Surrey Primary Care Trust axes pharmacy-based smoking cessation services

Sad to learn that the funding for pharmacy-run smoking cessation services will be axed in the autumn! Surrey Primary Care Trust has announced that it will no longer fund pharmacies to offer smoking cessation after October. GP services will not be affected.

This (I understand) doesn't mean that you won't be able to buy Niquitin from the chemist. It means that pharmacies won't get incentive payments for enrolling patients on to smoking cessation services. See Appendix 2, para h in this Warwickshire PCT report from 2008/2009 that describes payments for every patient who names a quit date, successfully quits at this date, or, incredibly, fails to quit at this date.

Chemist & Druggist is aggrieved and to some extent I can sympathise with the argument that the services offered by pharmacists are being sacrificed so as to avoid antagonising the GPs and the BMA, and that the pharmacy has much more regular and convenient access to the public than the average GP. However it's difficult to get worked up about who gets the lion's share of the smoking cessation market. Even ASH UK acknowledges the treatment is a patch-up job (see 'Habit, not nicotine prompts cigarette cravings').

That's what we are talking about here: who gets the market share of a product that promotes official anti-smoking agendas, and who gets the sweeties for delivering the marketing service. There is surely a wider tale to tell of rivalries between pharmacies and medically trained personnel in delivering health care ...

No smoking, or no treatment!

The text below is lifted from the comment thread in the blog of David Milliband. The post discusses 'bold plans to save Britain's pubs', which concern regulation of the beer tie. Arguments are advanced in the blog about whether this will help pubs. Milliband does not consider the smoking ban worth touching in this context.

Is this comment typical of modern medical professionals?

Just prior to the smoking ban being enacted in 2007, I and other like minded people got together and set up an anti-smoking patrol watch in our local community. I have organised and run this watch with much success to date.

We gather photographic and camcorder evidence of anyone flouting the law of smoking in public places. We approached our local dentists and GPs, who then told us that anyone who smoked illegally would be refused treatment should their names appear on their patients’ lists. We also have the full support of our local police Superintendent – who agreed that this strategy would help in time to reduce smoking within our community. So far we have had no come back about Freedom of Information.

After several prosecutions we have seen the tide turning, but still need to remain vigilant on behalf of all our residents, after all it’s their health that’s at stake.

You have to remember that over 30,000 people are killed each year by SHS (second hand smoke), and this figure is rising year on year. We are still unclear about how many are affected each year by THS (third hand smoke), although there is good epidemiological evidence to show how dangerous it is to the health of young children.

I wrote to the then health secretary at the time Patricia Hewitt, who fully supported our efforts and asked to be kept up to date with our progress, which of course we did. I would like to see this kind of programme being rolled out across the country.

We are also supported by ASH UK, ASH Scotland, BHF and of course CRUK.

Dr Steven Johnson GP

[emphasis added]

Is there any other crime in the criminal justice system judged so adversely that it would merit the withdrawal of medical treatment? It is just not ethical for medics to pick on a specific group of (alleged) lawbreakers and deny treatment. I find it absolutely shocking that this comment has gone uncensored on the blog of a contender to the Labour Party leadership.

This story relates the intentions of NHS Grampian to treat smokers similarly – to punish them for flouting the legislation.

Withdrawing treatment on any other than clinical grounds must be considered very dangerous territory.