Written contracts would guarantee a certain standard of treatment in return for attending appointments and following doctors' advice in areas such as diet or addiction.

A consultation paper will be discussed at Labour's annual conference this autumn with the eventual results forming the basis of the party's manifesto.

Do you agree with these proposals? Will they help to cut back on waste in the NHS? Should a person's lifestyle affect the treatment they receive on the NHS?

This debate is now closed. Read a selection of your comments below.

The following comments reflect the balance of views we have received:

SUGGEST A DEBATE This topic was suggested by Jenny, Scotland Are health contracts the thin end of the wedge for all of us and are they an infringement of our personal liberties? Send us your suggestions for Have Your Say debates

Those who smoke, eat the wrong foods or are generally not in good health should be allowed to opt out of paying national insurance on the proviso that they take up private health insurance. Or how about those who do not use public health services because of good health being given a refund? I am sure the government would have a sudden change of heart if this was allowed to go through.
Andrew Graham, UK

What about sporting injuries, people who choose to have children despite having genetic problems, having had screening and not aborting "abnormal" babies - will they also be refused treatment? It is what is commonly known as "the slippery slope argument".
Millie, Great(?) Britain

Although we have removed the spectre of hunger in the Western world, our diets are based around cheap foods which are high in fat and sugar and healthier foods are priced out of poor families' budgets. Until we get our priorities right and ensure that healthy food is competitively priced along with a willingness by society to eat better, nothing other than compulsion will change our habits.
Ray, UK

Ray, UK: What rubbish. I'm now unemployed and have to buy the cheapest healthy food - fresh vegetables and fruit, no convenience foods, no sugar and fat-saturated ready made meals or sauces. I cook fresh food every day. It's individual choice and laziness that makes poor families choose to fry everything, and live on chips.

Everyone knows what is healthier, everyone has equal access to it, there's no excuse. Some people still make conscious decisions to fill their bodies with rubbish and never exercise. In return, we should make conscious decisions not to divert much needed NHS resources to undo the damage.
Nat, UK

From the cradle to the contract.
Pete, UK

Here already is a contract. I pay NI and a doctor will see me when I fall ill. Or is this and example of New Labour once again charging me twice for the same service?
Anon, UK

The problem is that we have the commercial promotion of unhealthy living and we're penalising people who become victims. My proposal would be to tax food according to its saturated fat content with the aim of doubling or even tripling the cost of sausages, hamburgers etc. Then use the revenue to subsidise anti-smoking aids and healthy food.
Charles Moore, Scotland

Those who smoke and consistently become ill need to change Nick Broom, England

Our culture is 'rights' orientated but a simple contract requiring people to try to change their lifestyle so that they may live healthier, seems to me to be a good idea. Those who smoke and consistently become ill need to change. After all, doesn't this benefit everyone else ie more money for the NHS..?
Nick Broom, England

A victim or rights culture might not be ideal but is a blame culture any better?
Alan, London

Let's give up on the NHS and reduce taxes. We will all then have the choice what to do with the money saved - private health insurance and membership of a gym or a packet of fags and a six pack to wash down the deep-fried Mars bars after a sedentary night-in watching the box? Trouble is most people would probably choose the latter.
Paul, UK

Poor health is linked to deprivation and poverty. Many of those who find themselves in this situation do smoke and may well not lead the healthiest of lifestyles. Now "new" Labour is abandoning them with these phoney contracts and non-binding arrangements. Nothing useful will be achieved, but the paperwork will grow massively. Message to Blair: Stop fiddling with the NHS before it really does fall to bits.
David, UK

Who said they could change the rules? Wendy, UK

Surely this is breaking the contract between state and population? WE pay National Insurance, THEY provide us with healthcare. Who said they could change the rules?
Wendy, UK

Before we start restricting access to UK citizens on the basis of poor lifestyle, can't we first stop the "health tourists" (not only from the EU, mind you) who come over for free treatment - often for very expensive treatment?
Caroline, UK

The further privatisation of health provision... Now we will have a society where the wealthy can 'sin' to their heart's content (or limit) safe in the knowledge that should they need help they can pay for it, while the poor must remain 'pious' and 'pure' to hope to get any form of salvation.
Andrew Bartlett, UK

Ahh, so then we will all be perfect size 10 clones. When people realise they will not be eligible for treatment, they will try anything to lose weight, using dangerous diet pills and other unhealthy weight loss regimes that can be more destructive. Overeating is a recognised eating disorder. The government should recognise this and treat it as such by offering the appropriate help.
Carrie, UK

How on earth are they supposed to enforce this? Spies in chip shops?
Tim, UK

The word responsibility seems to have been lost from the English language. All everyone talks about these days is their rights. About time someone pointed out to those that expect everyone else to pick up the pieces that they should do something about it themselves first! Provided this is linked with programs to help people alter behaviour, it seems like a great idea. Free Weight Watchers membership for all!
Diana, UK

I think that it is a great idea. I currently have to wait two weeks for a doctor's appointment, and anything that frees up doctors time is definitely worth it. If people don't take the doctor's advice on how to get better and just want easy quick fix pills, then they should have to pay for them privately.
Richard, England

I gave up smoking to improve my health prospects, a direct consequence of this is that I have put on over three stone in weight, which of course is detrimental to my health prospects... should I take up smoking again, will my doctor ever grant me another appointment?
Peter Grant, England

Don't they already do this? Carol, England

Don't they already do this? My father was refused treatment for a stomach problem until he stopped smoking. My uncle had to give up all drink, even the odd glass of wine. My mother's problems were blamed on her weight - it turned out he had a gall bladder about to burst...
Carol, England

People who drive well get cheaper motor insurance, why shouldn't people who look after their health get better service?
Alex Gray, UK

Why stop there? DIY mishaps, sporting injuries, road accidents, injuries sustained whilst drunk and so on. Virtually everything we do is voluntary, so why stop with smokers and those with less-than-perfect diets? Crazy scheme, sounds like a diversion to draw fire away from something less controversial to me. Watch the headlines over the next few days for some other kind of "announcement"...
Bernard Blundell, UK

I already have a contract - I pay the government money, they then treat me when I need it. I consult medical staff when I fell there is something wrong, I shouldn't have to take their advice if I don't like it. Where's nanny?
Steve, UK

My wife and I are in our mid-50s and have smoked since the age of 16. We have paid our national insurance all our working lives and paid the duty levied against our cigarettes. Why then can't the government use some of this money to cure us if we fall ill?
Geoff and Pat, Liverpool, England

Maybe it is about time that we scrapped the NHS? Why should the tax-payer fund the healthcare of those who will not take care of themselves? This is yet another example of the "victim culture" - people who suffer because of lifestyle choices are not victims; it is self-inflicted.
Tony Emmerson, UK

Stress is acknowledged to be a major contributor to many diseases. Nagging causes stress. If all the holier-than-thou amongst us stopped nagging, stress levels would be considerably reduced, thereby saving the health service and all those of us who have no choice but to pay for it a considerable amount.
Lisa, UK

Can I have a contract with my doctor that he will give me the best treatment? Sandra Patterson, UK

What about those who DO lead what can be called a healthy lifestyle - do we get to go to the top of the queue for treatment should we need it? Can I have a contract with my doctor that he will give me the best treatment available, including GP appointments, in a prompt and timely manner? Sorry but I cannot agree with this - it is just another "money saving scheme", which will cause more paperwork for all concerned, put in place to divert attention from the problems of our poorly funded health service.
Sandra Patterson, UK

Below are some HMG statistics related to smoking - tobacco revenue: �8bn pa. Cost treating smoking-related illness: �1.5bn pa. It would appear smokers are subsidising the NHS!
Mike, Bucks

I expect the next step down this line of thought is the NHS only available for the healthy?
Simon Hattersley, England

OK, I smoke. OK, I may one day need hospital treatment. However, on the basis of how much tax I pay to Gordon Brown every day I buy my tobacco I expect a private room complete with personal doctors and nurses, never mind being told I may not get treatment without improving my "lifestyle".
Neil, UK

I totally agree with the proposals. I can't think what anyone who is simply too lazy to change their lifestyle and eating habits has to worry about. It would make it far easier to identify people who have a genuine need for healthcare. Although I think that the government should lead by example, starting with the deputy PM John Prescott.
Steve, UK

Surely the government will be shooting itself in the foot. If all smokers decide to give up to receive the same level of treatment as a non-smoker, where will the government make up for the huge amount of revenue lost from the sale of tobacco in this country?
Kate, UK

This contract business is a waste of time Janice, UK

Sure patients have responsibility for their health and in their relationship with the NHS. But this contract business is a waste of time and if it does lead to being legally enforced this would be immoral and against the Hippocratic oath. I have recently had a pulmonary embolism subsequent to a trans-Atlantic flight. Should I have been denied treatment for endangering my own health here and should I now be banned from flying ever again?
Janice, UK

How about tax breaks for people with a healthy lifestyle, so the cost of the NHS is footed by the people most likely to use it?
Abigail, UK

Having read this article I find it difficult to believe this can be enforced. My doctor, when asked for patches to stop smoking, informed me to go 'cold turkey'. How can you expect people to adhere to certain standards when we are not receiving the medical attention required?
Michelle Libby, England

This is what happens when the state provides healthcare. Patients are regarded as recipients of charity who should be grateful for anything they are given. And now it seems they are going to have to prove themselves deserving of that charity. Contrast this with the customer is always right approach of the private sector. The sooner healthcare is privatised the better.
Alan, UK

I think it's a great idea. I don't see why those who look after themselves should be penalised by those who destroy their health. As for the argument that obesity and smoking is predominantly a symptom of poverty - an apple is cheaper than a jumbo bag of crisps! And have you seen the price of cigarettes?
A, UK

Don't doctors have one of the highest rates of alcoholism? Gerry, Scotland

Don't doctors have one of the highest rates of alcoholism? Can I insist that my doctor meets the same health requirements he will insist for me?
Gerry, Scotland

Given the lack of investment in the NHS since 1979, I can't see any alternative but to start to make those who waste the NHS's time (by breaking appointments without notice or by failing to follow advice without good reason) accept the consequences of their actions. The NHS should never lose sight of its purpose or reason for being and if operated properly, such a regime would free up more resources for those in need.
Robert Crosby, Nottingham, UK

One in three adults is overweight, one in four smoke and most drink. At a rough estimate some where between 35% and 45% of the electorate have just been given a reason not to vote Labour at the next election.
Al, UK