Handouts could be frozen if doctors' advice is ignored

Overweight or unhealthy people who refuse to attend exercise sessions set by their doctor could have their benefits slashed under pioneering council plans.

The scheme, floated by Conservative-led Westminster Council in a link-up with the Local Government Information Unit, would enable GPs to prescribe leisure activities such as swimming and fitness classes. Under the plans, smart cards would be brought in to monitor the use of leisure centres, meaning local authorities could reduce welfare payments for those who fail to follow their GP's advice.

As well as potential cuts to benefits, the measures, contained in a report entitled A Dose of Localism: The Role of Council in Public Health, would also enable payments to be “varied to reward or incentivise residents”, its authors say.

But a prominent doctors’ leader told the BBC that there are better ways of encouraging people to lead healthier lifestyles, branding the plans “silly”.

British Medical Association GP committee chairman Dr Laurence Buckman, a doctor in north London, said: "The best way [councils] can intervene is to stop restaurants and fast-food chains providing the kind of food that make people put on weight, and interfere with the way foods are sold in shops."

Westminster Council, however, says the measures could help it to save £5bn from the NHS budget when local authorities take over public health provision from April.

The issue of incentives and disincentives has featured increasingly in the UK health insurance industry in recent years, with some insurers such as PruHealth offering members financial perks and consumer goods as rewards for improving their health and therefore reducing their propensity to claim.

The trend is even more widespread in the US, where an estimated one in ten employers offers some sort of financial incentive for staff who take part in a wellness programme, such as smaller insurance premium contributions, gift cards, merchandise or even cash, according to the 2012 Employer Health Benefits Survey from the Kaiser Family Foundation and the Health Research & Educational Trust.