Wednesday 27 November 2013

NICE Are Not Nice At All

Another day, another case of counter-productive anti-smoker bullying.

Unsurprisingly, the BBC splashed this tiny story everywhere they possibly could; devoted their Radio 5 phone-in to it; and - of course - opened up a rare 'Have Your Say' page on their web story as per usual.
The NHS must stop turning a "blind eye" to smoking and ban it in all hospital grounds in England, according to new guidance. 
The National Institute for Health and Care Excellence said it wanted to see smoking shelters scrapped so patients, visitors and staff could not light up. 
Staff should also stop helping patients out of their beds to go for a smoke. 
And patients who smoke must be identified and offered help to quit, the guidance added.

Now, NICE issue guidance on many things. They have issued 13 items this month alone, only one of which I expect will have crossed the autocue of Nicky Campbell or any other presenter on the BBC. Can you guess which it might be?

So what this boils down to, children, is that you're just not listening to them. The managers at NHS trusts up and down the country have been banning smoking in grassed areas, car parks and sitting on the wall by the main road, but the spurious reasons are so pants that people are not taking any notice. So put your hand out, you naughty boy, the regulator's ruler is to be applied to your smoky palms.

Naturally, by far the most popular comment under the BBC's article was the one which offered the most common sense.
252. landscape
My local hospital has a shelter for smokers. It's 20-30 metres away from the main entrance and off to the side of the car park so no one has to walk past it unless they choose to.
Still people stand just outside the doors but Hospital security are very good at moving people to the smoking shelter.
Perfectly fair way to deal with the issue.

Indeed, this is what Oxford University Hospitals NHS Trust found to be the most advantageous solution when they applied to construct 12 shelters back in August.
Mark Trumper, director of development and estate at the NHS trust said it would "continue to discourage smoking" on all of its hospital sites, but had "taken the decision to establish a limited number of smoking shelters for patients and visitors". 
He added they would "create a more appropriate environment" around entrance areas where smokers "historically" have caused "a significant problem".
But common sense seems alien to NICE, who don't seem to be very nice at all.
[NICE public health director Prof Mike Kelly said] “We need to end the terrible spectacle of people on drips in hospital gowns smoking outside hospital entrances."
Yes, it's a disgrace from a 'caring' industry to force them to do so. Bring back smoking rooms and the "terrible spectacle" can indeed end. However, Mike's solution would never consider such a thing, it's not quite nasty enough.

Is the NHS prepared to compound the disgusting treatment of smokers by making them walk even further away from the building for no reason, or by taking away their liberty to do so?

You guessed it. Mike suggests a system of social engineering, coercion and restricting liberties. While you're in hospital contrary to what you'd like to be doing - and most who are there will not be suffering from smoking-related problems - NICE want staff to take that opportunity to nag, cajole and bully you. Even to the point of not assisting you if you decide you'd prefer to ignore their advice and have a smoke.

Hmm, this public sector organisation seems to forget who pays their wages and those of every NHS member of staff in the UK, doesn't it?

A long time ago (it seems) the banning of smoking was all about secondhand smoke. It wasn't restricting your freedoms, oh no, it was about ensuring others are not harmed. Now, though, NICE want you hounded even in wide open carbon monoxide riddled car parks ... for your own good, natch.

OK, that's the rant over with, but now for the comedy.

If you read NICE's full guidance, there are quite a few astounding and often hilarious suggestions. I'll just leave these two here.
"Varenicline and bupropion can be used with caution in people with mental health problems"
Varenicline, aka Chantix, because a drug linked to 500 suicides should be fine for them. Nope, can't see anything wrong with that.

Whereas, on the other hand ...
Encourage people who are already using an unlicensed nicotine-containing product (such as unlicensed electronic cigarettes) to switch to a licensed product [i.e patches and gum].

It's not about health. Again.


castello said...

WHO is nice? ;)

Sam Duncan said...

“The managers at NHS trusts up and down the country have been banning smoking in grassed areas, car parks and sitting on the wall by the main road, but the spurious reasons are so pants that people are not taking
any notice.”

Heh. Waiting for a taxi outside the Glasgow Royal Infirmary a few months ago in a wind you could barely stand up in, I suddenly heard a shrill, German-accented voice - yes, really; you couldn't make this up - yelling at the top of its lungs, “Ve haff banned smoking in ze hospital, you know!”. I turned round to see a tall, blonde woman marching off with her nose in the air and a wee old guy sheepishly stubbing his fag out on the ground... because, obviously, no ashtrays.

Sure enough, there were Notices. The reason they gave was that the smoke gets into their air conditioning system and clogs it up. To which I can only say it must be pretty bloody shonky air conditioning if it seizes up trying to filter a few parts per billion of tobacco smoke. The Royal, by the way, is right next to Junction 15 on the M8, Townhead Interchange, one of the busiest road junctions in the country. Literally bang-up against it. So the system can handle 24-hour diesel fumes apparently, but not a few fags. Then again, it's the National Health we're talking about. It probably can't.

“Hmm, this public sector organisation seems to forget who pays their
wages and those of every NHS member of staff in the UK, doesn't it?”

It doesn't care. After all, it's not as if we're doing it voluntarily, is it?


Bit of a giveaway, that one, isn't it?

For Heaven's Sake.... said...

A long time ago (it seems) the banning of smoking was all about secondhand smoke. It wasn't restricting your freedoms, oh no, it was about ensuring others are not harmed. Now, though, NICE want you hounded
even in wide open carbon monoxide riddled car parks ... for your own good,

Sorry, DP, but it’s never been about SHS. The current antismoking crusade, much like previous crusades, has been a moralizing, social-engineering crusade from the outset: The goal has been to eradicate tobacco use (see Godber Blueprint) by a bunch of miscreants that hate smoke/smoking/smokers. In the 1970s, there were few interested in social engineering, particularly in relatively free societies. So the zealots that met at the World Conferences on Smoking & Health contrived secondhand smoke “danger”.
The zealots kept insisting “we’re not doing social engineering”, “we’re not
moralizing”, “we’re only wanting to protect nonsmokers from SHS ‘danger’”. It’s a massive lie that has been told many times over the last three decades. SHS “danger” was a means to keep antismoking alive for a social-engineering crusade that would have otherwise stalled.

It should be apparent by now that antismoking is only moralizing
and social engineering, and the lies are coming thicker and faster to impose more draconian, spiteful and baseless social-engineering bans.

Jax said...

Of course, even if this OTT suggestion is made official
policy, much will depend on how individual hospitals apply it. My own local hospital already officially has a “no
smoking on the premises” rule, but it is regularly ignored by all and sundry
and people are rarely challenged, mainly because most of them go to the trouble
of moving away from the main entrance to go further up the driveway or into the
car park to smoke. The hospital’s policy
seems to be (quite reasonably, I think) that if people have made a bit of an
effort to smoke in an obviously open-air space, then it probably isn’t worth
the angst and bad feeling which would result from asking them to stop.

And realistically, what can they do about it? “Security” of course, could request a smoker
to leave if they wouldn’t stop smoking, but as most visitors only light up when
they’re leaving anyway, that’s as good as no good at all; and they can’t
exactly ask a patient to leave the premises because that would be, essentially,
a security guard taking on the responsibility of discharging a patient, with
all the medical (and legal) ramifications which that might lead to, and I can’t
see many security guards wanting to take that responsibility on board. And they don’t exactly have the option, as
they did with the smoking ban, of punishing a landlord with whom the offending
smoker wants to remain on friendly terms, either. So how, exactly, are they intending that such
a ruling should be enforced effectively?

truckerlyn said...

Ah, Jax, you forget, the NHS can refuse to treat you if you cause trouble or 'harm' to the staff or other patients! I am sure, if they are brainwashed enough, they will not hesitate to take this stance. Therefore, if anything untoward happens to you, it is of your own making because you refused to stop smoking whilst in hospital!

truckerlyn said...

I left this response on Taking Liberties, yesterday:

I heard Vasos on Chris Evans this morning saying that smoking means healing takes longer, especially after an operation, so this makes sense!

Of course, if mindless plebs are told something often enough then, of course, they believe it. Just like the anti smoking lobby, say something often enough and it must be true!

Smoking does not cause a more lengthy healing process, however, being denied the right to smoke would not only prolong healing of physical wounds/symptoms, it would also perpetuate mental illness, stress and anxiety. Therefore, the medical profession would be doing far more harm than good. Prior to the ban I was able to manage my depression with the help of cigarettes and did not need to resort to medication. Now, for nearly 7 years I have been on various medications for depression, anxiety and stress, all caused by this insidious ban.

As for bullying patients into giving up, NOTHING and especially not their 'wonder drugs' (NRT) will work UNLESS the smoker actually wants to give up and if that is the case NRT might be a mental crutch to aid them, but is not what perpetuates them quitting. The fact that they truly want to give up is how and why they mange to quit. I was also horrified when I registered with a different GP surgery and had my New Patient assessment to be told that they were now able to offer a new wonder drug that was really successful in helping people to quite, it is called Champex! I told the nurse, in no uncertain terms, what they could do with their 'wonder drug' and under no circumstances would I ever consider taking it as it is responsible for far more deaths than smoking is! I went on to explain the suicidal tendencies it caused and she was dumbfounded. As I said, it does a better job of killing people than I have so far managed when trying to top myself!

As for people who are terminally ill and want a smoke, to deny them this pleasure is too cruel for words. It is also extremely distressing for their family. My father died in hospital in February 2002 and the night before he died he asked for a smoke; we were told it was too much trouble to manoeuvre him out of the side ward he was in. I was going to get him outside, somehow, but my mother didn't want to make a fuss. He died the next morning. It still haunts me that I was not able to fulfill his last request.

The NHS has become a despicable organisation that no longer adheres to the ethos under which it was set up and ALL those intent on discriminating against those that do not conform to their ideologies should not be working in a the caring profession, as they so obviously do not care for the wellbeing of anyone. Scum, the lot of them.

truckerlyn said...

But, hospitals and staff, and of course all the members of NICE, need their precious cars, so the fumes from these cannot possibly be anywhere near as harmful as SHS! These bullies are very good at brainwashing those without enough gumption to think for themselves, like the guy a few years ago who complained in our local cafe that he wanted to sit outside in the 'fresh air' with his coffee but the tables were full of people smoking! My husband (and he will not usually get involved) said, "Fresh air - the tables are 8 feet from the main road, so what fresh air?"

Blad Tolstoy said...

“We need to end the terrible spectacle of people on drips in hospital gowns smoking outside hospital entrances." - Prof Mike Kelly
Oh, oh, oh, the terrible spectacle of it all, shriek, shriek, shriek. Oh, oh, shriek and shriek some more. Please tell me what is the attraction in sounding like a prim old woman in over starched knickers?
The language is totally appropriate for someone who has never lived properly but why half the Labour Party insist on sounding like old maiden aunts as well has me lost. Oh yeah, of course, it must be something they put in the water.

JonathanBagley said...

Vasos was a heavy smoker. Think he's given up. I'm interested in this "healing" thing. Heard it repeatedly. Does anyone have any references for it. Could be lack of oxygen in blood, due to carbon monoxide. Heard a suggestion this was one reason why smokers shouldn't receive medical treatment. There's plenty of evidence to study. Soldiers of lower ranks, and even higher (Prince Harry) tend to be smokers and these days have huge wounds due to limbs being blown off.

moonrakin said...

I see the BBC have extended the kiting of the plain packs story with a Labour Party angle - something must be done!

So now the colour of cigarette packets has become a national party political issue - way to go guys 'n gals ... got your finger on the pulse of the nation there and no mistake.

The way this is being handled is just so wrong, on so many levels that it's difficult to get a grip of the enormity of the stupidity and arrogance involved. What's clear though is that there must be folk behind this - pushing the agenda behind the scenes, doing the rounds, wielding influence - call it what you will - this hasn't just spontaneously popped into existence...., I expect they're dusting off smoking permits.

DP said...

Dear Mr Puddlecote

One wonders at the mentality of those who pretend to be health 'professionals' that they can without seemingly noticing any contradiction inflict their obsession on smoking on those who are already suffering.

The abuse of smokers is reaching all time lows amongst those who are paid from the public purse.

I recently received a missive from the Nazi Health Service part of which states:



If you are a smoker and may require an operation you will need to bring your Stop Smoking completion letter/certificate to this appointment. This can be obtained by attending the stop smoking service at your GP surgery.


When did these people decide that they can gratuitously abuse adults for indulging in a legal activity? When did it the NHS acquire the power to provide services based upon arbitrary criteria?

Eighty years ago you could, in certain parts of the world, cross out 'smoker' and substitute 'Jew' to justify abuse.

How have we progressed to the stage at which government departments behave in virtually identical ways as totalitarian regimes of nigh on three generations ago apparently without any comprehension of what they are actually doing?


Ivan D said...

Kelly has a degree in Sociology and Economics. He is clearly an illiberal spiteful ideologue which I suppose is what attracted him to public health in the first place. Unsurprisingly he is an Honorary Fellow of the Royal College of Physicians.

Dick_Puddlecote said...

Another sociologist? Tobacco control is packed full with them too.

Dick_Puddlecote said...

A bit harsh saying politicians only treat coloured boxes as a high priority issue ... they come close to declaring a state of emergency when dealing with chocolate oranges ;)

Dick_Puddlecote said...

Quite, which is why I have always said it's never been about health. I was quoting that because it was the only incredibly flimsy reason they could think of to counter the pub-goer's simple point that you choose to go in a pub so it's none of their business. Once the public fell for that, they realised that they could make up any old shit and would be believed. It's a different made-up heap of toss for whatever they are trying to ban at any particular time.

Dick_Puddlecote said...

Exactly. ;)

moonrakin said...

earrrrrghhh... hadn't seen that - it would seem they've taken Yes Minister as an instructional self help video.

A civil servant (MoD) pal of mine was tasked to organise a national seminar - the subject of which turned out to be deciding what colour ring binders they were going to use for records (it wasn't that long ago either!) well catered and accommodated the delegates were. She was disgusted and I got the impression they couldn't decide between maroon or dark brown and probably set a date for further deliberation after commissioning a consultant..

nisakiman said...

I've not seen any research / studies on this subject, although I have seen a few articles opining the smoking / slow healing idea. From personal experience, I'd say it's a crock of shit. I heal quite extraordinarily fast, and have surprised the medicos on more than one occasion, despite having smoked for 50 years. But that's just me, of course. I have no idea about anyone else. So not exactly overwhelming evidence! :) But it would be interesting to find out if there was really any correlation, or if it was mere (wishful) speculation on the part of the anti concerned.

moonrakin said...

Judging by the career trajectories of the social "scientist" Guardian reading lazy incurious gits I passed though the education system alongside - after a taster of dealing with the actual "social problems" they'd been regurgitating received Toynbee-isms about - they resolved to get into something with negligible actual client contact, NO chance of being held responsible for anything and salary increments for every dubious "professional advancement" course they could get onto = cnuts..