Smokers will be fined for puffing on cigarettes on hospital grounds and eventually banned from smoking altogether under radical new plans in Sandwell.
The hardline proposals, put forward by Sandwell and West Birmingham NHS Hospital Trust, would see smokers confined only to smoking ‘shelters’ for three years – before a total ban on taking a drag is introduced in 2018.
Trust board members discussed their options on how to tackle smokers inhaling in and around hospitals at a meeting on Thursday.
The smoking shelters would be the only place smokers can puff away in the first instance and if they are caught doing so anywhere else they would be slapped with a fixed penalty notice.
The trust aims to introduce a new policy next year at its hospitals – Sandwell General, City and Rowley Regis – before bringing in the zero tolerance ban at all sites when the new Midland Metropolitan Hospital opens in 2018.
Medical director Doctor Roger Stedman said: “I think [the opening of] the Midland Metropolitan Hospital is an opportunity.
“No cigarettes will cross the threshold of that hospital – not even in the car park.
“That sets us an objective and target which accords with our philosophy [to tackle smoking].”
This would apply to all staff, visitors and patients, and smokers would be given advice and help on how to quit.
Members were in agreement that the staged plan – starting with the shelters and penalty notices and then bringing in the total ban in three years – would provide the best chance of tackling the underlying issues around smoking.
Chief nurse Colin Ovington said: “Having a staged approach to try to get people to stop smoking is the right thing to do morally.”
The board also discussed whether e-cigarette users should be treated the same way as normal cigarette smokers.
As research into the effects of e-cigarettes is not yet comprehensive, creating a ‘semi-detached’ shelter for both e-cig and normal cigarette smokers was suggested.
This would stop e-cigarette smokers inhaling smoke from cigarettes.
The board members agreed a decision in principle to bring in the shelters early next year and then start its zero tolerance crackdown on all smoking in 2018. This will be confirmed at its next meeting in December.
They plan to wait for more research into the harm of e-cigs before making a decision.
Chief executive Toby Lewis said: “If we can cohort people in shelters then we can target support at them. That gives our staff and visitors who smoke a period of three years of support.
“A Fixed Penalty Notice gives us a remedy, as opposed to simply saying ‘you shouldn’t be doing this’ then walking away.”
I wonder where their “philosophy” comes from? Is it something that the Trust board has dreamt up itself? Or have they been getting their “philosophy” from the BMA or the WHO? And what if their “philosophy” is in collision with the “philosophy” of their patients?
To what extent have patients or staff in the hospital been consulted?
If their “philosophy” included tackling obesity, would they starve patients they deemed overweight. If their “philosophy” included tackling meat, would they force all patients to eat vegetarian meals? If their “philosophy” included keeping fit, would they force all patients to exercise?
Who pays the Trust board’s wages? To whom are they answerable?
I’ve been wondering today how to find answers to these sorts of questions. Where does one go? I decided to ask the Chief Executive. Here’s what I sent him:
I read today in the Express and Star that the Sandwell and West Birmingham NHS Hospital Trust board has decided upon a “zero tolerance crackdown” on smoking, I further read that Medical director Doctor Roger Stedman has said “That sets us an objective and target which accords with our philosophy [to tackle smoking].”
I wondered whether the board’s “philosophy” might be set out on its website. I couldn’t find any philosophy (perhaps you might ask Dr Stedman where I may find it), but I did find on your Values and Promises page.
The nine care standards, or promises are:
I will… make you feel welcomeI will… make time to listen to youI will… be polite, courteous and respectfulI will… keep you informed and explain what is happeningI will… admit to mistakes and do all I can to put them rightI will… value your point of viewI will… be caring and kindI will… keep you involvedI will… go the extra mile
May I ask in what way a “zero tolerance crackdown” on smoking will make smoking patients “feel welcome”? And equally in what way such a crackdown is “polite, courteous and respectful”? Or indeed “caring and kind”? And it seems to me that it will be your smoking patients who will actually be “going the extra mile” (to find somewhere to smoke).
In fact, I could find no mention of a “crackdown” on smoking anywhere on the Sandwell and West Birmingham NHS Hospital website. It’s not even mentioned in your blog. Although in June of 2013 I find you writing:
In the next few weeks we will place before our Board proposals to define our future role in tackling health inequalities and amenable mortality. This is a huge agenda nationally and of course locally. No one part of the economy can work alone to change behaviours and enhance opportunity but as a large employer, with experts in the field, and important opportunities to make every patient contact count, we see ourselves playing a very important role in tackling smoking, alcohol misuse and physical inactivity which together to do so much to damage the health of the people we serve.
May I ask to what extent “changing behaviours” is compatible with your care standards and promises, listed above? It seems to me that the aim of changing the behaviour of smokers does not, for example, value the smokers’ point of view.
And finally, may I ask whether the “philosophy” of the board is decided by its members, or whether it has been handed down as an edict from some higher body?
I think that’s quite a nice letter! And, who knows, I might even get a nice reply!