# NHS To Pay the Obese and Smokers



## Invicta (Feb 9, 2006)

_'Smokers and the obese could be paid to give up their vices as part of NHS incentives designed to promote a heathier lifestyle.

An NHS advisory group suggested offering incentives to people to quit smoking or eat healthier food can lead to positive changes.

A pilot scheme saw pregnant women being awarded supermarket vouchers to give up cigarettes and the obese paid to lose an agreed amount of weight.

Children were also offered toys as a reward for eating more fruit and vegetables.

The independent Citizens Council, run by the National Institute for Health and Clinical Excellence (Nice) and made up of members of the public, has backed the scheme.

The wider public are now being asked to give their views before Nice considers whether to implement the policy.

Sir Michael Rawlins, chairman of Nice, conceded paying people to quit smoking was a "divisive issue".

But he said it was important to consider alternative policies.

"The Citizens Council makes an important contribution to the work of Nice by providing a snapshot of what the general public thinks about controversial health challenges," Sir Michael said.

"I am extremely grateful that the council has considered whether there is a place for incentive schemes to encourage people to change their bad habits and live healthier lives.

"The majority of the council has voted in favour of the use of incentives under certain circumstances, but this clearly remains a divisive issue. We are now very keen to hear what the general public thinks about their conclusions."_

So what do you feel?

Me? Well as a retired nurse, midwife, district nurse and health visitor my opinion is the scheme is preposterous!

I have seen so much abuse of health services over the years and this 'reward' scheme would just perpetuate that abuse. What is to stop people from restarting to overeat and smoke when they want the latest designer clothes and the like?

Too much emphasis has always been placed on curative medicine and not enough on preventive; even more so these days with the huge reduction in the numbers of health visitors. As a health visitor I used to go into the homes of families with young children and talk to them face to face about healthy eating, the dangers of smoking and alcohol abuse. Advice on meal preparation on a low income was necessary in quite a number of young families and the elderly. I don't see that happening these days. From what I see and hear today's health visitors' time is taken up now with meeting targets, paperwork and everlasting child abuse case conferences.

Just a couple of suggestions from me; much better to use the 'reward' money to increase sports facilities and make them financially accessible to all, not just those who can afford to go to the gyms and swimming pools. Bring back school dinners and in turn make them compulsory. What better way to teach youngsters about healthy eating?

Health education and health promotion is the only way forward and needs to be commenced at birth. By the time the age has been reached when smoking, gluttony and binge drinking is the order of the day, it is too late!


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## Glandwr (Jun 12, 2006)

It might appear to be preposterous at first sight, but if it works and saves us all money we need to get over it.

On the other hand if it doesn't work and/or doesn't save us money don't bother. It'll only feed miles of Daily Mail editorial and we get too enough of that anyway.

Dick


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## raynipper (Aug 4, 2008)

Are we now in a 'Bribery Culture'?

Ray.


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## mandyandandy (Oct 1, 2006)

Both of us are morbidly obese, we both hate it, we both know we should do something about it. Would we take bribes to do so , no!! it would not make any difference to the way we eat only we have the power to do that. 

Just like when we both gave up smoking over 10 years ago, you had to want to do it and we both did so stopped. 

Neither of us drink, maybe a pint a month for Andy and a glass of wine for me. 

Earlier this year we both had health checks done by the GP and blood tests taken for as many things that could be tested, both of us were stinkingly healthy, he told us himself he was very disappointed not to be able to blame something on us being over weight . Cholesterol and sugar levels were excellent as were heart rates and blood pressures. 

We are trying to loose weight and do not want to yoyo but just eat a diet we can stick to for life. 

I think smoking is a little different as it does affect others not just the smoker and help with giving up has to be a good idea, but not prizes just real help..

Mandy


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## Seeker (Dec 26, 2005)

If people stop smoking and overeating and over-drinking don't they already get a financial reward from all the money they save?

If that incentive hasn't worked why should doling out taxpayers' money work any better?

Harry


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## sallytrafic (Jan 17, 2006)

Seeker said:


> If people stop smoking and overeating and over-drinking don't they already get a financial reward from all the money they save?
> 
> If that incentive hasn't worked why should doling out taxpayers' money work any better?
> 
> Harry


I think that's a very good point. There are already incentives.


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## Briarose (Oct 9, 2007)

I think it is one of the most ridiculous ideas that has ever been thought up.

And personally I am getting really sick of this nanny state that thinks it can tell us or bribe us all what to do.


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## DTPCHEMICALS (Jul 24, 2006)

Will I get paid to give up sex?
Or will that just happen naturally. :roll: 

Dave p


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## Briarose (Oct 9, 2007)

DTPCHEMICALS said:


> Will I get paid to give up sex?
> Or will that just happen naturally. :roll:
> 
> Dave p


 :lol: Ohhhh hasn't it already :wink:


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## xgx (Oct 14, 2005)

as usual they've got it A/F ... they should pay the rest of us not to smoke and/or not to become obese!

Where's the money coming from you might ask... simples...

from the coughers (pun intended!)

... and the fat cats :lol: 

the smokers have already made their contribution via the tax on tobacco............we need a new tax... based on BMI :lol:


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## Zebedee (Oct 3, 2007)

xgx said:


> ............we need a new tax... based on BMI :lol:


Nah . . . Dave p got it nearly right.

All males should have a motion sensor chip inserted into their buttocks at the age of about 12. :wink:

We have the technology!! 8O :lol: :lol:

Dave

P.S. In Dave p's case he could sell it back . . . now it's of no further use for tax gathering!! :lol: :lol: :lol:


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## erneboy (Feb 8, 2007)

Sex? I can't quite remember but that sounds familiar, Alan.


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## Rapide561 (Oct 1, 2005)

*Smoking*

Right, I am on my way to get a few grand. How quick to I get the pay out? Can I start smoking again later and get a few bob extra?

Russell


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## eddievanbitz (May 1, 2005)

What about disabled people? Some of them are a drain on resources often from the day that they born! 

And stupid people, as well as fat people and stupidly skinny people, 

Oh and old dribbly people, and very tall people and midgets and, well Stupid people they are a waste of space and contribute nothing. Black people, white people, yellow people, smokers and drinkers!

I think you get the gist! If we are going to have a National Health Service it has to be just that! If we start dividing it up, you will have sportsmen being told that the broken leg is their own fault!

Fat people should eat less, swimmers should take more care, mountaineers shouldn't be hanging off of ropes halfway up a mountain! Car drivers? Well exclude them if they were speeding.... 

It is impossible to try to rationalise who should and who shouldn't receive treatment! Take car drivers as an example! Non drivers could think that a speeding driver would bring injuries on him/her self and why should precious resources be wasted on him/her? On the face of it a reasonable arguement.

Yet the same hspeeding driver may get incensed when they watch a cycle race, where a multiple rider pile up, that requires teams of paramedics storm halfway up a mountain! taking resources away from other areas.

I personal think that we need to do whatever it takes to help all of us, and perhaps we should trust the professionals a little more and believe a little less what we read or watch in the media which in its own way is calculated to cause a knee jerk public reaction.

Ultimately if a fellow human being needs medical help under the NHS he or she is as entitled and any other human being!

Just my opinion

Eddie


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## Jented (Jan 12, 2010)

Hi.
I say roll it out across the board,pay muggers,burglars,a/social people money to stop,we allready pay scores of people who could work, not to,( This does NOT!! include those who are in unemployment,through lack of work,not commitment),The insurance rates would drop,you would not have to go out and buy replacement articles,A&E would be empty at weekends,job done.Police officers,would have time to stop and have a chat,ooops,that may be a deciplinary offence,(Remember the sledging p/officers,harmless fun),to whoever dobbed them in,"get a life"
Ted.


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## Zozzer (Aug 13, 2006)

If there are to be any incentives to get people to lead an healthier lifestyle then it should be done through the tax system.

A Tax on food based on the calorific and nutritional value of the food.

A massive tax hike on alcohol based on the Proof rating of the drink.
Stronger the drink, higher the tax.

Massive tax hike on tobacco, along with higher penalies for those caught smuggling tobacco or alcohol into the country.


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## Hobbyfan (Jul 3, 2010)

I've no problem paying for people who have accidents, even of their own making. If a state refuses medical aid to a speeding driver or to someone who's over their limit for the number of children (as in China) it's a slippery slope.

However, I see a huge flaw in the argument that paying for a gastric banding operation will save the NHS more money in the future.

It is one extra step in absolving people from any personal responsibility and that's an even slippier slope. Why bother dieting and exercising if you know that ultimately you'll get the quick-fix operation courtesy of the taxpayer?

We get one chance in life, there is no rehearsal and it's up to us all to exercise some self restraint and responsibility.

And as for massive taxes on food and drink, why should the responsible majority have to pay for the excesses of a minority?


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## Senator (Apr 24, 2008)

Around a year or so ago there was a push (in our area) to build up the Health Trainer Service, with the local councils building up teams accordingly.

My wife took up one of these roles, and at the time joined a new team to work alongside the existing team in Brighton, thus creating coverage accross East and West Brighton.

Over the last year, local cut backs and loss of funding have hit, and what was a full team of around 12 Health Trainers has diminished down to 3!

This role has seen huge approval and support through the PCT and local doctors are referring people of all different walks of life and with different issues.

Now, it looks likely that the service will be dropped.

Health trainers offer a free (doctor referred) one-on-one service to help people with nutritional, drug, alcohol and smoking issues.

The best way to help people is through education, and not to give them money!

It just seems crazy that the role of the Health Trainer could potentially be lost through cut backs in spending and yet there is money available to pay people to lose weight or stop smoking!

I just hope that they provide incentives for people to go to join a recognised weight loss programme (for instance) rather than physically hand out money!

Hey ho, it's a crazy old world!

Mark


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## Sonesta (May 10, 2005)

I am very overweight myself  and just like Mandy and Andy, I desperately long to be slimmer! It's a problem I have battled with all of my life and I have been up and down the scales like a yo yo! Over the years I have lost stones of unwanted 'padding' and once even got down to a sylph like size 10,  I felt absolutely wonderful, so much fitter and looked and felt so much nicer too and I vowed never, ever to regain weight again but - just like so many overweight people, the willpower failed and I ended up bit by bit putting it all back on again and each time I have ended up heavier than before I started dieting!  It's nobody's fault but my own and I have to accept that I am not fortunate enough to eat whatever I fancy and NOT pile on the pounds! I wish I was but sadly, nature hasn't blessed me with that kind of metabolism! I would say that for most obese people food can be both their best friend and their worst enemy! 8O

Do I believe I should be given a cash incentive ..... ABSOLUTELY NOT!!!! How flipping ridiculous is that suggestion and if wanting to be fitter, healthier and more attractive is not incentive enough for anyone, then why should a cash payment work? People have to WANT to lose weight, quit smoking or give up drugs etc etc etc  and unless they are REALLY ready to tackle their demons, then there is no way they will succeed! It takes willpower and determination coupled with the right mental attitude and no amount of money offered can get inside a persons head and arm them with the necessary mental approach towards whatever battle they are facing! 

If they really want to help seriously overweight and obese people to lose weight, then the money would be far better spent on setting up schemes and centres, whereby overweight people of all age groups; who truly WANT to address their weight problems or learn to understand why they may use food as an emotional comfort blanket; can go to, where they can get to speak to medical and nutritional experts and be given the correct nutrional and medical advice. A scheme; where apart from dietary advice; the patient can be instructed and taken under the wing of trained exercise coaches who can set up an exercise plan that is individually suited to their specific needs and capabilities. It needs to be somewhere, where people can go who are perhaps too embarrassed to attend a 'normal'' gym class or swimming session for fear of standing out like a sore thumb. Some place where they can feel happy to go to without feeling intimidated or concerned by the looks and stares of rude and ignorant people.  

I strongly believe that if centres like this were set up in existing gyms and health clubs and everyone else who attended these sessions was overweight too, then it would encourage larger people to participate in a much needed exercise routine and I'm certain many obese people would be falling over themselves to take advantage of such help, advice and support. I know I would, as I love to swim but I just hate going to a public swimming pool as I feel far too embarassed to undress in the changing rooms or walk around in my swimsuit! However, if the other swimmers were larger people too, I would feel so much more comfortable about joining in as obviously, we would all be there for the same reason and therefore
we would all immediately feel at ease with one and other! The encouragement and support we would all enjoy from fellow patients I believe would be invaluable.
    
Surely something like this would be a far more sensible approach to obesity than handing out cash incentives and would mean that the only people taking advantage of such government funded facilities are those people who truly WANT help?

Sue


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