Hewitt defends NHS treatment bans

She said it was "perfectly legitimate" for primary care trusts to set a collective policy to deny operations to certain patients.

Ms Hewitt was responding to a Sky News survey which found nine PCTs refused joint replacements to obese patients and four blocked orthopaedic surgery for smokers.

The areas concerned cover six million people, but Ms Hewitt said it was common practice in individual cases in other parts of the country.

Ms Hewitt told Sky's Sunday Live: "Primary care trusts are absolutely entitled to get together with their doctors on any particular area of clinical judgment and say 'these are the guidelines we are putting in place for this particular kind of treatment'.

"Those decisions are being made by individual doctors all over the country.

"In a few places doctors have come together collectively through the primary care trusts to put in place guidelines for all of their patients.

"This isn't a matter for managers or indeed Government ministers to decide who gets what operation - it's a matter for doctors and always has been.

"The NHS will treat you with help to stop smoking if the doctor's advice is that you shouldn't have the operation until you've stopped smoking.

"That is a perfectly legitimate clinical decision. I support doctors making clinical decisions in the interests of their patients."