The UK and Germany are taking preventative health care seriously. Prime Minister Gordon Brown is defending himself against reports that treatment would be withheld from people who lead “unhealthy” lifestyles. The controversy was sparked by a letter to the staff of the National Health Service from Mr Brown to congratulate them on its 60th anniversary. He foreshadowed a bill of rights for NHS patients which would spell out both their rights and their responsibilities. A spokeswoman for Mr Brown said that she wanted to make “very, very clear” that people would not be punished for their bad habits.

And in Germany, an attempt has failed to impose financial penalties upon patients who do not follow their doctor’s advice. The plan was abandoned after protests from doctors and patient groups who said that it would destroy the patient-doctor relationship. Under a compromise reached before Christmas, patients with chronic disease will only be penalised if they explicitly declare that they have ignored advice and will continue to do so. ~ BMJ, Jan 12