Across the pond

Which groups waste most NHS money?

Is it:

A. Smokers
B. Drinkers of alcohol
C. Those who eat too much food
D. NHS managers
E. Big companies
F. Politicians

This question is provoked by news of yet more discriminating measures against smokers. Health service authorities in Norfolk and North Staffordshire are refusing non-emergency operations, like hip-replacement, to smokers.

It is perfectly true that some smokers who die slowly of cancer use up a big chunk of health service money. However, other smokers die quite quickly, particularly those who have heart attacks, which are more likely amongst smokers. But in terms of the cost to the economy it does not follow that even those smokers who die slowly of a smoking related disease are costing the health service more. If they had given up and lived longer they would have eventually contacted other diseases which be expensive to treat.

Drinking too much is a much bigger killer than smoking. And it not only costs the NHS in treating the drinker, it creates a huge bill for those injured in accidents caused by drink driving and for those who are beaten up by drinkers whose aggressions have been released by alcohol.

Eating too much – and the latest study shows that British young people are nearly top of the world league in terms of obesity – also makes people vulnerable to all sorts of expensive to treat diseases, notably heart attacks. Almost certainly over-eating is a bigger drain on the health service. But of course it would be very difficult to prove statistically.

I hope this demonstrates the absurdity of economic case for discriminating against smokers, rather than heavy drinkers or excessive eaters. I could have easily expanded the list. What, for instance, is the cost to the national health service of the current fashion for extreme sports?

If we really want to reduce NHS spending I suggest that the best targets are:

Those health service managers who advocate this kind of thinking and who are eroding the Hippocratic oath which doctors subscribe to.

Those big companies which pedal the drinking culture, including those who own pubs which encourage binge drinking.

Those big companies (and small companies) who pedal the most fatty foods. And the biggest quantities of it. Pubs and restaurants throughout Britain serve far too much of the fattiest foods. Since I am a smoker, who does not need food for comfort, I frequently leave half on my plate.

Those politicians who encourage the climate of opinion which targets just one easy target, instead of the politically more dangerous option of challenging the conventional wisdom of the times.

But finally on behalf of all smokers I must point to the obscentity of the allegation that we are a drain on the economy. Quite apart from what I have said above, smokers contribute hugely through extra taxation to the NHS and all public services. My pack of Camels a day contributes £1,653 year to tax revenues at current rates of taxation. My lifetime consumption would have contributed about £88,000 at current tax rates.

The only global figures I could find quickly just now come from Forest, the smokers’ pressure group. They say that in 2003 the revenue from smoking was £7 billion against the NHS estimate for treating smoking related diseases which was £1.5 billion.

I rest my case, m’lud.