Access to healthcare 'should be linked to lifestyle'


PEOPLE WHO behave irresponsibly should not enjoy the same access to healthcare as people who behave prudently, a leading economist argued last night.

Jim Power of Friends First said in an era of finite resources greater efforts had to be made to obtain value for the billions put into our health service.

He said spending had to be prioritised on the basis of “genuine need” as well as “equity and fairness”.

He asked if people who adopted risky lifestyle behaviours like smoking or abusing alcohol should, in such a climate, be given the same access to healthcare as people who adopt healthy lifestyles.

“I don’t believe on grounds of equity and fairness they should,” he said.

He pointed out that about 7,000 people die directly as a result of smoking-related illnesses every year in the Republic and up to €2.25 billion a year is spent in the developed world treating people with smoking-related illnesses. He argued it could be better spent.

Mr Power was participating in a public debate at Trinity College Dublin where he was speaking against a motion that: “This house agrees that all patients are entitled to equal access to healthcare whatever their lifestyle choices.”

It was the first of the 2009 Pfizer Health Debates series in association with The Irish Times.

Speaking for the motion, Prof Donal O’Shea, a consultant endocrinologist at St Columcille’s hospital, Loughlinstown, Dublin, argued that equal access to healthcare was a fundamental right for everyone, not least patients with alcoholism and obesity. If one was only to grant access on the basis of healthy lifestyles people would have to keep a log of the number of pieces of fruit and vegetables they ate every day of their lives as evidence of healthy living when they required healthcare which was, he said, “a kind of crazy scenario”.

The motion was overwhelmingly carried.