Last Updated: 2003-06-03 12:42:58 -0400 (Reuters Health)

LONDON (Reuters) - Chain smokers and the overweight may be asked to sign contracts promising to lead healthier lives in return for medical treatment under plans being considered by the British government.

The contracts would set out patients' responsibilities and offer them help to cut down or quit smoking, lose weight, get more exercise or eat a more nutritious diet.

Patients would receive treatment in return for following the doctors' advice, according to the concept. Those who fell by the wayside would not actually be turned away -- but the mere idea has prompted predictions of the demise of Britain's free National Health Service (NHS).

"The NHS was founded on the principle that you do not discriminate on people on the basis of lifestyle," said a spokeswoman for the Freedom Organisation for the Right to Enjoy Smoking Tobacco.

"If people are forced to give up smoking or lose weight before they see a doctor it will signal the death of the NHS."

Even doctors themselves are unenthusiastic.

"This idea amounts to a bureaucratic nightmare," said Dr. John Chisholm, chairman of the British Medical Association's General Practitioners Committee.

"The proposals seem to threaten the doctor-patient relationship and potentially even to deny people the free care to which I believe they are entitled," he added in a statement.

A Labour Party spokesman denied any intention to withdraw treatment.

"The consultation document covers the shared rights and responsibilities between the NHS and patients. It is not about restricting treatment or making treatment conditional," he said.

The agreement would take the form of a joint statement of "mutual good intent," he added.

The proposals, which could become part of Labour's manifesto at the next general election if ratified at the annual party conference, are aimed at easing the pressures put on the NHS by avoidable, lifestyle-related diseases.