Hospitals Update
Read more: UK Hospitals Page 3
Discarded fag ends are a legacy of the smoking ban
14th February 2009
THE headline of your recent story, “Litter legacy of smokers at the Royal Bolton Hospital” (February 12), was misleading.
The proper headline would have been “Litter legacy of the smoking ban at Royal Bolton Hospital”.
Your reporter spoke to a groundskeeper who had been working there for 16 years.
It would have been very easy, and a very obvious and responsible thing to do, to ask him the simple question: “Did the litter problem change once the hospital banned all indoor smoking?”
The answer would probably have been a very resounding yes, but I guess it wouldn’t be very politically correct to point out that the hospital had created its own problem by refusing to provide even a few decent and separately ventilated smoking lounges for its patients, staff and visitors.
Easier to just blame the smokers who’ve been thrown out into the cold, right? And certainly more in tune with the nasty little mechanics of social engineering.
Michael J. McFadden
Author of “Dissecting Antismokers’ Brains”
Total smoking ban at the Royal Bolton hospital
9th February 2009
SMOKING will be banned from the entire Royal Bolton Hospital site from July 1 this year, health chiefs have revealed.
Patients, visitors and staff are already prohibited from lighting up in any of the buildings and under canopies at entrances.
But the new rule means they will no longer be allowed to smoke anywhere in the grounds of the hospital. Hospital bosses say they have taken the decision because they want to promote healthier lifestyles.
Dr Jackie Bene, medical director at the hospital, said: “It is a well-known fact that smoking is one of the major causes of many illnesses and diseases.
“As a health-promoting hospital, we want to be at the forefront of preventing illness and a smoking ban is an important part of this.
“Not surprisingly, we get many complaints from visitors and staff who do not want to walk through clouds of smoke to get into the hospital.
“We already do what we can to prevent this and a total site ban will help.”
The hospital banned smoking in its buildings in 2006 and many smokers light up under the canopies in the entrances to the buildings — even though this is against the law.
People have been allowed to smoke around the site, with smoking shelters provided, and staff have specific areas they can use as long as they cover their uniforms.
Anyone smoking in a no-smoking area like the public buildings or under the canopies faces a fine of £200 or a fixed penalty of £50.
However, the new plan could see that extended across the whole hospital site, with anyone wanting to smoke forced to leave the hospital grounds.
The hospital is still working on the detail of how best to police the ban and enforce the new rules.
Members of the public and employees of the hospital who are smokers are being asked to support the ban and prepare for it by giving up smoking.
Dr Bene said: “We know that it is difficult for people to give up but lots of support is available now.
“We are asking staff and members of the public to support this for the good of everyone.”
All hospitals were required by government policy to ban smoking in their buildings by the end of 2006. Many have followed this by extending the ban into their grounds.
Doctors fight plans to hand medical records to researchers and private companies The British Medical Association has attacked plans which could give researchers and private companies access to NHS medical records without patients’ consent.
By Laura Donnelly, Health Correspondent
20 Dec 2008
20 Dec 2008
The association said the Government was “dancing with the devil” with its proposals to give researchers, which could include commercial organisations, access to a giant computer database of patient records.
The Government’s own health information watchdog has also written to ministers to express his concern about the plans, which could see patients’ names and addresses handed over.
Medical researchers claim being given access to the new database would make it easier to carry out studies.
But the proposals have horrified privacy campaigners, who say it could be used to “hoover up” personal data which could become a gold mine not just for researchers, but for pharmaceutical companies and firms which sell health products.
Now the BMA’s head of ethics has warned that doctors were prepared to fight a public battle with the Prime Minister if the proposal is not dropped.
Dr Tony Calland said: “There seems to be a view in some parts of the Government that if you receive services from the health service then it is OK to have open season on your medical records. As they stand, these proposals run the risk of giving researchers and pharmaceutical companies access to a captive market.
“Unless some major changes are made, we are heading for a major collision between bodies like the BMA, and the National Information Governance Board for Health and Care (a statutory body set up to protect NHS data) and people like Gordon Brown, and the medical research bodies who want to open up the public’s records without consent”.
The database, part of a long-delayed controversial scheme to give NHS staff access to computerised medical records, will hold details of almost all visits by patients to hospitals and GPs.
Dr Calland said neither patients nor doctors had been properly informed about plans to share that information with third parties which he believed many people would feel “deeply uncomfortable” about.
“I think this is like the DNA database, the information may be taken for one purpose, but we don’t know what controls would be placed on access to it.
The fundamental point remains that if data about a patient is being used for the benefit of research, their permission needs to be sought first”.
The senior doctor said that under the current proposals, on which consultation closed last week, there was nothing to stop pharmaceutical companies or firms which sold health products using medical data to target their sales , after being given access to the records for research purposes.
“This is a really murky area; if people end up being targeted because of a health condition they are an extremely vulnerable captive market. These proposals are dancing with the devil, and we need a really open public debate, and clear rules governing the way data is used”.
Harry Cayton, chairman of the National Information Governance Board, on which Dr Calland is also a member, said he wrote to the Department of Health on Thursday expressing concern about plans to enshrine the proposal removing the right to consent, in British law, as part of an NHS constitution.
Mr Cayton said: “The public do value medical research but they rightly want to be asked first. Consent and confidentiality are the building blocks of trust in the NHS, and it cannot be in anyone’s interests including researchers to undermine that trust.”
A spokesman for the Doh said discussions were currently ongoing about how electronic health records could support research in an ethical and secure way.
Smoking ban ‘causing NHS problems’
04 November 2008
Psychiatric wards in the NHS are struggling to cope with the delayed smoking ban which came into effect on July 1st, it has been claimed.
In a letter to the Guardian, Dr John Dent, a consultant psychiatrist in London, said that despite psychiatric wards being given extra time to prepare for the consequences of outlawing smoking, there have been a number of unforeseen consequences.
Dr Dent said the most alarming result was the sharp increase in the number of small fires in units.
“At the mental health trust where I work, the frequency of fires has quadrupled since the start of the ban,” he claimed.
He said the increasing number of fires is thought to be a result of patients no longer being supervised in smoking rooms.
——————
Dear Editor, Foreseen Consequences…
Psychiatrist Dr. John Dent wrote to the Guardian on Nov. 3rd about the “unforeseen consequence” of numerous small fires and other problems resulting from the smoking ban. It is unfortunate that the NHS did not bother to do proper research before the ban’s implementation, because there was nothing at all “unforeseen” about such results. I wrote and warned about the clear risk of such fire increases resulting from “hidden smoking” and “hasty and improper disposal of smoking materials” five years ago in “Dissecting Antismokers’ Brains,” and Free-Choice groups around the globe have long warned of such things to any who would listen.
The UK’s smoking ban was implemented with callous disregard for the lives of all that it would impact, from the pub owners and veterans seeking a warm evening over a pint down to the elderly in hospices and the patients in long term medical/psychiatric facilities. No objection or voice of reason or moderation was listened to: the goal of a total governmentally imposed ban was seen as all-important by the extremists who pushed it, and the “collateral damage” was wilfully ignored.
Dr. Dent’s concern with the effects of the ban on psychiatric patients is doubly justified since so many psychiatric patients “self-medicate” with nicotine to calm themselves, deal with swings of depression, and equalize their moods. The most surprising thing may be simply that the NHS has not yet been hit with crushing lawsuits over this.
Thousands of businesses closed, tens of thousands rendered jobless and on the dole, crowds of smokers filling sidewalks and lounging on properties neighboring banned venues, fires in psychiatric hospitals, dormitories, and airplanes, muggings and rapes in alleyways, a thriving criminal black market due to punitive taxation… all fully foreseen consequences that are now passed off as unexpected by the same folks who claimed their measures would be “cost-free” to society.
They lied about the cost and they lied about the health risks of wisps of smoke in well-ventilated areas, and they should be held fully accountable for the damage they have caused. Smoking bans in the UK, the US, and elsewhere need re-evaluation and amendment for the welfare of everyone. The Great Smoking Prohibition Experiment has been tried, and it has failed, just like America’s Great Prohibition Experiment almost a century ago. The only difference is that this time the politicians were fully warned of the costs and chose to blunder down the path regardless.
I’m from the US, but during my time in the UK a few years ago I grew to love your pubs… and you have destroyed them for the sake of a “confidence trick.”
Michael J. McFadden
Author of “Dissecting Antismokers’ Brains”
Mid-Atlantic Director, Citizens Freedom Alliance
Director, Pennsylvania Smokers Action Network
References:
Reference: Passages from “Brains”:
p.135:
If airline pilots are to be believed there may well have been more problems with airline fires started by sneaked and improperly extinguished smokes after the bans went into effect than there were before. According to a pilot writing in the Air Safety Forum of airborne. org’s web pages :
Psychiatrist Dr. John Dent wrote to the Guardian on Nov. 3rd about the “unforeseen consequence” of numerous small fires and other problems resulting from the smoking ban. It is unfortunate that the NHS did not bother to do proper research before the ban’s implementation, because there was nothing at all “unforeseen” about such results. I wrote and warned about the clear risk of such fire increases resulting from “hidden smoking” and “hasty and improper disposal of smoking materials” five years ago in “Dissecting Antismokers’ Brains,” and Free-Choice groups around the globe have long warned of such things to any who would listen.
The UK’s smoking ban was implemented with callous disregard for the lives of all that it would impact, from the pub owners and veterans seeking a warm evening over a pint down to the elderly in hospices and the patients in long term medical/psychiatric facilities. No objection or voice of reason or moderation was listened to: the goal of a total governmentally imposed ban was seen as all-important by the extremists who pushed it, and the “collateral damage” was wilfully ignored.
Dr. Dent’s concern with the effects of the ban on psychiatric patients is doubly justified since so many psychiatric patients “self-medicate” with nicotine to calm themselves, deal with swings of depression, and equalize their moods. The most surprising thing may be simply that the NHS has not yet been hit with crushing lawsuits over this.
Thousands of businesses closed, tens of thousands rendered jobless and on the dole, crowds of smokers filling sidewalks and lounging on properties neighboring banned venues, fires in psychiatric hospitals, dormitories, and airplanes, muggings and rapes in alleyways, a thriving criminal black market due to punitive taxation… all fully foreseen consequences that are now passed off as unexpected by the same folks who claimed their measures would be “cost-free” to society.
They lied about the cost and they lied about the health risks of wisps of smoke in well-ventilated areas, and they should be held fully accountable for the damage they have caused. Smoking bans in the UK, the US, and elsewhere need re-evaluation and amendment for the welfare of everyone. The Great Smoking Prohibition Experiment has been tried, and it has failed, just like America’s Great Prohibition Experiment almost a century ago. The only difference is that this time the politicians were fully warned of the costs and chose to blunder down the path regardless.
I’m from the US, but during my time in the UK a few years ago I grew to love your pubs… and you have destroyed them for the sake of a “confidence trick.”
Michael J. McFadden
Author of “Dissecting Antismokers’ Brains”
Mid-Atlantic Director, Citizens Freedom Alliance
Director, Pennsylvania Smokers Action Network
References:
Reference: Passages from “Brains”:
p.135:
If airline pilots are to be believed there may well have been more problems with airline fires started by sneaked and improperly extinguished smokes after the bans went into effect than there were before. According to a pilot writing in the Air Safety Forum of airborne. org’s web pages :
The present no-smoking regulations on board aircraft are welcomed by many. However, these smoking restrictions have resulted in concealed smoking by passengers, and in some cases even crewmembers, increasing risks of an in-flight fire. (; Emphasis added.)
p. 146-147
It is not known how many patients put off checking into care facilities when they otherwise should and would have done so, but it’s likely that more than a few depression-caused suicides would have been prevented if patients knew they’d be allowed to smoke after checking themselves in. Perhaps the ultimate tool for fighting such smoking bans will arrive someday in the form that‘s been so popular with the Crusaders: Lawsuits over fires, injuries and deaths caused by ban-created situations may some-day form a potent incentive for their repeal!
Remember that sometimes when fires are labeled as “smoking-related” they may well have been caused by hidden smoking, marijuana smoking, and/or the improper and hasty disposal of forbidden butts. …
Relatives of students or senior citizens injured in dormitory or senior care center fires in situations where no safe indoor smoking accommodations were provided should consider the issue of liability carefully. These bans do result in clear and present harm and should be overturned before they produce more deaths or injuries.
p. 183:
A common news slant on fires in facilities where smoking has been banned is to blame the fires purely on the smoking while never mentioning the fact that they might never have occurred had smoking not been banned and ashtrays and such things were allowed or provided. Generally the fact that a smoking ban was in place is not even mentioned, leaving the viewer or listener to think that such a ban would have prevented the fire!
In addition, there has never yet been an attempt by the media or the government to quantify the number of deaths caused by teenagers sneaking smokes in unsafe manners because of laws or propaganda-inspired parental and school restrictions. Only occasionally do we hear of the more catastrophic instances. One of particular note was the massive Colorado wildfire of 2002 that was sparked by students sneaking smokes behind a school where smoking had been banned: even then, the smoking was the focus, not the ban (P. Solomon Banda. Associated Press 04/26/02).
The pressure to hide smoking can be intense: some schools now treat possession of tobacco products as being exactly the same level of offense as carrying a deadly weapon! An infraction that used to merit a half hour detention for actually using tobacco products can now result in the outright expulsion and total ruination of an entire educational career for the mere possession of such (Alisha Hipwell. “New State Law….” Pittsburgh Post Gazette 04/04/01).
A particularly sad incident in this vein occurred recently not among teens, but among older folks. In 2000 there was a fire at a Philadelphia senior citizens center in which two residents died. From the content of news stories later it seemed that a quickly and improperly disposed of cigarette seems to have started the fire. Of the dozens of stories aired and printed concerning this fire, I saw only one that mentioned that a smoking ban had been put in place before the fire.
While specific details were not released, it seemed likely that the delay in calling for aid during the early and controllable period of the fire may have been due to the fear of the seniors involved that they would be thrown out alone into the street for violating the no-smoking rule. When you’re 80 years old and without other resources such delay and confusion even in a burgeoning emergency would be almost unavoidable.
Remember that sometimes when fires are labeled as “smoking-related” they may well have been caused by hidden smoking, marijuana smoking, and/or the improper and hasty disposal of forbidden butts. …
Relatives of students or senior citizens injured in dormitory or senior care center fires in situations where no safe indoor smoking accommodations were provided should consider the issue of liability carefully. These bans do result in clear and present harm and should be overturned before they produce more deaths or injuries.
p. 183:
A common news slant on fires in facilities where smoking has been banned is to blame the fires purely on the smoking while never mentioning the fact that they might never have occurred had smoking not been banned and ashtrays and such things were allowed or provided. Generally the fact that a smoking ban was in place is not even mentioned, leaving the viewer or listener to think that such a ban would have prevented the fire!
In addition, there has never yet been an attempt by the media or the government to quantify the number of deaths caused by teenagers sneaking smokes in unsafe manners because of laws or propaganda-inspired parental and school restrictions. Only occasionally do we hear of the more catastrophic instances. One of particular note was the massive Colorado wildfire of 2002 that was sparked by students sneaking smokes behind a school where smoking had been banned: even then, the smoking was the focus, not the ban (P. Solomon Banda. Associated Press 04/26/02).
The pressure to hide smoking can be intense: some schools now treat possession of tobacco products as being exactly the same level of offense as carrying a deadly weapon! An infraction that used to merit a half hour detention for actually using tobacco products can now result in the outright expulsion and total ruination of an entire educational career for the mere possession of such (Alisha Hipwell. “New State Law….” Pittsburgh Post Gazette 04/04/01).
A particularly sad incident in this vein occurred recently not among teens, but among older folks. In 2000 there was a fire at a Philadelphia senior citizens center in which two residents died. From the content of news stories later it seemed that a quickly and improperly disposed of cigarette seems to have started the fire. Of the dozens of stories aired and printed concerning this fire, I saw only one that mentioned that a smoking ban had been put in place before the fire.
While specific details were not released, it seemed likely that the delay in calling for aid during the early and controllable period of the fire may have been due to the fear of the seniors involved that they would be thrown out alone into the street for violating the no-smoking rule. When you’re 80 years old and without other resources such delay and confusion even in a burgeoning emergency would be almost unavoidable.
Talking signs tell smokers to stub it out
Aug 8 2008
by Rebecca Edwards, Chester Chronicle
TALKING signs warning people that smoking is banned have been installed at Halton General.
Smokers outside the hospital will receive a verbal warning every few minutes from the signs, which are designed to remind visitors, patients, and staff not to smoke on the grounds.
Talking signs have been installed at key areas such as main entrances and outside departments where smoking is still a problem.
Smoking has been banned through- out the hospital site since the ban on smoking in public places was introduced last year.
Although the ban has dramatically reduced the number of people smoking on site, hospital staff still remind people to put out their cigarettes.
Smoking bins are also being replaced and signs are being put up to remove contradictory information that it is still permitted to smoke outside.
The talking signs idea was adopted from technology used for reminding people to wash their hands.
Catherine Beardshaw, chief executive, North Cheshire Hospitals NHS Trust, said: “Visitors, patients and staff found smoking on the site are politely requested to put out their cigarettes by us on a regular basis. The new talking signs will hopefully make our job easier.
“We don’t want people to take offence at the ban – it is a decision made on health grounds to keep our sites clear of smoke and as an NHS organisation we feel it is the right thing to do.
“Most people understand our decision to be smoke free and have been very supportive and we hope this will be a final reminder to those who still think it is fine to smoke on site.”
Smokers and obese must get NHS treatment despite lifestyle, says head of Nice
Smokers and the obese should receive drugs and operations on the NHS despite their lifestyle, according to the head of the Government’s drugs rationing body Nice.
Smokers and the obese should receive drugs and operations on the NHS despite their lifestyle, according to the head of the Government’s drugs rationing body Nice.
By Rebecca Smith, Medical Editor and Robert Winnett, Political Correspondent
26 Jul 2008
26 Jul 2008
A personal lifestyle choice must not be used as a reason to deny someone treatment on the NHS, Andrew Dillon chief executive of the National Institute for health and Clinical Excellence said in an interview with The Daily Telegraph.
Mr Dillon says the only circumstance where such a refusal would be justified is if the drug or treatment would not be effective unless the patient changed their lifestyle.
The treatment of self induced or lifestyle factors is a central and hotly debated topic for the NHS.
Earlier this week a survey of IVF clinicians found the majority do not believe smokers should receive treatment.
Prof Peter Braude, of King’s College London, said the reasons were that there is some evidence that smoking affects the chances of successful treatment but also the welfare of the resulting child must be taken into account.
Guidelines from the British Fertility Society also say that patients with a body mass index of more than 36, classed as clinically obese, should not receive treatment because it is risky and less likely to work.
Surgeons have also been debating whether obese patients should have knee replacements, as the general anaesthetic is riskier in overweight patients, but also because the replacement may not last as well.
Mr Dillon said Nice asked its Citizens Council, a representative group of 30 people who have no involvement with healthcare, to consider the issue and they concluded that treatment should not be rationed according to lifestyle.
He said: “The only circumstances in which we say the way people behave individually should be taken into account is if that behaviour has the effect of directly reducing the effectiveness of the treatment.
“Simply because you have a lifestyle is not a reason for refusing a treatment. If that was the case any of us who go skiing would be told if you get a broken leg don’t expect us to fix it.
“It is a lifestyle choice if you ski, I like to ski. I go out and I know there is a much greater risk of serious injury than if I didn’t go skiing or if I went walking in the Lake District or lay on a beach instead and no-one says to me because of that lifestyle choice the NHS will treat your differently.
“I think we have to be extremely careful about saying that the way people live their lives is a factor in decision making and Nice has said it isn’t, except where continuing with a particular pattern of lifestyle renders the treatment ineffective. ”
Mr Dillon said the Citizens Council had also rejected any notion of Nice weighting their decisions in favour of the young over the old or those in work over those not.
He added: “Their response was that a year of life at age three was worth just as much as a year of life aged 83.” When a group of schoolchildren were asked their response was the same, he said.
The proposed NHS Constitution says that patients have the right to drugs and treatments that have been recommended by Nice and if your doctor believes they are appropriate for you.
A cruel and unusual ban
May 22, 2008
Ken McLaughlin
Ken McLaughlin
The smoking ban in psychiatric institutions means their patients are the only people in Britain forbidden from smoking ‘in their own homes’.
This week in the UK, High Court judges ruled that psychiatric patients detained in high-security hospitals have no ‘right to smoke’ (1). The case was brought by three patients at Rampton Hospital, who argued that a ban on smoking was an attack on their human rights. They lost, and now the new ruling will cover Rampton and England’s two other high-security hospitals, Ashworth and Broadmoor. It is also likely to apply to the many other regional ‘secure units’ scattered around the country.
That even psychiatric patients, some of whom are locked up for years, will be denied the small pleasure of having a fag shows how petty and cruel the anti-smoking crusade can be.
The appeal by the three Rampton patients followed the introduction of the ban on smoking in ‘enclosed public spaces’, which came into force in England on 1 July 2007. That ban was an affront to freedom and choice, no doubt, but at least most smokers could continue to light up in the privacy of their home or by popping outside of an ‘enclosed public space’, whether it be on the street outside their workplace or outside a pub or restaurant.
Yet this is not so simple for many people whose home doubles up as a ‘public space’ – for example, people who live in residential homes or psychiatric institutions. Often they do not have the freedom to go outside for a cigarette, and because people work where they live – in their recreational areas, kitchens, bedrooms – they cannot smoke ‘at home’ either (2).
It was in recognition of these complexities that the New Labour government gave psychiatric institutions until July 2008 to come up with some form of secure outdoor smoking area for psychiatric patients.
However, Rampton has already implemented a smoking ban, which means that patients can no longer smoke anywhere in the hospital. And it now looks like other institutions will follow suit.
However, Rampton has already implemented a smoking ban, which means that patients can no longer smoke anywhere in the hospital. And it now looks like other institutions will follow suit.
Staff at Rampton, Broadmoor and Ashworth frequently stress that these places are hospitals, not prisons. This is rather unfortunate for the patients who live there and who enjoy smoking – where prisoners are still allowed to smoke in their cells, hospital patients are not allowed to smoke in their beds. This week’s High Court ruling means that psychiatric patients are virtually the only group of people in the country who are not allowed to smoke in the ‘privacy of their home’. As Neil Rafferty of the pro-smoking group Forest said: ‘I think it is cruel to impose what is a petty bureaucratic decision in this way. The hospital should be able to provide a facility for these people to have a cigarette.’ (3)
Detained patients have one other major disadvantage over ordinary prisoners – they do not have a release or discharge date. It is up to psychiatrists, tribunals or the Home Office to decide when they should be let out. Many who live in Britain’s Special Hospitals will never be discharged back into the community; others will remain within the confines of the hospital for several years, if not decades. As such, it seems reasonable to allow them to have a smoke – after all, it’s hardly going to ruin their lives.
Yet according to Lord Justice Pill in the High Court this week: ‘Both health and security considerations justify the ban.’ (4) In fact, neither of these considerations is as clear cut as the judge makes out.
Of course, nobody doubts that smoking is bad for smokers’ physical health. But many of these patients are given, often against their will, high doses of psychiatric medication which can have severe side effects.
Some of them may see smoking as relatively harmless in comparison to their drugs, and also as a pastime that alleviates boredom and encourages sociability. Meeting in a designated space to share a cigarette is a way of talking to and getting to know others.
Of course, nobody doubts that smoking is bad for smokers’ physical health. But many of these patients are given, often against their will, high doses of psychiatric medication which can have severe side effects.
Some of them may see smoking as relatively harmless in comparison to their drugs, and also as a pastime that alleviates boredom and encourages sociability. Meeting in a designated space to share a cigarette is a way of talking to and getting to know others.
It is true, of course, that many (though certainly not all) of the patients in Special Hospitals are extremely disturbed and dangerous individuals who will have committed serious offences, including manslaughter, rape, arson and assault. So the judge is right that security needs to be taken seriously in these establishments. However, the clue is in their names – they are High Security Hospitals or Regional Secure Units. Such places are surrounded by walls and the security within them is extremely tight. On the few occasions I visited Ashworth between 1995 and 2001, I was not allowed to go anywhere on my own, searches were common, and the security procedures were rigorous.
In short, security has always been a major issue in these hospitals. So to argue that the smoking ban is justified due to possible ‘security difficulties’ is absurd. Yes, there may be occasions when certain individuals or groups are not allowed to congregate together due to security concerns, but to replace day-to-day risk assessment by hospital staff with a total ban on smoking anywhere in psychiatric institutions suggests that the ban is being used to institutionalise risk aversion.
Many used to refer to the old lunatic asylums as ‘the bins’. Their rise was viewed by some, not as a consequence of medical advance, but as an institutional solution to social problems; they became places to dump those who were not wanted by the rest of society (the incarceration of unmarried mothers was the clearest example of this). Today, exaggerated claims from health campaigners on the dangers of passive smoking have been mixed with a broader risk-averse outlook, and once again it is to the detriment of those confined in long-stay mental institutions. At least the inmates of the old asylums could have a cigarette; now they cannot even enjoy that small mercy.
Patients in smoking ban challenge
March 11, 2008
Patients at a top security psychiatric hospital are launching a human rights test case challenge over the Government’s smoking ban.
Detained patients, or former patients, at Rampton in Nottinghamshire say the ban, which came into force last year, is a “disproportionate interference” with their rights under Article 8 of the European Convention on Human Rights.
Three patients are all seeking judicial review before Lord Justice Pill and Mr Justice Silber at the High Court in London.
Their lawyers argue that the hospital is their home, and to prevent them smoking there when they are not free to go elsewhere to light up interferes disproportionately with their Article 8 private rights.
NHS smoking ban ‘flouted daily’
March 3, 2008
By Emma Wilkinson, Health Reporter, BBC News
Smoking bans are routinely flouted in many NHS hospitals, researchers say.
Researchers spoke to three-quarters of hospital trusts in England last year, with two-thirds reporting non-smoking rules were being broken daily.
By Emma Wilkinson, Health Reporter, BBC News
Smoking bans are routinely flouted in many NHS hospitals, researchers say.
Researchers spoke to three-quarters of hospital trusts in England last year, with two-thirds reporting non-smoking rules were being broken daily.
And spot checks by a team at Nottingham University uncovered staff and patients lighting up even though hospitals should have been smoke free since 2006.
The government said it did not accept the findings and had no evidence to show regulations were being broken.
National guidance published in 2005 stated that smoke-free policies should cover hospital buildings and grounds because of the role of hospitals as “health promoting” organisations.
There have been exemptions for mental health trusts but these are due to come to an end in July.
The study took place in 2007 before the ban on smoking in enclosed public places started in July but after the NHS smoke free policy covering buildings and grounds took effect.
The researchers questioned three-quarters of acute health trusts in England and carried out checks in 15 of them.
More than eight-in-10 hospitals and six-in-10 mental health trusts had implemented non-smoking rules in both premises and grounds by February 2007, results published in journal BMC Health Services Research show.
About half of hospitals allowed some exemptions, mainly for bereaved relatives or psychiatric patients, in outdoor areas or smoking rooms.
Enforcement
But when it comes to enforcing the rules, hospitals seem to struggle, the research suggested.
Two-thirds of acute trusts and over a third of mental health trusts said the rules on smoking were being broken on a daily basis.
When researchers visited hospitals they saw patients and visitors smoking at 94% of them and staff smoking at 35%.
Hospitals told the researchers they were also battling with litter from cigarette butts and crowds of smokers congregating outside hospital entrances.
The researchers said the flouting of non-smoking rules appeared to be “widely tolerated” in hospitals.
And they warned now the smoking ban had come into force, the NHS could fall behind other work and public places.
Professor Ann McNeill, an expert in health policy and promotion at the University of Nottingham, said: “It tends to undermine efforts to use the hospital to encourage people to stop smoking.
“But it’s not an easy thing to do. We want to acknowledge that trusts have made a lot of progress.
“We want to get the message across on how dangerous smoking is and it should not be tolerated but there needs to be support.”
She added that one problem was a lack of clarity on who was responsible for enforcing the rules and questioned whether it should fall to medical staff or security guards.
Co-researcher Elena Ratschen added that trusts had all been very keen on smoke-free policy.
“It would be helpful to have further guidance on how to support staff with enforcing the policy.”
She added: “It’s no use just putting up signs, you have to provide support for people to quit and that needs funding.”
A spokesperson for NHS Employers said NHS trusts were taking a similar approach to any other organisation in ensuring the smoking ban is enforced.
“In addition to complying with the legislation and making staff and patients aware of the legal requirements, employers have been encouraged to offer staff training to help them understand the new law and their responsibilities and to provide both staff and patients with support to quit smoking.”
SMOKER BAN PLAN IS AXED
January 2008
BY CATHY BUSS HEALTH CORRESPONDENT
Health bosses have scrapped plans to ban smokers from operations until they quit the habit.
Instead, they will leave it to doctors to advise patients about the potential risks.
The decision has been welcomed by clinicians who say they are delighted that health bosses are “taking a common sense approach” and leaving them to make individual decisions.
In May last year, Leicester City Primary Care Trust discussed putting routine operations on hold while patients were helped to stop smoking.
If patients managed to go without a cigarette for four weeks they would then be put back on the operating list.
Now bosses say it was never intended as a policy and was one of a number of ideas discussed and which has now been ditched.
They say any decision about giving the go-ahead for operations will now remain with the patients’ doctors.
In a statement a PCT spokesman said: “We are not considering a ban on operations for smokers and have no plans to do so for the foreseeable future.
“In spring 2007 it was one of a number of ideas discussed as to how we might improve the health of our community.
“However, we considered this decision should remain with clinicians and agreed not to take it any further.”
Dr Alan Cole, a consultant anaesthetist and medical director at the University Hospitals of Leicester NHS Trust, said: “I am encouraged that the PCT is taking a common-sense approach – clinical decisions are best made by the doctors involved.
“It is always better for a patient not to smoke before an operation as they are far more likely to suffer complications.
“I have never refused a patient an operation because they are a smoker although there are cases where, because of their condition, the risks of operating outweigh the benefits.”
Louise Ross, manager of the city Stop! Smoking service, said: “We are getting people wanting help to stop smoking before operations and would encourage anyone due to undergo surgery to try and quit.”
Bosses previously denied the plan would lead to a blanket ban on smokers having operations.
They said clinical evidence showed people who smoked took longer to recover from operations and were more susceptible to infections.
Introduction of the ban was backed by the trust’s professional executive committee.
In August the trust said the next step would be consultation on the proposal.
At the time Tim Rideout, PCT chief executive, said: “There is very strong clinical evidence that patients who smoke are at much greater risk of being affected by an operation.
“We are here to help people give up. We also have a duty to improve people’s health.”
US GROUP VOWS: ‘WE’LL PAY FOR SMOKER’S CARE’
27 September 2007
A pro-smoking group in the United States is pledging to pay for the private treatment of a Newlyn smoker who is being denied surgery on the NHS.FORCES International is waiting for permission from John Nuttall to start a fund-raising campaign.
The human rights group, which proclaims to protect personal lifestyle choices, was alerted to Mr Nuttall’s plight after it was documented on a Boston physician’s website.
Michael Siegel’s article stimulated 131 replies with many involved in a debate demanding action.
Twenty-nine pro-smokers pledged 1,545 in individual donations of 20 to 100.
FORCES International president Maryetta Ables said the John Nuttall fund-raiser would meet the full cost of private care.
Speaking to The Cornishman from West Virginia, she said: “All we need to know is our target goal and he will be free to go get his surgery.”
Mr Nuttall’s story hit the national headlines this month.
The 57-year-old, who broke his ankle two years ago, has been repeatedly turned down for surgery and is being prescribed a daily dose of morphine tablets for pain.
Steve Parsons, an orthopaedic surgeon at Treliske Hospital, is refusing to operate on the grounds that Mr Nuttall’s smoking habit would adversely affect the outcome and hinder the healing process.
Mr Parsons was unavailable for comment. A hospital spokesperson, however, reiterated his decision and said “he would not be changing his mind”.
And as Mr Parsons is also the consultant surgeon at Duchy Hospital, which is the leading provider of private health care in Cornwall, Mr Nuttall may be forced to consult a surgeon outside Cornwall.
He is considering the offer after being contacted by FORCES International this week.
“I was over the moon when they said they would pay for it,” he said.
“But then I realised that I don’t want to accept charity.
“For me this is all about getting the NHS to give me some of the money back that I’ve paid in my National Insurance all these years.
“If I let them pay it’ll mean the NHS is getting off with it. I will have to think this over and let them know next
Doctors refuse to fix builder’s broken ankle unless he quits smoking
By CHRIS BROOKE
14th September 2007
14th September 2007
A man with a broken ankle is facing a lifetime of pain because a Health Service hospital has refused to treat him unless he gives up smoking.
John Nuttall, 57, needs surgery to set the ankle which he broke in three places two years ago because it did not mend naturally with a plaster cast.
Doctors at the Royal Cornwall Hospital in Truro have refused to operate because they say his heavy smoking would reduce the chance of healing, and there is a risk of complications which could lead to amputation.
They have told him they will treat him only if he gives up smoking. But the former builder has been unable to break his habit and is now resigned to coping with the injury as he cannot afford private treatment.
He is in constant pain from the grating of the broken bones against each other and has been prescribed daily doses of morphine.
Mr Nuttall, of Newlyn, Cornwall, broke the ankle in a fall in 2005. Initially he refused surgery because he had caught MRSA at a different hospital four years earlier, and was terrified of history repeating itself.
He hoped the fractured bones would knit together with a standard plaster cast to immobilise his ankle.
But six months and three plaster casts later, it became clear that an operation to pin the bones was the only solution.
However, the hospital told Mr Nuttall, who no longer works because of smoking-related chest problems, that he would have to give up smoking before an operation could be carried out.
Mr Nuttall said: ‘”I am in agony. I have begged them to operate but they won’t. I have tried my hardestto give up smoking but I can’t. I got down to ten a week at one point but they said that was not good enough.
“I spent 12 months trying to give up and used patches and everything, but nothing works.
“I have smoked for over 40 years and it’s not going to happen.
“We were brought up at a time when cigarette advertisements were everywhere and there were no warnings.
“I want to warn other smokers that they could be denied medical treatment and there is nothing we can do about it.
“I have paid my dues as a taxpayer-and now the NHS won’t treat me.”
Mr Nuttall, who is single, uses a walking stick to get around and fears his bones will now be so ‘calcified’ that an operation would not work even if he were allowed to have it.
“It is very painful,” he said. “If I walk more than a few steps I can feel it grinding.”
A spokesman for the hospital trust said: “Smoking has a very big influence on the outcome of this type of surgery, and the healing process would be hindered significantly.”
——————-
UK Doctors Refuse to Fix Man’s Broken Ankle Unless He Quits Smoking
9/17/07
By Michael Siegel
Are these physicians also going to deny surgery to overweight patients with broken ankles unless they lose weight?
Read More
Even the begonias are puritans now
When even flowerbeds start to order us around, the guardians of our well-being have lost the plot
Nick Cohen
Sunday August 19, 2007
Last week, a young NHS psychiatrist, who blogs under the pseudonym Shiny Happy Person, described how she ‘was just taking five minutes out, enjoying the sunshine in the surprisingly pleasant grounds of my new hospital, when the flowerbed spoke to me’.
She went on to reassure her readers: ‘No, I’m not neuroleptic-deficient. Other people heard it too. One moment, all was quiet and the next a disembodied voice was bellowing from somewhere in the vicinity of the begonias. Strictly speaking, it wasn’t actually addressing me and I know this because it said, “This is a no-smoking area. Please put your cigarette out. A member of staff has been informed.” I gave up smoking six weeks ago. But, really, how Orwellian is that?
‘The smokers looked understandably alarmed, glanced furtively around and then scarpered. I can’t help questioning the wisdom of installing a talking flowerbed to tell people off in the grounds of a psychiatric hospital, of all places.’
One of the many difficulties in reporting on the NHS is that doctors cannot speak freely about the idiocies of their managers. Threats of dismissal mean I can’t identify the junior psychiatrist or say where she works. But it is on the record that hospitals have banned smoking and some, such as the University Hospitals Coventry and Warwickshire Trust, have put smoke alarms outdoors to catch patients who nip outside for a quick fag.
The makers of a new generation of alarms say their trade doesn’t stop with the NHS. They are doing good business with local authorities, drug rehabilitation centres and government departments. Their Cig-Arrete (geddit?) detector provides ‘a visual and audible re-enforcement of your commitment to creating a smoke-free environment’.
Sensors pick up the whiff of illicit smoke and a voice cries: ‘This is a no- smoking area. Please extinguish your cigarette. A member of staff has been contacted.’ Which sounds very like what Shiny Happy Person said she heard.
You might think there’s nothing wrong with alarms blaring out threats when smoking is the biggest cause of preventable death. But then it’s not illegal to smoke in hospital grounds or any other open space. NHS managers are going way beyond the law and not thinking about the likely effects on the mentally ill of having flowerbeds shout at them when they do it.
Their hectoring is hardly novel. Last week, we had example after example of British bureaucrats, grown fat on extra powers and extra funds, using an ever-more audacious authoritarianism to hide their manifold shortcomings.
As psychiatric patients were fleeing from talking begonias, the Metropolitan Police threatened to use anti-terrorist legislation against climate-change protesters at Heathrow, even though the demonstrators were not, in fact, terrorists. A few days earlier, the West Midlands Police and Crown Prosecution Service had referred Channel 4 to the media regulator, Ofcom, for exposing Islamists who preached hatred of unbelievers and called for homosexuals ‘to be thrown off mountains’.
As Joanne Cash, a distinguished libel lawyer, said at a meeting in defence of the programme makers, the police and CPS have ‘no power and no jurisdiction’ to censor investigative journalism. ‘They have overstepped their powers into the realm of freedom of expression.’
Meanwhile, the Chief Constable of Cheshire, Peter Fahy, gave the clearest sign yet that drinking was replacing smoking as the vice the 21st century can’t tolerate. He responded to the arrest of four teenagers for the alleged murder of Garry Newlove by calling for the legal age for drinking alcohol to be raised to 21. Three of the accused are under 18 and were, allegedly, drinking before the killing.
But the accusation that they had broken an existing law his officers failed to enforce did not deter Mr Fahy from demanding a new law and, indeed, the overturning of the basic principle of English law. ‘At the moment, you can drink anywhere you like unless the local authority has designated that you can’t drink in that area,’ he continued. ‘I would like to see the emphasis changed and that we say drinking in public is not permitted apart from in those areas where a local authority says, “Yes, in this particular park, this particular location, people can drink.”‘
It is alarming to realise that a chief constable charged with upholding the law has no respect for the 800-year-old common law principle that any act which isn’t specifically illegal is legal. He and others want to turn it on its head so that all acts are illegal except those the authorities specifically say are legal.
The alternative would have been to promise to break up gangs and remove the licences of pubs and shops that sold to underage drinkers. But that would require hard police work and the sending of more criminals into an overcrowded prison system that doesn’t want more prisoners.
The seduction of authoritarianism is that it is easier, much easier, to install screaming smoke detectors than persuade patients to stop smoking; to shoot the messengers rather than investigate totalitarian religion; to stop law-abiding people from drinking or protesting rather than take action against teenage gangs or real terrorists.
I suspect the overbearing streak in government is going to get worse. As Labour’s public spending increases slow down, the incentive to lash out will grow among institutions such as the NHS and the police which need to conceal how much public money they have wasted.
More insidious is the notion that people can be forced to be good. If you are a puritan, you can believe we would be a happier society if cigarettes and alcohol had never been invented. If you can close your eyes and sink into the daydreams that there is no need to protest about climate change or that sexist, racist and homophobic preachers are the invention of the media, you will be happier still.
Any assault on freedom becomes justifiable if it will help lead us to a clean-living, conflict-free, multicultural Utopia. The shrieking from the flowerbeds is only going to get louder.
When even flowerbeds start to order us around, the guardians of our well-being have lost the plot
Nick Cohen
Sunday August 19, 2007
Last week, a young NHS psychiatrist, who blogs under the pseudonym Shiny Happy Person, described how she ‘was just taking five minutes out, enjoying the sunshine in the surprisingly pleasant grounds of my new hospital, when the flowerbed spoke to me’.
She went on to reassure her readers: ‘No, I’m not neuroleptic-deficient. Other people heard it too. One moment, all was quiet and the next a disembodied voice was bellowing from somewhere in the vicinity of the begonias. Strictly speaking, it wasn’t actually addressing me and I know this because it said, “This is a no-smoking area. Please put your cigarette out. A member of staff has been informed.” I gave up smoking six weeks ago. But, really, how Orwellian is that?
‘The smokers looked understandably alarmed, glanced furtively around and then scarpered. I can’t help questioning the wisdom of installing a talking flowerbed to tell people off in the grounds of a psychiatric hospital, of all places.’
One of the many difficulties in reporting on the NHS is that doctors cannot speak freely about the idiocies of their managers. Threats of dismissal mean I can’t identify the junior psychiatrist or say where she works. But it is on the record that hospitals have banned smoking and some, such as the University Hospitals Coventry and Warwickshire Trust, have put smoke alarms outdoors to catch patients who nip outside for a quick fag.
The makers of a new generation of alarms say their trade doesn’t stop with the NHS. They are doing good business with local authorities, drug rehabilitation centres and government departments. Their Cig-Arrete (geddit?) detector provides ‘a visual and audible re-enforcement of your commitment to creating a smoke-free environment’.
Sensors pick up the whiff of illicit smoke and a voice cries: ‘This is a no- smoking area. Please extinguish your cigarette. A member of staff has been contacted.’ Which sounds very like what Shiny Happy Person said she heard.
You might think there’s nothing wrong with alarms blaring out threats when smoking is the biggest cause of preventable death. But then it’s not illegal to smoke in hospital grounds or any other open space. NHS managers are going way beyond the law and not thinking about the likely effects on the mentally ill of having flowerbeds shout at them when they do it.
Their hectoring is hardly novel. Last week, we had example after example of British bureaucrats, grown fat on extra powers and extra funds, using an ever-more audacious authoritarianism to hide their manifold shortcomings.
As psychiatric patients were fleeing from talking begonias, the Metropolitan Police threatened to use anti-terrorist legislation against climate-change protesters at Heathrow, even though the demonstrators were not, in fact, terrorists. A few days earlier, the West Midlands Police and Crown Prosecution Service had referred Channel 4 to the media regulator, Ofcom, for exposing Islamists who preached hatred of unbelievers and called for homosexuals ‘to be thrown off mountains’.
As Joanne Cash, a distinguished libel lawyer, said at a meeting in defence of the programme makers, the police and CPS have ‘no power and no jurisdiction’ to censor investigative journalism. ‘They have overstepped their powers into the realm of freedom of expression.’
Meanwhile, the Chief Constable of Cheshire, Peter Fahy, gave the clearest sign yet that drinking was replacing smoking as the vice the 21st century can’t tolerate. He responded to the arrest of four teenagers for the alleged murder of Garry Newlove by calling for the legal age for drinking alcohol to be raised to 21. Three of the accused are under 18 and were, allegedly, drinking before the killing.
But the accusation that they had broken an existing law his officers failed to enforce did not deter Mr Fahy from demanding a new law and, indeed, the overturning of the basic principle of English law. ‘At the moment, you can drink anywhere you like unless the local authority has designated that you can’t drink in that area,’ he continued. ‘I would like to see the emphasis changed and that we say drinking in public is not permitted apart from in those areas where a local authority says, “Yes, in this particular park, this particular location, people can drink.”‘
It is alarming to realise that a chief constable charged with upholding the law has no respect for the 800-year-old common law principle that any act which isn’t specifically illegal is legal. He and others want to turn it on its head so that all acts are illegal except those the authorities specifically say are legal.
The alternative would have been to promise to break up gangs and remove the licences of pubs and shops that sold to underage drinkers. But that would require hard police work and the sending of more criminals into an overcrowded prison system that doesn’t want more prisoners.
The seduction of authoritarianism is that it is easier, much easier, to install screaming smoke detectors than persuade patients to stop smoking; to shoot the messengers rather than investigate totalitarian religion; to stop law-abiding people from drinking or protesting rather than take action against teenage gangs or real terrorists.
I suspect the overbearing streak in government is going to get worse. As Labour’s public spending increases slow down, the incentive to lash out will grow among institutions such as the NHS and the police which need to conceal how much public money they have wasted.
More insidious is the notion that people can be forced to be good. If you are a puritan, you can believe we would be a happier society if cigarettes and alcohol had never been invented. If you can close your eyes and sink into the daydreams that there is no need to protest about climate change or that sexist, racist and homophobic preachers are the invention of the media, you will be happier still.
Any assault on freedom becomes justifiable if it will help lead us to a clean-living, conflict-free, multicultural Utopia. The shrieking from the flowerbeds is only going to get louder.
Read More: UK Hospitals Page 1
