Obese patients 'sent to back of NHS queue' as only those 'fit to proceed' will undergo surgery

The move is part of Labour's plan to reform the NHS "from top to bottom", with tens of thousands of patients needing hip and knee surgery being asked to complete a 12-week weight loss programme first.

Smokers will also be urged to quit before receiving treatment dates for non-cancer operations and will only be scheduled when "once they have been confirmed in their pre-assessment as fit to proceed".

According to the reform plans, stopping smoking four weeks before surgery reduces respiratory complications by 25 per cent and wound healing complications by 30 per cent compared to those who continue smoking.

The Department of Health and Social Care and NHS England's Elective Reform Plan states that "prehabilitation" before surgery can boost productivity by reducing complications and cancellations.

Getting patients fitter before treatment also means more can receive day surgery rather than requiring lengthy hospital stays.

While advice to lose weight or quit smoking has previously been given to surgery patients, the new plan makes fitness assessment mandatory for receiving operation dates.

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While NHS authorities have previously banned obese patients and smokers from certain surgeries, others have required patients to lose at least 10 per cent of their body weight, which surgeons have criticised as "brutal".

Under the new system, "unfit" patients will remain on waiting lists while those assessed as eligible will receive speedier treatment.

Professor Sir Stephen Powis, NHS national medical director, said the clinical view supports being "fighting fit" before surgery for "better post-op outcomes and increase productivity".

The reforms are part of a broader NHS overhaul that will see up to one million extra NHS appointments offered annually - a 20 per cent increase on current levels.

Speaking at Epsom Hospital in Surrey, Keir Starmer said rebuilding the NHS would be the "cornerstone" of efforts to rebuild Britain, acknowledging that "some people won't like" the increased use of private sector capacity as he insisted that it was "in the national interest".

The agreement with private healthcare providers will target specialties with the longest waiting times, including gynaecology and orthopaedics, while also aiming to ensure more private care is offered to patients in deprived areas.

Health Secretary Wes Streeting said: "Millions of patients are being forced to wait unacceptably long for treatment, failed by 14 years of neglect of the NHS. This Government will pull every lever available to get patients treated on time again.

"I'm not going to allow working people to wait longer than is necessary, when we can get them treated sooner in a private hospital, paid for by the NHS. If the wealthy can be treated on time, then so should NHS patients."

The new agreement will prioritise reducing waiting times in areas with the greatest need, particularly in gynaecological care "where women are left waiting far too long".

The reform plan intends to cut the number of patients waiting more than 18 months for treatment by almost half a million by March 2026.