Ms Hewitt, fresh from her recent victory over Britain's nicotine junkies, took time out from shortening NHS waiting with lists with Tippex to talk exclusively to Utterpants over a glass of freshly-squeezed (organic) carrot juice in our Purley offices.

Ms Hewitt is clearly a woman on a crusade—if not a jihad—to turn a nation of obese, allergy-challenged, drug-dependant wheezing wrecks into perfect specimens of glowing physical health and mental fitness, as embodied in the persons of the Deputy Prime Minister, John Prescott and the late Mo Mowlam. Under her new proposals, patients will be required to prove that their circumstances and lifestyle are not responsible for the conditions they are suffering from in order to obtain medical help. When we pointed out that such radical steps were likely to exclude over 75% of the population from receiving treatment, the Minister nodded approvingly and launched into a long tirade against the 'army of scrounging malingerers' who cost the British taxpayer millions of pounds and undermine the efficiency of a health service that is the 'envy of the world.'

Pausing only to tear down the large sign affixed to our editor's door which read 'Visitors who persist in not smoking will be forcibly ejected from these premises,' the slim, teetotal non-smoker went on to outline her sweeping new proposals with breathless enthusiasm.
"Under my new proposals, all obesity-related illnesses will be treated at the patient's expense. Obesity causes huge health problems and costs this country a fortune in medical insurance. People have a choice. Labour is all about choice. If people choose to spend their dole money stuffing their faces with microwaveable pizza, chips and chocolate they can hardly expect to cop a free triple heart bypass when their clogged arteries finally give out, can they?"

"Is there a name for these new proposals, Minister?" we asked.
An expression of indescribable disgust passed over the Minister's face as our reporter lit the first of many cigarettes.
"Yes, NICE—the National Initiative for Clinical Economisation. Gordon Brown estimates it will save the Treasury 62 billion pounds in the first year of operation. And, of course, waiting lists will simply vanish."
"How's that?"
"Well...really!" ejaculated the Minister smugly. "Half of all hospital beds are filled with fat, ageing smokers and drinkers and the other half are filled with even fatter malingerers who used to smoke and drink."
"Are you saying your proposed denial of treatment would apply to ex-smokers and drinkers too?"
"Naturally. Otherwise some wheezing, gin-sodden, overweight scrounger will simply give up their filthy vices and starve themselves for a month or two before applying for treatment. We're not stupid, you know."
"And you don't see any flaw in this reasoning, Minister?"
"No—none."
"Then perhaps you'd care to explain how someone is expected to determine whether their illness is self-inflicted or not? How can you be sure that a smoker who has a heart attack might not have had one anyway even if they had never smoked?"
Ms Hewitt swallowed and drummed her fingers noisily on the tabletop.
"I...er…we...look—a patient's individual circumstances and lifestyle will only be taken into account when there will be an impact on the clinical and cost effectiveness of the treatment."
"So what you're saying is that if an overweight smoker goes to the doctor with an ingrowing toenail they'll receive help but if they collapse with a heart attack outside Tesco's they'll be left to die?"
"Well—they should have jolly well thought of that before they started smoking and stuffing their face, shouldn't they?" snapped Ms Hewitt, waving her arms in the air as our reporter exhaled a noxious cloud of cigarette smoke in her direction.

"What about sports injuries, Minister?" we asked.
"I'm glad you brought that up. The government believes that dangerous sports are another area long overdue for new legislation. Whilst sensible physical jerks—a few press-ups in the bedroom during the monthly conjugals or gentle arm-stretching upon rising in the morning—are admirable activities with little risk attached to them, vigorous jogging can cause serious injuries. Consequently, we propose that reckless pavement pounders should be refused treatment for any knee and foot injuries they acquire through their selfish activities."
"What about skiing?"
"Frankly, if you can afford to bugger off to Klosters every February for three weeks on the Piste, you can certainly afford to pay for your own bloody hip replacement!"
"And football?"
"According to a recent survey conducted by my department, football-related injuries cost this country approximately £236,437,382 every year. Under my new proposals soccer hooligans will no longer be treated for broken ankles—or heads."

"We understand you're also going after sunbathers?"
"Absolutely! Sunbathing has been directly linked to a variety of malignant cancers. It is completely unacceptable to this government that sunbathing-related diseases should be treated at the public expense. Under my new proposals, any patient presenting with a suspected tumour will be tested for evidence of tanning during the last thirty years—"
"—Thirty years?" we interrupted.
"Well...we were going to make it fifty years, but compromised after lobbying from pharmaceutical companies."
"And if the tests are positive they'll be refused treatment?"
"Exactly."

Implementing such sweeping improvements in the health of our nation might run into some resistance, but Utterpants had the Minister's personal assurance that—just as the smoking ban due to come into force in 2007 will practically eliminate this filthy vice—persuading the nation to forego hospital treatment should not prove insurmountable. Which is more than we can say for getting Britons to give up drinking and stuffing their faces with chips and microwaveable pizza. But we can tackle that later.

We asked the Minister when her proposals were likely to be implemented.
"Many of them are already common practise in many Health trusts throughout the UK."
"Such as?" we asked.
"Well...hip replacements, for one."
"Are any still being done?" we asked.
"Very funny," snapped Ms Hewitt. "Yes they jolly well are; on those whose individual circumstances and lifestyle qualify them for treatment under current NHS guidelines."
"Which are?"
"That clinically obese people should not be automatically entitled to hip and knee replacement surgery."
"Why ever not?"
"Because it's not NICE!" retorted the Minister irritably.
"Nice?"
"Providing clinically obese patients with new knees does not conform to the guidelines laid down by the National Initiative for Clinical Economisation."
"In what way?"
"The risks of operating on obese patients are much higher and the treatment may be less effective, with replacement joints wearing out sooner."
"So, it's all a question of money?"
"We prefer to call it a national initiative for clinical economisation."
"Nice..." we replied.

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