'Hewitt should back off', moaned The Daily Express. Most newspapers reacted with some contempt to the health secretary's statement that it is 'best practice' for doctors to order individuals to lose weight or give up cigarettes before they are treated.

In an interview with The Sunday Times, Patricia Hewitt said that she supported the trend of GPs and surgeons to make decisions about whether it is appropriate and safe to operate on smokers or patients who are overweight.

In the interview she said: 'What I've been seeing is more and more health centres and GP practices focusing on that kind of support. They will say to patients, you shouldn't have this operation until you've lost a bit of weight and stopped smoking.'

But the media rounded on her. The Express accused the 'health nanny' of loving 'nothing more than telling people how to run their lives'.

Although they admitted she had a point, the paper was at pains to point out that it was a decision best left to clinical judgement.

Meanwhile, the Daily Mail told its readers that it was the first time a minister has explicitly endorsed the policy, which has, it said, already been adopted in some NHS trusts.

And The Sunday Telegraph explained that Ms Hewitt's comments were in line with guidelines published a year ago by the National Institute for Health and Clinical Excellence.

However, it said that 'some doctors are concerned that the policy could be exploited by some NHS trusts to save money'.