Tactful and proportionate hospital smoking policies needed, so what happened?

Extract from minutes of Scottish Workforce and Staff Governance Committee, 14 May 2010 at Victoria Quay, Edinburgh

Mary Cuthbert and Lorna Renwick presented an update to the Committee on recent guidance regarding workplace anti-smoking policies in NHS Scotland. Cooperation with staff on the issues involved were agreed to be a priority for any effective lasting progress. It was pointed out that the NHS Healthy Working Lives Criteria [link added] would need to be adjusted, most usefully by considering the relevant rules of the European Network of Smoke-free Hospitals (ENSH),which considers a very holistic view of patient and staff data.

It was emphasised by the Committee that this area of debate is necessary to approach with care, not least because of the estimated 40,000 NHS Scotland employees who smoke and would be affected by any change to national or Board level guidelines. It was expressed that in practice whole-hospital-grounds smoking bans were in the main impossible to police and undeliverable. [emphasis added]

The need for staff to be treated consistently across NHS Scotland was underlined. The particular difficulty of dealing with care-in-the-community guidance was discussed. It was generally concluded that Board Policy for Staff on Premises needed to be re-examined. The Committee expressed firm, unanimous support for the principle of reduction of staff smoking levels, but reiterated that regulations would need to be both tactful, proportionate and implementable. The need to balance employee rights with any drive towards smoking cessation was emphatically asserted by all members. [emphasis added]

All this commendably prioritises the need for a consensual approach, and several weeks ago I would have thought it spelled good news. Yet three months after this meeting we had this story about NHS Grampian, this story about Ninewells Hospital Dundee, and yesterday this story about the Carstairs State Hospital. Why, when the health service staff and managers tell Scottish Government representatives unanimously and 'firmly' that smoking bans in hospitals don't work and cannot be implemented, and that equality, proportionality and tact are as important as smoking cessation, do we get more health boards insisting that smoking must cease in the grounds of hospitals (and probably just as much pressure on the issue of smoking cessation)?

More on Freedom to Choose (Scotland)'s challenge to smoke-free mental health services here.

Meetings of the group are listed here. Minutes of more recent meetings (August and November) don't appear to have been posted yet.