Patients may have to make slim pledge

London: Overweight patients may soon have to sign a "contract" to get slim before getting a new hip on the NHS.

The idea of denying expensive surgery to people who refuse to play their part in making such operations successful is said to be under discussion as part of a major Downing Street review.

Tony Blair is keen to base new policies on his idea of linking rights and responsibilities, using a range of new contracts between citizens and the State.

Other examples could include making parents agree to support their child's education by ensuring good behaviour and that homework is completed on time.

The police could pledge to respond to incidents within a strict time limit in areas where residents have struck an agreement on localised law and order priorities. Blair's strategy is to create "a new, more explicit contract between the State and citizen on agreed public outcomes", according to Cabinet Office papers reported in the Guardian yesterday.

The proposals are being debated between ministers on six Whitehall policy review groups set up by Blair to come up with fresh ideas over the next few months.

The groups, which include Cabinet ministers, were first seen as an attempt to carry on the Prime Minister's agenda after he retires but they are now emerging as a bid to refresh government thinking before the next election.

Ideas from the series of meetings are to be fed into the Budget, ministerial speeches and departmental reviews rather than being published as policy papers.

- Evening Standard