Letter: Rationing the NHS

Sir: Dr Nicholas Leach's letter on NHS rationing (2 December) and your further articles on the dangers of smoking (3December) surely suggest one area in which NHS expenditure could be reduced.

No one is required to smoke tobacco. It is a voluntary exercise, particularly among young people starting the habit. After years of publicity no one can claim ignorance of the medical dangers. Why, then, should the taxpayer pay for the medical treatment of those who, wilfully, deliberately, carelessly, indulge themselves in a practice they know will harm them?

I should like to see and hear discussed the suggestion that, with effect from some arbitrary cut-off date in the future (say the year 2000) people with smoking-related illnesses should not normally receive free treatment under the NHS. Such people should be made individually to contribute towards the cost of their treatment. Let NHS money be spent on people who are sick or injured through causes beyond their control.

Perhaps people who know that if they become ill through smoking they will have to pay for treatment will summon up some self-discipline and not smoke again or not take up the habit.

DENYS WHATMORE

Cheltenham, Gloucestershire