Wednesday, 8 September 2010

NHS Grampian bunks decision on smoking

Back at NHS Grampian, 3 August saw the meeting that deferred a decision to implement a complete smoking ban. The papers are listed here: the relevant ones are listed together (Item 5.2). They are Word documents (I can't trace the 2009 consultation responses at present but I'll keep trying).

The 2009 summary of consultation responses on NHS Grampian's Draft Tobacco Policy was quite clear in its view that most people thought 'a middle way' would be desireable as a complete site ban would not be workable. The minutes of the 3 August meeting claim that 'compliance issues raised' as a result of the current tobacco policy 'will be dealt with in the 2009 Draft Policy'.

There appears absolutely no acknowledgement that many people who have read this policy want it kicked permanently into the long grass. Off the top of my head I can think of at least three things that don't seem resolved by the 2009 Draft Tobacco Policy, which were all aired in the consultation responses:
  1. the anxiety that people will be deterred from necessary health care if they fear being forced off tobacco while they are being cared for in hospital;
  2. the anxiety that nicotine substitutes are not available and that not enough staff are trained to know how to work with them;
  3. general enforceability of the policy.
The 2009 draft policy also (sections 4m to 4o) sets out the procedure that might lead to a patient being denied care, following non-compliance with this policy, claiming that this is a 'last resort'. Last resort or no, a refusal to desist from smoking is not a grounds for withdrawing care. Persistent and violent abuse of staff, maybe, but not petty rule-breaking. Refusal to treat people for such trifles is not an insignificant management problem, it's a question of medical ethics. Are medics putting their jobs on the line if they disagree with their managers' decisions on this?

The Scotland Patients' Association, all trade unions, and all professional medical associations should demand that treatment decisions should be made by clinical staff for clinical reasons.

More common sense here from The Third Estate. Enjoy.

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