....How about we reward them???? Thu 20 May 2010 16:22:44 GMT+1 morleyp Its not about if people live healthy lives, its whether people are living honest lives. Why don't they stop wasting tax payers money on stupid ideas like this and start saving the tax payer some money. At least those people that may live unhealthy lives probably work and pay tax and national insurance - what about those that don't contribute to this country - that scrounge off the state - most of them fraudulently. So if you scrounge of the state, get your rent and council tax paid for and all the other little benefits that come with it, but leave a nice healthy lifestyle - you are entitled to more of tax payers money with a nice little bonus! What is wrong with this country! Thu 20 May 2010 16:21:45 GMT+1 Andrew N Firstly would people please stop saying that treatment provided on NHS is free, its paid for by every tax paying man and woman in the country!!! (this does include smokers, drinkers, overweight ppl etc etc)The point of the NHS is to provide healthcare with no charge at the point of treatment for EVERYONE! The idea that you can turn around and say people that like a drink, a smoke or a few to many burgers should not recieve treatment is crazy!!What next? someone with a risky job? maybe someone who enjoys football, rugby, hiking, ice skating etc etc should be refused treatment too for putting themselves at risk?Stating that treatment should be refused or charged extra for people who live a lifestyle that YOU do not agree with is a very very slippery slope..... Thu 20 May 2010 16:15:13 GMT+1 ian cheese They should promote death! as staying alive is going to cost everyone more money! Thu 20 May 2010 15:55:42 GMT+1 Tripdee Brilliant idea. Now give me £50 or I'll start smoking. £100 will be enough to keep me away from the pub. I'll lose weight for a further £400. I'll use the money on a holiday in the sun, thus increasing my risk of skin cancer and to support my rather expensive drug habit. Thu 20 May 2010 15:51:15 GMT+1 angry_of_garston Are they rewarding people stopping smoking and drinking or merely returning a tiny fraction of the punitive taxes these people have paid on their vices? Thu 20 May 2010 15:35:10 GMT+1 corum-populo-2010 'Should the NHS reward lifestyle choices'?Well, as the National Institute for Health and Clinical Excellence (NIHCE)generically known as NICE, set up by last government, and still run by the same people - this whole piece has to be taken with a pinch of low sodium salt?This HYS piece doesn't mention that there is more to be gained by decent rehabilitation and integration with alcohol and cigarette addiction which is piecemeal and drains budgets of PCTs., GPs., Health Centres and A&E departments (alcohol)? As for paying people to lose weight/buy healthy food? Hmm - high fat, high sugar and high salt 'snacks' and 'convenience' meals are addictive too - by taste, comfort, and heavily advertised and highly profitable for supermarkets. Pass some of that profit on to farmers please?Perhaps the 'academics' and politicians should climb down out of their own primeval trees and 'ivory' towers to advocate many of the above are a 'treat' and not part life - and have a detrimental effect on your personal appearance and natural beauty? As celebs culture is a way of life for many (especially) children - maybe celebs/footballers etc., should ditch the crisps and be employed in enjoying eating well - quickly or slowly and economically?Celebrity advertising comes with responsibility? Thu 20 May 2010 15:28:18 GMT+1 Richard The reward for a lifestyle change(to a healthier one) is that you live longer and have a much better chance of surviving illnesses.Cash is not the way to go on this one. is this a loony labour policy that is a bit late? forms of social control(and this is one just with a positive spin rather than negative) are extremely un free society. if this was America i would say its communist just to forever make it disappear but its not so ill stick to the elites telling us to live and leave it at that Thu 20 May 2010 15:24:56 GMT+1 maledicti I'm not overweight, I have never smoked and I don't drink that much either. Can I get a discount for being healthy to start with? No? I didn't think so. Thu 20 May 2010 15:23:19 GMT+1 lochnagar Definitely NOT !!! - Lifestyle changes are everbody'd personal responsibility. It is not for the tax payer to finance lazy and can't be bothered people. Thu 20 May 2010 15:21:19 GMT+1 ruffled_feathers Why is it when I look back to my childhood from mid50s to early 70s - there was no one in school who was obese, apart from one lady with health problems which affected her metabolism.We ate breakfast, school meals (which did not include chips), had supper, no snacks in between meals, but often bread and dripping (incredibly unhealthy!!) after a roast dinner, ran around in the playground at lunchtime, no PC so no online networking, so after written homework we went and played outside.Get children back outside - walk and/or bus to school. Take-aways should be a treat, not the norm. For cheaper fruit and veg - take the family fruit-picking.I found it quite sad when we had a real snowfall (enough to play in) that there were so few children out building snowmen or playing.How you re-educate people if their parents aren't interested - I don't know. But wherever incentives come from - I don't think it should be from the NHS. Thu 20 May 2010 15:18:04 GMT+1 MrOverall It is really quite surprising that a serious organisation like NICE are even considering such an idea.There are too many obvious problems with such a scheme to list them all here.On the one hand it may be a good sign that people involved in directing clinical provision in the UK are seriously thinking about prevention rather than cure.On the other hand it is sad that they seem to be so misguided as to consider this concept.Schemes to prevent people getting unhealthy in the first place must centre around helping people make the right decisions and getting them to understand why they are the right decisions, not giving them short term rewards for blindly doing what they are told.I personally think it is very dangerous to 'incentivise' health. It is contrary to the principles of personal responsibility that any modern society should be encouraging.Even the new coalition is talking about societal principles such as 'fairness' and 'responsibility'. I can't see how incentivising health can lead to either. Thu 20 May 2010 15:00:26 GMT+1 binary The idea holds no merrit. Should I start smoking/drinking and taking drugs now, so I can get a financial reward for giving up later? Thu 20 May 2010 14:47:11 GMT+1 TR7RV I think its a ridiculous idea. If people are able to give up and really want to then somehow eventually they will. However its also clear that some people aren't able to give up, for whatever reason, therefore it seems logical that a cash incentive wont work for them. However the cash will be happily taken by those who could obviously have stopped in any case if they had really wanted to and then probably kept, if, or more likely when, they resumed their old lifestyle habits. I have known quite a lot of people who have 'given up' smoking at regular intervals, for varying amounts of time, and then relapsed. When would people like this be given the cash ? Would they have to give it back if they eventually relapsed even if this were months or even years later ? How would / could this scheme be managed ? Just how many administrators, assessors, processes, forms, etc will this require to operate ? Its a typical 'nanny state ill thought through naive proposal. Thu 20 May 2010 14:42:34 GMT+1 24 years and counting It's a weak sticking-plaster approach. I would have thought by now it was obvious that throwing money at a problem is usually not an effective way to solve it. Thu 20 May 2010 14:36:20 GMT+1 true grit A whacky idea. I disagree totally with rewarding people for doing the right think. Why not increase taxation on all people who buy and sell harmful substances. Including junk food. Increase taxation to people who do stressful work. Increase taxation to people who self inflict. But do not reward or punish people who do it right. Good health is its own reward. Thu 20 May 2010 14:31:11 GMT+1 Valerie P I totally disagree with this silly idea, why should the taxes I pay go to people who cannot be bothered to eat, drink or live sensibly. At the end of the day, if these irresponsible, NHS budget draining people want to shorter their life, it is their decision and I should not have to pay for their refusal to change their way of life especially when they know the risks. The NHS is not a nanny and its budget should be used to tackle more important health issues such as cancer, auto-immune disease, etc. Would you offer the same incentives to criminal if they stop living from petty crimes: NO because as an adult, we have rights but ALSO and ABOVE ALL WE NEED TO TAKE RESPONSABILITIES for our own actions, stop baby sitting the culture of lass and lads over-indulging, over eating, enjoying life with taking account the dangers and expect other to pay for them later on in life.... Thu 20 May 2010 14:15:56 GMT+1 Astrid Lindborg This post has been Removed Thu 20 May 2010 14:14:48 GMT+1 london Stock Exchange Why don't you just..educate in schools,increase benefit levels (remove means testing) and increase mental health facilities? Thu 20 May 2010 14:13:49 GMT+1 John McCormick Hi, SophiaT in #68 again,I mean, just look at the callousness in #102. "worthless" the Toad says. Let's put to one side the obvious inaccuracy of the remark - where would we be without Churchill the alcoholic? - and stick to the morality.Again, I'm not defending the proposal - just defending the people currently being called worthless. Who decides when a person is so worthless as not be treatable on the universal NHS? Nobody, obviously, and it would be a grim day if someone did. That somone has to ration due to finite resources is bad enough - but we have to accept that. To state that an individual, whatever state they are in, whatever they have done to get there, is worthless, means you have to establish a scale of value. This person is worth more than that one. That can only end in one place - destruction of the disabled at birth, euthanasia of the geriatric who only drain resources, refusal to treat the terminally ill and so on. For anyone to say that another human is worthless is to state, essentially, that humans must contribute to society or not be treated. Remind you of anyone? Hitler, Pol Pot, Mao, Stalin, and now Toad?All human life is inestimably precious - whether you are secular or faith-based - each human is a spark of enlightenment in a savage, uncaring universe and we have a shared responsibility to drag the wounded along with us. Anything less, and you are, like Toad's well chosen pseudonym, an animal. Thu 20 May 2010 14:00:15 GMT+1 sssmith · 102. At 2:07pm on 20 May 2010, Toad In The Hole wrote: Should the NHS reward lifestyle changes? No. As far as I'm concerned the NHS should not pay for the treatment of worthless junkies, smokers or alcoholics, it's their problem, they should pay for it. This would save billions each year.######################## Presumably this would include people like:Pregnant woman, they don’t have to have childrenRTA victims, they don’t have to driveHeart attacks, it must me their faultVictims of assault, they must have been asking for itThe list is endless, you have no argument Thu 20 May 2010 13:54:45 GMT+1 Steve This post has been Removed Thu 20 May 2010 13:49:45 GMT+1 Hillbeast Why don't we reward people who already have a healthly lifestyle e.g. appropriate BMI, don't smoke and excercise regularly. Suggestions include...- Cutting the Price/VAT reductions on Healthly Foods, Sports Clothing Gym Equipment.- Discounts / payment incentives for joining a gym/running club etc.- Money off your VAT/NI/or TAX contributions.- Link the above to loyalty/reward card, making people feel involved.If it's made attractive enough it may then encourage others to get fitter. The money saved could then be used to monitor everyones health on a regular basis,through use of health visitors, drop in clinics and would increase the chance that other potential health problems would be uncoved earlier, saving the health service even more money. Thu 20 May 2010 13:47:59 GMT+1 vivilanco Ok so I’m not the most healthy person in all of this here United Kingdom but, I don’t smoke, I don’t drink to excess and I don’t see why people should be paid to live healthier! (having read this through, I warn all – it’s a bit of a rant!)All my family live un-healthy lifestyles (bar the odd exception – either extended family or married into it) but all my close family smokes... between just 5 of them they have had too many heart attacks to count, too many strokes, lung problems, angina, diabetes, depression, alcoholism and many other traits... I am glad to say, I may have inherited some of their problems but I have not worsened them by my own doing! I don’t see why the NHS should pay out to my family (let alone anyone else’s) because they chose to take up habits that that they knew were bad for them and KILL PEOPLE! I was subjected to a lot of 2nd hand smoke as a kid, and now in my 20s, I have a house and a mortgage but because of my families ill health and lifestyle choices – I can’t get health insurance (life is fine...). I don’t see why people should be able get incentives to live healthier when they obviously don’t want to! - You then get the argument that “some people can’t” or “its hard for me I’m a....” will power is there for a reason! You find it hard to give up smoking, well then that’s your problem! Don’t subject me to your complex problem of “but I can’t help smoking, I need to”Why not turn it round... cash incentives for people to live healthier lives... If you smoke / are obese – you pay higher national insurance! In the past 5 years I’ve been to the hospital well over 20 / 25 times with my family and their habit led illnesses... in the last year alone, there is not a month past where I haven’t visited one of them in A&E because of their lifestyle. I myself have not been to hospital / the doctors with an illness in at least 10 – 12 years – why am I paying so much in to a system I don’t use (when others abuse it due to their own choices!)Wikipedia says “Natural selection is the process by which certain heritable traits—those that make it more likely for an organism to survive and successfully reproduce —become more common in a population over successive generations. It is a key mechanism of evolution.” Why not remove all NHS privileges for people who smoke and have a predetermined “unhealthy lifestyle”... then things would change. Just a thought... Thu 20 May 2010 13:43:10 GMT+1 Roy Excuse me but isn't NICE the organisation that says we cannot afford medecines for very ill people because there isn't enough money to buy them. Now they want to use that money to pay people to give up smoking and lose weight. Surely there is something wrong here. If these overweight smokers want help to change their ways they should sign direct debits to their NHS Trust equivalent to the money they spend on their bad habits so that they can't afford them and the money can be used to cover the cost of the treatment for their ailments. They stop payments when they have stopped smoking for say 2 years or lost a preset amount of weight and kept it off for another preset period. If they can't/won't commit then it is their funeral (literally) and we charge them for their hospital treatment. As this message suggests, I have no sympathy for such people unless their weight is a result of a medical condition. Thu 20 May 2010 13:38:30 GMT+1 Sally Gale How about subsidising gym membership for the workers rather than those on benefits. Free or subsidised pools too. Encourage people towards a healthier life style rather than bribing them. Thu 20 May 2010 13:36:25 GMT+1 John McCormick Hi, SophiaT in #68.I agree. As you will note, my first words were that I do not agree with this proposal. I just wished to emphasise that the addicted do not deserve the abuse directed at them in this stream. They've been called clowns, weak, whatever. No recognition here that substance addiction to something is a crutch most people may have to face at some point.I wholeheartedly agree that money is a short-term solution that won't have long term impact. People need to believe in themselves - have self-respect and hope for the future. That can't be supplied on any prescription. It's certainly not helping them in their fight (nobody wants to be fat) when their self-esteem is undermined at every turn - we've got to get over this attitude that every man is an island. Everybody hurts - eventually. Thu 20 May 2010 13:33:59 GMT+1 Trish SIMPLES NO NO NO, it is up to the individual to choose how they live their lives. I am sick and tired of people getting paid for having KIDS, NOT WORKING, BEING OVER WEIGHT, SMOKING. What is happening to this country If people choose to do any of the above LET THEM PAY FOR IT not ME and the THOUSANDS of other TAX PAYERS that get SHAFTED all THE TIME.NO NO NO NO Thu 20 May 2010 13:17:58 GMT+1 jono-been 19. At 11:02am on 20 May 2010, Vanessa wrote:What an idiot you are. People need to realise that PREVENTION is the only way to solve the national epidemics of obesity, diabetes and heart disease. Thanks for the personal insult, obviously your brain power is too low to determine that the NHS was created provide 'healthcare in this country [that] is available to all, free, and based on need, not ability to pay'.Where does it say here that the NHS was created 'to preach about the 'terrible personal lifestyle choices of the UK's population'?Furthermore, by your ideology, electricity should be taxed 500% because it creates pollution that will have health effects on us all, mainly the 'fact' that we will all drown from sea level rises, be dissolved by acid rain, die from ozone depletion, oh and also die when we run out of oil.21. At 11:06am on 20 May 2010, Custador wrote:Nonsense! You obviously have never worked in the NHS! The NHS does all kinds of health promotion to help prevent future problems - IN ORDER TO SAVE MONEY!It is far, far, far cheaper, for example, to employ a smoking cessation nurse to give nicotine replacement therapy and counselling to people and pay for it through future savings in not having to treat as many people for the myriad of conditions that smoking increases the risk of.However, back to the point:No, I don't think the NHS should offer financial incentives. What they should do is refuse to treat people who won't stop engaging in high-risk behaviours.No I have not worked for the NHS. Anyway, people learn from their mistakes, if they eat so much fatty food, end up with ultra-high cholesterol and require surgery, they are unlikely to eat so much fatty food again. People live by a general motto of 'it won't happen to me'. Hence why no prevention scheme will ever work.I think the NHS quit smoking support is very good. I used it while attempting to quit, and although I wasn't successful, I still found the support very helpful. Also, it does not pressurise you to quit, and provides a carrot, rather than being hit with a stick.Oh on your final comment, everyone who the NHS refuses to treat should refuse to pay their taxes in that case. Have it either way. Thu 20 May 2010 13:15:21 GMT+1 JD Overcoming one evil (e.g.addiction) with another evil ([stirring a..]love of money) seems like a diabolic solution, don't you think? Thu 20 May 2010 13:11:01 GMT+1 U14366475 Should the NHS reward lifestyle changes? No. As far as I'm concerned the NHS should not pay for the treatment of worthless junkies, smokers or alcoholics, it's their problem, they should pay for it. This would save billions each year. Thu 20 May 2010 13:07:35 GMT+1 Chris Personally I don't buy the "people must stay healthy for the sake of the country" argument. No matter what policy you have on health you cannot guarantee that people will drop dead instantly and conveniently outside a morgue.We all die of something and it may or may not be a protracted (and therefore expensive) illness.It is for the individual to make their choices and if some people pop off early due to lifestyle choices, well... taking a purely pragmatic approach... it helps with the pension crisis! Thu 20 May 2010 12:59:22 GMT+1 MattM Another cracking idea. We had child tax credits to give 'some' people an incentive to overpopulate the country with children they don't actually want so they can spend the money on alcohol and basically not get a job.Now we're going to offer cash incentives to people who stop smoking and lose weight? Crikey, i've never smoked i wonder if they could backdate the payments. I wonder also how many who bleed the country on other weak areas are going to start smoking so they can give up for cash.No incentives should have cash values. Surely if we're going to adopt another namby pamby stance we could at least make them as someone else stated in the form of facility vouchers/discounts. Thu 20 May 2010 12:54:56 GMT+1 Samantha G smoking cessation is already funded - it is possible in some areas to get vouchers for nicotine replacements that are redeemed at the local chemist and they then test the carbon monoxide levels in your breath to check you really are giving up. this type of funding is acceptable, handing out money isn't, but I imagine this is the sort of scheme they hve in mind - I certainly hope so Thu 20 May 2010 12:54:37 GMT+1 LancashireLass Which idiot came up with this idea in their 'brainstorming' session.Then which other idiot santioned it.If the NHS concentrated on the job it had to to instead of the job it would like to do, there might be enough money to cut waiting lists, create 'real' nurning jobs and get rid of the tiers of management, that seem to be paid to come up with more hair brained schemes.Hopefully the new government will put a stop to the likes of this and get us back to basics Thu 20 May 2010 12:54:15 GMT+1 Seqenenre They'd do better to send Health Toursists home before doing this.At least those here have paid for it. Thu 20 May 2010 12:52:41 GMT+1 sssmith · 58. At 12:42pm on 20 May 2010, Halfbreed wrote: Clearly none of the above people have actually read the article (surprise surprise). What they are suggesting is offering grocery vouchers to pregnant mothers who insist on smoking.The success rate of getting mothers to quit is twice that of any other method. Sad state of affairs though this is it demonstrably works, protects an innocent party (the unborn child), and saves the NHS money in the long term.Good work from NICE, who once again have to make difficult decisions in the teeth of the Tabloid press. Good on them.################### The Question being asked is “Should public money be used to reward healthier lifestyles? Is becoming healthy something people should already be doing anyway? What's the best way to promote healthy living?” Thu 20 May 2010 12:42:31 GMT+1 chrisk50 The reward is already there - You live longer.But then again depending on circumstances maybe not a reward.How about the people that live or work amongst city pollution, never smoked but are breathing in the equivelant of a 20 a day smoker. They would probably be very glad to be assisted with changing their lifestyle.How do we know the food we eat is healthy? That fish you ate for supper could be contaminated with mercury, cyanide or chromic acid depends where the fish came from. We may have strict pollution control but many of the countries we import from do not.Take a look at all of the staff in the NHS, should they be setting an example?Classify healthy foods and subsidise very heavily with no tax whatsoever to produce.Why is there no healthy options takeaways - because it is too expensive to market. Thu 20 May 2010 12:33:25 GMT+1 Alex McBride Please tell me that it's April 1st and this is a joke. Of 450 women who went on the scheme in Scotland a fifth a still not smoking? Well pat yourselves on the back because by that math 360 still are, and I assume they are/were paid the credits too.Question: According to the NHS, at 6"2 and 14st2 I am overweight. I also used to smoke (so could again). How much money will the Government give me (back) to lose a few pounds and give up smoking which I can easily take up again? I'll even throw in refraining from binge-drinking for a token fee...Why is everything in this country someone else's fault? Why is it up to the Government to fix all of our problems? Why are self-inflicted medical requirements treated for free? Thu 20 May 2010 12:31:57 GMT+1 FatPeace - A Promise to Heather And here was me thinking a change of Government might mean they get off our backs about how we choose to live our lives and treat our bodies. No such luck - the more things change, the more they stay the same. Never mind that the alleged 'public health crisis' is manufactured, exaggerated nonsense to give the immense number of DoH-funded pressure groups like ASH, the BHF and Weight Concern something to wax all apocalyptic about. We're living longer, generally healthier lives than any generation before us and yet the degree to which our health is now scrutinised, monitored and moralised about, and the amount of energy, verging on obsession, we're now expected to expend on following healthy living and lifestyle diktats are similarly unprecedented. Smoking has dropped to a hard-core of around 20% of the population, lower than most EU countries, and will continue to fall, albeit slowly, The 'binge drinking' moral panic rests on a relatively tiny minority of students, young people and dependents who genuinely drink to excess and the definition of a 'binge' being set so low (two drinks in a sitting) that virtually everyone is pathologised. Even obesity - that condition that it's now heresy to deviate from mainstream opinion and defend - is far more complicated than the 'eat less, move more, now to convince the stupid fatties of that' peddled by the media and health establishment. People have been convinced by lurid media stories (and it's not just tabloids; the BBC is one of the worst) about 40st mothers and the headless shots of very fat people used to illustrate obesity panic items that such people are commonplace when they actually represent about 2-3% of the population. Studies going back to the 1970s put the heritability of body size at between 70 and 80%. In fact the vast majority of the 'epidemic' comprises those of BMI 25-35 which has been has been linked with increased survival rates and other benefits, yet even the elderly folk who benefit most from having extra reserves are still told to lose weight at any cost. No-one seems to be able to decide whether fat children become fat adults, and in any case the expensive and intrusive interventions they've tried thus far have produced only weight-obsessed, neurotic teens and an explosion of eating disorders and weight-based bullying and victimisation, but still they persist with the same disproven methods causing immense damage in the process because they've no other ideas and because the ideas that there exists a problem to be solved and that fat people are broken thin people in need of being 'fixed' have become so ingrained and pervasive. As a larger person myself (and perfectly happy being so) I don't want to see people paid to lose weight. With so many other better uses for limited resources this will only breed deeper resentment against fat people, many of whom don't want the sort of attention currently focused on them to continue. Whilst I'm not entirely convinced that we have the level of control over our weight that as assumed I think it should be a matter of individual, uncoerced choice and priorities, and I certainly don't believe it is the place of Government to tell us how big we should be or to mobilise and manipulate social pressure that will make life more difficult for people who can't or won't comply with their demands. Thu 20 May 2010 12:31:55 GMT+1 Harley OK. So let me get this right. I'm a non-smoker, non-drinker, paying my National Iinsurance contributions, much of which is for funding the NHS. Now the NHS want to give that cash away to someone for giving up smoking (which they might start again immediately after getting the handout while celebrating down the pub), while other poor souls are being denied life-prolonging cancer treatment due to lack of NHS funding? Sorry, I'm lost!! Thu 20 May 2010 12:25:58 GMT+1 b_riggs The doctor who carried out the first studies of this in the US found that after the incentives are taken away people revert to their former lifestlyes. His conclusion was that it was not a viable long term option to increase the health of a nation. Quite why we're wasting time and money on further studies in the UK when our preliminary evidence points to the same conclusions is beyond me. Thu 20 May 2010 12:24:17 GMT+1 Boops_84 Shocking! I believe that the investment should go on things such as money off at Gyms, classes or work out DVDs etc....But giving people CASH to get off their bums and do something about their weight is outrageous! Being out of breath going up the stairs was an incentive for me to get off my bum! and so I ditched the car and cycle to and from work every day losing 22lbs in 2010. GRRRR - Once again spending our money on total rubbish. Give them the cash and they will go out and spend it on takeaways/beer at weekend! Thu 20 May 2010 12:24:13 GMT+1 Russ I don't agree with this at all unless it's extended to ALL of us who help ourselves!In my late-teens, over the space of a couple of years I got down from a 40" to a 32" waist (at a height of only 5ft 8"!) through exercise and sensible eating. Almost 10yrs on, I've maintained that by continuing to keep an eye on what I eat, and visiting the gym three times a week.So, why shouldn't I get £12.50 per week or my monthly gym membership paid?Nope - the irony is that for someone who can't lose weight/stop smoking until they start getting paid to do so, it's not right that they get paid when they clearly had the capability to do it had they wanted to do so in the first place. Thu 20 May 2010 12:24:05 GMT+1 Andy L Leeds Is it April 1st? Or has the NHS gone mad???Incentices to stay healthy is an outstandingly bad idea, staying healthy is in fact the incentive. Tax payers money should not be wasted on those that are too lazy or idle to look after themselves.Educating people to eat a healthy diet and do some exercise would be better. And ultimately if they choose not to take this option then let them become fit/ill/unhealthy/etc and if they require NHS support make them pay for it not us pay for them. I would far rather tax payers money went to those that deserve it. Thu 20 May 2010 12:23:46 GMT+1 No Victim No Crime Now they come up with this after i've already given up a 30+ yr cigarette habit and the same for alcohol..... typical.No it shouldn't is the answer. Thu 20 May 2010 12:20:45 GMT+1 Tony of Britain 58. At 12:42pm on 20 May 2010, Halfbreed wrote:Clearly none of the above people have actually read the article (surprise surprise).What they are suggesting is offering grocery vouchers to pregnant mothers who insist on smoking.The success rate of getting mothers to quit is twice that of any other method.Sad state of affairs though this is it demonstrably works, protects an innocent party (the unborn child), and saves the NHS money in the long term.Good work from NICE, who once again have to make difficult decisions in the teeth of the Tabloid press. Good on them.----------------------------------------------------I do believe it is you who should read the article. It does not mention anything about "offering grocery vouchers to pregnant mothers who insist on smoking". It states that vouchers could be offered for "anything from food to gym membership". So, because someone smokes, they can get free groceries and gym membership, but because I am not fat and do not smoke, I have to pay for groceries and gym membership. Fair? Not really. If fatties and smokers want groceries and gym membership, they should pay themselves. It is in their interests and their families to stop eating like a pig or smoking like a chimney. If they don't see that, then more fool them, its their problem. I am all for helping these people to try and better their lives, but bribery is not a good way to do it. Thu 20 May 2010 12:19:30 GMT+1 Allan There is a danger in looking at fat people, drinkers and smokers and assuming that they are to blame for the resultant illnesses. It is true that most of these people know what they should be doing, and a least measures have been taken to make smpking unfashionable.but what about the celebration drink, the giving of sweets as a reward,the birtday cake, the chocolate easter egg, the Christmas dinner. All of these imprint an image that eating and drinking is a reward or something special.Its no wonder then that people confort eat, or have a drink to wind down.We need to change the message. Thu 20 May 2010 12:18:49 GMT+1