One of the first things you see on arriving at my local hospital, King’s College in south London, is the clear plastic bus shelter housing several patients a long way from their wards. Some of them are in wheelchairs, dressed in their pastel green hospital gowns, others looking so frail you wonder whether they should be out of bed at all and outside in the cold. All of them are smoking.
As you walk into the hospital, with the stress and worry of your own illness or that of a member of your family uppermost in your mind, it is a truly depressing sight.
If advice by the National Institute for Health and Care Excellence (Nice) to ban smoking on hospital premises is followed, these sad shelters will be gone. No patients - or staff – should be allowed to smoke anywhere on site, even in a far-flung outpost in the car park, Nice says.
As a former smoker, and as someone instinctively wary about the state becoming too much of a nanny, I should be in favour of allowing patients to do what they want, as long as it doesn’t affect others.
But when Professor Mike Kelly, public health chief of Nice, says the NHS needs a “culture shift” to end “the terrible spectacle of people on drips in hospital gowns smoking outside hospital entrances”, I am afraid he is right.
It is one thing to not stop a smoker satisfying his or her addiction – if they are fit enough to walk off site, then let them do that. But if the patient is not able to walk that far, the last thing they should be doing is smoking. The NHS should not act as an enabler for their addictions, either by permitting nurses or healthcare assistants to help the patient down the stairs, or by providing the shelter in the first place.
From my smoking days, I know there is nothing like seeing a group of people puffing away on cigarettes to make you also want a fag. Like banning smoking in pubs (instrumental in helping me quit several years ago), removing it from the NHS will indeed encourage an out-of-sight-out-of-mind cultural shift – and improve patients’ lives.
For nurses, doctors and other staff who want to smoke in their breaks, trusts should be even tougher: don’t smoke when you’re on duty. I will never forget the moment a midwife, on a home visit to my week-old baby, put her finger in my daughter’s mouth to demonstrate latching-on. As my baby clamped her lips around the midwife’s finger, the smell of fresh cigarette smoke wafted around her hands, and I recoiled in horror. Any who comes into contact with patients – nurses who have hands-on contact - should not be doing their jobs smelling of smoke. Staff will say they need a cigarette to relieve stress, but the long-term effects of smoking do more harm.
Nice’s new advice underlines the mixed messages we are given on public health. The Government, after the election, promised to introduce plain packaging on cigarettes, acknowledging the evidence that it would curb smoking, but then caved into pressure from the tobacco industry by shelving the plans. Ministers should back Nice on smoking in hospitals – but they should also look again at plain packaging to wean us off this habit altogether.