A CRACKDOWN on staff and patients lighting up outside hospitals has been urged amid reports the public are routinely abused by smokers flouting the law.
An Evening News investigation found 23 people smoking near, or outside, the entrance of Edinburgh Royal Infirmary in little over an hour.
All hospital sites are due to go smoke-free by 2015 under Scottish Government legislation but anti-smoking campaigners and patient groups said action was needed now.
It comes as Unison chiefs warn there was at least one report of verbal abuse per week from NHS Lothian staff who have approached visitors, patients and colleagues asking them not to smoke outwith designated areas.
One senior NHS insider called the “foul-mouthed” abuse of staff by smokers “a real problem”.
It should be a place where the sick get better. But instead, the outside of our hospitals often resemble an advertisement for everything that is wrong with Scottish health.
Patients standing in their pyjamas, some attached to drips, smoke cigarette after cigarette, oblivious as the carcinogenic smoke blows back into the wards.
Alongside them are NHS Lothian staff who, like the patients, seemingly cannot be bothered walking the short distance to the designated smoking shelter.
Above is a large red sign that is ignored by all: No Smoking In This Area.
Frustrated staff who call security demanding action are told there’s nothing that can be done. “They just shout and swear at us. We can’t intervene.”
But today – amid a groundswell of support for action – NHS Lothian has been urged to immediately end its informal acceptance of smoking outside hospitals by staff and patients.
Health chiefs are facing demands to get tough after the Evening News captured staff and patients brazenly flouting rules at the flagship Edinburgh Royal Infirmary.
We photographed dozens of uniformed staff and patients ignoring the warning signs and smoking just yards from the hospital building.
Though building work currently taking place has led to the smoking hut positioned outside A&E being cordoned off, over a 70-minute period only six people out of 29 observed smoking outside the building made any effort to stand near the smoking area. Eight people, including five who could be easily identified as hospital workers, were seen smoking directly outside one of the entrances to A&E – underneath a sign which clearly states smoking is prohibited.
All but one of the people seen smoking in this area used plastic chairs which appeared to have been left there specifically for people to sit on during a cigarette break.
Indeed, smoking directly outside has become so common that staff from Consort – which manages the ERI site – have been seen using leaf blowers to move the large number of cigarette butts lying on the ground.
NHS smoking policy states that staff who smoke are only permitted to do so “off NHS Lothian premises”. The 2006 policy also goes on to state: “They should also be aware that smoking during business hours, or whenever in uniform or wearing an identity badge, compromises the public health message.”
A spokeswoman for NHS Lothian said no decision had been made regarding a penalty for staff who continue to flout the rules, but said discussions were ongoing.
All hospital sites are due to go completely smoke free by 2015 under Scottish Government legislation but anti-smoking campaigners and patient groups said action was needed now.
Sheila Duffy, chief executive of ASH Scotland, said: “Genuinely smoke-free hospitals have an important part to play in changing the culture of our society, helping the next generation to grow up free from tobacco.
“We understand that nicotine is highly addictive and it is not always easy for patients to quit abruptly when admitted to hospital. But stop-smoking support should be available – and we need to see leadership from NHS staff, who have no excuse for not following their own policies.”
Union reps and disgruntled staff have been receiving abuse from smokers who refuse to stick to the rules.
Unison’s Tom Waterson said: “We have had reports from NHS Lothian staff members who unfortunately have been verbally abused by members of the public who they have approached and asked not to smoke outwith designated areas.
“I would estimate that at least once a week we hear concerns from staff members who have asked people to move to a designated area and who have been hassled as a result.”
One senior NHS insider called the “foul-mouthed” abuse of staff by smokers “a real problem”.
He said: “As a non-smoker I find it particularly galling that I’ve got to walk by people exhaling a cloud of cancer-causing smoke to get to my work.
“It’s a real problem. I have noticed patients have been getting a lot more abusive and gravitating away from their smoking shelters at a number of hospitals.
“Like most things, time passes, and people get lazy or forget what they’re supposed to do. But that’s never an excuse for people to direct foul-mouthed vitriol at staff asking them to do the correct thing and stub their cigarettes out.”
He added: “At the end of the day, we’re the people who deal with the other end of it – the throat and lung cancers and the heart attacks caused by smoking. It’s funny how unabusive people then can be when they’re in a room with us and really need us.”
The Scotland Patient Association has called on staff to set a better example but said more support from higher up was necessary to help them kick the habit.
Dr Jean Turner, of the Scotland Patient Association, said: “For many years now there have been large signs at hospital entrances saying you are entering a no smoking area, but it’s been plain to see that’s simply not true.
“A lot of the time you practically have to hold your breath when you’re walking to the entrance. You pass patients with drips smoking in their pyjamas and you’ll also see uniformed staff members smoking outwith the designated smoking shelters.
“The NHS should be aiding and abetting staff and patients who have nicotine problems to help them stop smoking. It is very difficult to stop and I understand that people working in hospitals are in a stressful environment, but if patients see the staff smoking wherever they want, then obviously they are going to do it, too.”
George Curley, director of facilities at NHS Lothian, added that the issue was being taken seriously by officials, with wardens patrolling the grounds to catch those lighting up in prohibited areas.
He said: “Smoking is not allowed, other than in the designated smoking areas. Smoking in designated areas was introduced as an interim measure as we work towards completely smoke-free grounds by March 2015, as announced in the recently published Scottish Government’s Tobacco Strategy.
“We are currently undertaking an audit of smoking in our grounds as part of our action plan for smoke-free grounds. The action plan includes the removal of dedicated smoking areas.
“NHS Lothian has 36 trained smoking cessation advisers, seven covering our main hospital sites, who offer help, advice and information to help people quit smoking. This includes approaching people who are seen not to be using the smoking shelters provided. As part of their training, staff are trained to address difficult and distressing situations effectively.”
The Scottish Government announced in March that smoking is to be completely banned on all NHS property by March 2015. Smokers will be offered support to help them refrain from smoking during hospital visits, with services also available to those who wish to stop permanently.
When asked about the number of uniformed staff seen smoking outside the ERI, a Scottish Government spokeswoman said: “NHS boards should be exemplars in providing smoke-free environments. In moving towards smoke-free hospital grounds by 2015, our tobacco control strategy recognises that NHS Boards will need time to communicate smoke-free policies to patients and visitors. This should include advice and support on managing temporary abstinence for staff and those visiting hospital grounds, as well as access to specialist smoking cessation services for those motivated to quit.”
The government spokeswoman added that the penalties for those caught smoking on hospital property after the introduction of the ban would be decided by each individual health board.
Hospital staff members have also reported being abused by smokers in other parts of the country.
It emerged in June that all three smoking wardens employed at Gartnavel Hospital in Glasgow, which is also home to the Beatson West of Scotland Cancer Centre, had quit within days of beginning their new jobs, citing “unbearable intimidation and verbal abuse” from smokers they challenged.
Sign of the times
The Evening News observed the outside of the ERI A&E department over a 70-minute period and saw 29 people – including identifiable staff members – smoking on the premises.
Within a minute of arriving we observed two female staff members smoking on a bench. The most popular spot for a fag break were the chairs right under the No Smoking sign. A seemingly endless procession of patients in their pyjamas and staff in their scrubs made a beeline for the spot.
No-one was challenged by NHS staff during the time we watched the busy department entrance. Last night an NHS source said it’s now rare to see staff challenge smokers – in case it turns ugly.
“People are of the opinion they can do without the hassle, which is just wrong,” he said.
French energy firm in ERI deal
A FRENCH energy firm is to provide meals and clean wards at the Capital’s flagship hospital following a multi-million pound buyout.
Balfour Beatty WorkPlace had previously been responsible for providing the key services under the terms of the private finance initiative (PFI) deal that built the Royal Infirmary.
But it has been announced that GDF Suez is set to buy out the business for £190 million – meaning a firm with expertise in energy is to assume responsibility for vital hospital services and 539 Capital-based hospital staff will switch employer.
NHS Lothian said it was looking forward to working with its new partner while MSPs said there would be no tears shed for the previous provider, following a series of scandals at the hospital relating to staffing, ward cleanliness and building maintenance.
Critics said the fact that provision of essential hospital services could be sold off to the highest bidder with no NHS input once again underlined the absurdity of the PFI deal and called for assurances over jobs and standards.
GDF Suez is also set to take over services including building maintenance and portering by the end of the year, as a sub-contractor to Consort, which has the ultimate responsibility
for the running of the hospital.
SNP Edinburgh Southern MSP Jim Eadie said that the sale was another example of private firms using the NHS for “blatant profiteering” on the back of a “disastrous” contract and said he would be renewing calls for a Holyrood debate on the PFI deal and the way the ERI is run.
He added: “I will be seeking reassurances from Consort and NHS Lothian that standards will not be put at risk for the sake of profit and that jobs will not be lost.”
A Consort spokesman said that the ongoing provision of day-to-day services would be maintained following the change in sub-contractor.
George Curley, director of facilities operations with NHS Lothian, said that health bosses had been kept informed of the potential sale and that services would be unaffected.
He added: “We look forward to working closely with GDF Suez and hope that this deal may bring some benefits to NHS Lothian in the future.”
GDF Suez did not respond to an Evening News request for comment.