Scotland Patients' Association falls short on smoking issue

The Scotland Patients' Association will be twenty years old next year. A small organisation, it possesses just two office bearers, and is supported by half a dozen or so sponsors. In the past few years it has published statements on a number of health service shortcomings

Its consultation response document, Better Health, Better Care, shows awareness of a range of issues surrounding patient care, including the anxiety of patients and their relatives on entering hospitals, communication breakdowns infection control (leaking intravenous drips, for example, p 6), a culture of secrecy (p 8). On the face of it they seem to be on the patients' 'side', taking pains to point out what is clear to the patient, but sometimes less clear to medical staff, about the experience of being on the receiving end of NHS treatment.

Therefore the unimaginative approach of Chairperson Margaret Watt to NHS Grampian's ambition to turn its properties into a smokefree zone comes as something of a surprise. The proposals, to reiterate recent posts on this blog, include banning smoking on all premises, indoors and out, making the carrying of tobacco a disciplinary offence, and actually denying patients treatment if they refuse to co-operate.

Following a media storm, NHS Grampian took the decision to shelve implementation of the policy for six months. Their decision was driven by concerns that it would be hard to enforce different parts of the policy. Astonishingly the threat to withhold treatment from patients as a punishment if they failed to co-operate with the policy raised no protest from the Scotland Patients' Association. The trade union representative (Tommy Campbell from UNITE) did his bit by protesting on behalf of workers, but Margaret Watt said that she 'could not understand the delay'. 'It doesn't matter how bitter the pill is, you just have to swallow it and carry it out': unfortunately this advice ceases to be relevant when a policy has nothing to do with a specific clinical case and everything to do with following dogma.

Even courts do not punish people by withholding health care: should a nationalised health service be allowed to withdraw care from a patient for refusing to desist from smoking? Shouldn't a Scotland Patients' Association even be asking the question?