HEALTH bosses in the North-East were last night on a collision course with ITV over claims they discriminate against obese patients.

A documentary will tonight name County Durham Primary Care Trust (PCT) as one of 16 in the country to restrict operations because of patients' lifestyles.

The Tonight with Trevor McDonald programme will claim that a survey of all 152 PCTs in England found that one in ten restricts joint replacement or other non-emergency operations to obese people or smokers.

But County Durham PCT chiefs last night denied having such a policy and said they were unaware of any ITV investigation.

Director of public health Dr Tricia Cresswell said: "I want to reassure patients of County Durham and Darlington, where the same policies operate, that we would not prevent anyone having surgery for that reason."

County Durham PCT officials will contact ITV today over the allegations with a view to having the documentary, called Too Fat for Treatment, removed from tonight's listings.

If it is shown, a spokesman warned it would consider legal action and demand an apology if false allegations are made. The documentary, due to be screened at 8pm, says eight trusts, including County Durham, have a policy that limits operations because of a patient's weight. One restricts on the basis of smoking habits only, and seven have guidelines that cover both smokers and the obese.

The programme examines whether barring patients from surgery because they smoke or are overweight is medically justified or a cost-cutting exercise.

Body mass index (BMI) is often used to decide whether someone meets the criteria for surgery. But critics argue that setting a limit based on weight unfairly rules out thousands of otherwise perfectly healthy patients.

Obesity experts also say that the BMI measurement, which is a person's height divided by weight, is too inaccurate.

Dr David Haslam, who helped formulate the guidelines for obesity management in primary care in the UK, tells Tonight: "Technically speaking, a BMI of 30-plus means that you're obese.

"But that figure in itself tells us very, very little about fitness and your medical risk and so on."

Guidance set out by the General Medical Council states that treatment should not be refused or delayed because of a patient's lifestyle. But campaigners say that is exactly what is happening.

Michael Summers, chairman of The Patients Association, tells the programme: "It's absolutely clear that many of the decisions that have been made whereby patients are deprived of treatment are made on financial grounds and not clinical grounds.

"Merely to send patients away because they are smokers is morally wrong and, again, contrary to the rules which I think are set by the General Medical Council."

The Department of Health denied smokers or obese people were refused operations to save money.

In a statement it said: "If a clinician believes that a patient will have better outcomes from surgery if they change their lifestyle then they are right to make that decision on clinical grounds."