I have never wanted to set foot in a hospital - and I'm not alone in that. Few people want to be there, even those who are having babies. The large ones are complex, impersonal and generally officious with messages, instructions and warnings plastered on the walls of reception areas as well as the no-smoking signs at the entrance and on every building within the complex.
Had to stay in one or I'd have died. And there are follow-ups; lots of these and still ongoing every couple of years. So I've had stacks of time to speak to people and - invariably - they were folk I met at the smoking shelters, or close to the outpatient entrance whilst waiting, because the hospital invariably runs late on appointments.
What tickled me in the smoking shelters were the number of nurses, porters and service personnel who were enjoying a cigarette during their break, frequently with a mug of tea or coffee. There was a protocol; patients kept ourselves to ourselves, while the hospital staff ignored us!
After dark when visiting hours were over and the staff count dropped - and more importantly the administration and the back room people had left - things changed. It became a lot more relaxed and so some people who needed wheelchairs, drips and things would make their way to the front door, wheeling their drip on a pole, and have several cigarettes. I spoke to one who was a mother and grandmother at about 9 o'clock at night. She still had her dignity and those two cigarettes were all she had each day. I suspected her children and grandkids, who visited every day, were the main reason for her stress; having the tables turned is always a difficult one for parents to come to terms with, yet she knew her independence was gone.
What I noticed was no one gave either of us a second glance; people could see our naked legs and our slippers, they could see her drip and her catheter hanging from a hook way down the pole - and I was severely emaciated. There was no way either of us could make it to the smoking shelter and there was no point in kicking up a fuss because we were a fair distance from the doorway and not causing noise or smell.
Some nights there might be group of four or five of us, just minding our own business, getting some fresh air and of course having a cigarette. Some talking, some contemplating their future - and for some it looked fairly bleak.
On the 1st of April 2015 all hospital and NHS grounds became smoke-free (01), so they removed the smoking shelters and erected signs telling people of the new order of things. Yet there were slight differences; Lothian Health boards allowed e-cigarettes while many others did not.
However it wasn't actively policed and because people know it's not an offense to smoke outdoors a compromise was quickly established. Hospital staff knew of all the nooks, corners and sheltered places where they could sit down for a blather and a fag. Patients waited until all the day time shifts had left, then lit up as they had before, while day patients and their drivers either went back to their cars and smoked (though they really weren't supposed to do so because cars parked on their site are included), or found a place where they could down a quick one.
With incredible naivety many hospitals removed all the ashtrays from outside the entrances, so people just stubbed out where they stood. Next strong wind and the place was awash with fag butts.
However one year later a few of the more pragmatic hospitals did allow the use of vaping devices in their grounds (02). I thought that quite amusing because a good many smoker patients were way ahead of them; they've been vaping in their room, beds, or in the toilet for years!
Neither action worked terribly well, some hospital boards employed people to try to enforce the ban, usually with little success. The board in Lothian did not, so a "public outcry" was engineered. First came an article about smokers at the Edinburgh Royal Infirmary, with the usual outrage that people were not doing as they were told. They even used the Grenfell Tower cladding as another excuse to justify what Sheila Duffy states: "From next spring, we expect to see a 15-metre perimeter created by law around hospital buildings on NHS grounds with a fixed penalty of £50 or fine of up to £1,000 for breaching the law" (03).
Next came a fascinating article about 1700 people who were caught smoking inside hospitals over a three year period, even within maternity wards and A & E departments! (These being the ones who were caught and logged, the real figure is likely to be many times that). However the whole stunt was designed to give Duffy another opportunity to mention the 15 metre perimeter being proposed for hospital buildings (04).
What's curious about her statements is they were made in September 2017 and until that point no public mention had been made. However that position was reinforced by yet another "public outcry", this time engineered for the benefit of SNP MSP Alex Neil who, in a lengthy statement to the Daily Record in November 2017 (05), Repeated what Duffy had outlined a couple of months previously.
So it looks like we'll all have to either vape in public during the day or go 50 ft from any hospital building if we insist on a fag. An on the spot £50 fine if caught being naughty and £1000 if you give them two fingers. That's bound to happen, this is not about risk to other people, nor the litter: they removed all ashtrays, so self inflicted. No, this is only about the sight of people smoking; it's petty, spiteful and a massive abuse of power. It's "Fuck You Because We Can" legislation, so I shan't be surprised when some people respond in kind. And I'd love to be a fly on the wall when the first fine is challenged in court. Proving there's any risk to health, or that NHS sites are somehow hallowed ground is going to be childishly easy to rip to shreds.
An interesting development in England, where they're in the early stages of copying Scotland, were the very recent recommendations by Public Health England that hospitals allow vaping within their grounds; that hospitals should sell e-fags, smoking shelters converted to vaping shelters and even that vaping rooms be installed within hospital buildings (06)! Maybe they've learned something from the reaction of prisoners to being forced to go cold. Whatever, it'll be interesting if NHS Scotland adopt this approach, save for the smoking shelter conversions - they've been dismantled and cost £30,000 a pop to replace.
Some hospitals do employ wardens, some don't - and doubtless will continue to refuse do so, however they plan a level playing field to enforce the intended legislation so will entrust that to Environmental Wardens. Edinburgh has a total of 20 at the moment who are supposed to police the whole town 7 days a week. So, with holidays and sickness, probably no more than 10 will be on duty on any given day. Just walking round the two big hospitals in Edinburgh will take a good hour each - and they always patrol in pairs. Doing each and every NHS site in Edinburgh every day is impossible at that staffing level.
I suspect our bush telegraph will be a lot faster than these interlopers. Reminds me of my boarding school days when Prefects and Monitors tried their level best to catch pupils smoking. Never got caught because I always made sure I had a good field of vision, and that made every fag all the more enjoyable!
Oh and wardens in Edinburgh don't work at night - and their salary is paid for by ratepayers! I shan't spoil their fun by pointing out that wardens are one of reason why we only have fortnightly bin collections and some of the highest business rates in Britain. And it would detract from their enjoyment if I mentioned that smokers are now far less likely to volunteer to give blood, or to donate organs. These are far too trivial for Ms. Duffy and Alex Neil to consider at this time. I'll leave others to join the dots, it's vastly more satisfying that way!