Wednesday, December 21, 2005

Smoking On The Job

by Dr Phil Hammond

Should NHS staff be banned from smoking in public while wearing their uniform and ID badge, even if they're off duty and miles away from their place off work? This rather draconian proposal comes courtesy of Suffolk East Primary Care Trust, who recently announced a ban in hip and knee replacements for those with a BMI over 30. Apparently, 80% of the staff support the smoking ban but as with all rules, its success depends on its enforceability. Will the trust employ anti-smoking snoops to parole local car parks, bus shelters and pubs? Presumably they can now afford them with all the money they're saving on joint replacements. The unions are predictably outraged, with Unison calling it "an infringement of civil liberties that could force smokers underground, causing health and safety risks." Presumably all the nicotine addicts will be piling into the linen cupboards or holing out in the dungeons that most hospitals seem to have. They house the absurdly antiquated heating system but if you take a torch you can invariably find bodies of confused elderly patients who took a wrong turning on the way back from the League of Friends shop, armed with a packet of Nuttal's Mintoes. To be fair to the trust, it did announce its policy in advance, to give the staff a chance to enrol in its stop smoking clinics, but there are so many nicotine addicts working in the NHS, I'm keen to know what a sudden ban does to patient safety. Would you prefer a heart surgeon who keeps his hand steady with a drag of Capstan's Full Strength in the scrub room, or one who's dropping the scalpels and head-butting matron because he's in enforced cold turkey? As for the nurses, they're miserable enough without being denied five minutes of freezing addiction on the balcony. My guess is that smoking bans across the NHS lead to more deaths from accidents, more complaints for rudeness and more flaming linen cupboards.As for the patients, I'm not sure they're happy about it either. My local trust has banned smoking in all its premises, even on the oncology ward where it's far too late to make a difference. Watching a stream of patients with inoperable lung cancer pant their way to the smokers' room only to discover it's locked or converted into an MRSA isolation ward is just too cruel. In these days of supposed patient choice, the least we can do is let the nearly dead enjoy their fix. And that applies to the staff as much as the patients.