Discrimination or sensible risk avoidance?
Monday, December 9, 2013 at 8:10 On Friday, December 6, 2013, Peter Brown wrote:
Hello, I wonder if someone at Forest can point me in the right direction.
I suffer quite badly from smoking induced Emphysema. I am not complaining, it is entirely my fault. However, this has now caused me to be diagnosed with COPD. It normally does not cause me any great difficulty but it is complicated by the fact that I also suffer from Rhinitis which means that my sinuses constantly allow mucous to drain into my lungs. That in itself, is not too bad to cope with until I get a nose 'cold' and the infection spreads immediately to my lungs which go into overdrive in the mucous manufacturing stakes.
Again, I can normally cope with this as my GP allows me to keep a stock of the steroidal drug 'Prednisolone' which normally makes things bearable after 2 or 3 hours. The problems occur if I get an attack at night when the lung infection has a chance to build up causing me to wake up in severe pulmonary distress because I cannot rid myself of the mucous quickly enough. This occurred 3 nights ago and though I can normally persevere until the Prednisolone takes effect, this time, I was forced to call for an ambulance and was admitted to hospital. My blood oxygen levels were down to 86 per cent.
I was treated in the ambulance with oxygen and also at the hospital which, together with a nebuliser treatment got me back to a reasonable level of oxygen intake. I had been trying for some time to get a home oxygen supply for such an emergency and broached this with the Emergency Department doctor at the local infirmary.
I was told that as I am a smoker, they will not allow me to have an oxygen supply because, they said there was a danger that if the supply was left on by mistake, it would be too dangerous to allow a smoker to use one. I asked if that applied to non-smokers who use a gas cooker, gas boiler or an open fire. I was told that it did not apply to them. I then pointed out that my GP considered me responsible enough to keep a supply of Prednisolone which is very limited on the amount that you can take and yet the hospital thought that I may be stupid enough to smoke when using oxygen in an emergency when I could barely breathe anything let alone cigarette smoke.
It was finally admitted that the hospital had a policy of not supplying oxygen to smokers because the smoking was the cause of my distress. I was also told that even if I should give up smoking, my illness will not improve, it will merely make my life slightly longer. As I am 66 years old and have been smoking since I was 11 years old. I do not consider the extra couple of months of extra life worthwhile compared to the misery of attempting to stop smoking after so many years of addiction.
I consider that the hospital's attitude is entirely unreasonable especially as Heroin addicts are not required to give up their addiction to receive treatment by Methadone yet they refuse me a home supply of oxygen for use in an emergency to allow me to get sufficient oxygen in my blood to prevent me from passing out. This could be fatal as I live alone and become, at times, incapable of calling for help until I get sufficient breath even to speak.
I believe (hope) that this policy by the hospital may be actionable under Disability Discrimination Law. Do Forest have any links to any legal advisors that can help me in this?
On Friday, December 6, 2013, Simon Clark wrote:
Dear Peter,
Thank you for your email. I'm afraid we don't have legal advisors (too expensive) and we can't give advice ourselves, for legal reasons. So it's Catch 22, I'm afraid. The best I can suggest is that you contact your local Citizens Advice Bureau and your MP who might take up the issue with the hospital on your behalf. (You don't say where you live. It would be interesting to know who your MP is.)
Our role tends to be media focused so when people contact us with problems including allegations of discrimination we take the story to the media in the hope that any publicity may prompt a positive response/outcome. We don't do that lightly however because we are conscious that going direct to the media can be counter-productive because it can sometimes entrench existing positions.
Please let me know the outcome of any contact you have with the CAB or your MP. In the meantime I wonder if I might publish your email on my blog - keeping the source strictly anonymous. It's an interesting case study that raises a number of questions and at the very least I would like to bring your situation to a wider audience.
On Friday, December 6, 2013, Peter Brown wrote:
By all means, use my email in your blog. I do not have any reservations about the use of my name or the [local infirmary].
On Sunday, December 10, 2013, Simon Clark wrote:
I would be happy to forward your email to your MP on your behalf. However he would need to be able to verify that you are a constituent so we would need your full address. (I would copy you in our correspondence and invite him to contact you direct.)
In the meantime, have you discussed your situation with your GP or appealed to the hospital to review their decision? Do you have anything in writing from the hospital that confirms their position?
On Sunday December 8, 2013, Peter Brown wrote:
I have not been able to see my GP as yet due to a usual 2 week waiting list but I may be able to have a phone consultation before them due to urgency.
I have not had any formal refusal of oxygen facilities, just two conversations with doctors in the Emergency Department and the [infirmary] when I was admitted and also with a manager in the Respiratory Team and a home visitor yesterday. They all inform me that it is hospital policy not to give oxygen equipment to smokers.
I can understand their concern to a degree, especially as there was a report in yesterday's Daily Mail that a 47 year old woman has just blown herself up. However, she was stupid enough to light up a cigarette when she was actually taking oxygen. I am not that woman. My doctor trusts my competence to hold a supply of Prednisolone which has strict rules on the amount of usage.
I only want the oxygen for an emergency such as happened the other night when I was close to passing out because I could not get enough air into my lungs. As soon as I was able to breathe sufficiently to get to other equipment such as my nebuliser, I would stop using it. If I should pass out, it is potentially very dangerous as I live alone. I could not smoke a cigarette in those circumstances to save my life.
The doctors have said that they would not refuse an oxygen system to someone who lives in a property with an open flame such as a gas cooker, a gas boiler (pilot light) or an open fire yet suggest that a cigarette itself is more dangerous. However, I have done some gas welding in the past and it is impossible to light the torch with a cigarette, it just makes the cigarette glow brighter. I strongly suspect that the woman mentioned above blew herself up when she struck a match or used a lighter with an open flame right alongside the oxygen outlet.
If you feel that it is worth a try, by all means contact my MP about this matter.
I have forwarded this correspondence to Peter's MP. I won't reveal who it is but what were the odds?!!
Watch this space.
Reader Comments (15)
Get everything in writing Peter - including the hospital policy section on not supporting smokers with oxygen.
There is a PALS service at every trust which is a dept that listens to you, and will advise you, signpost you and give you support - or should be - it stands for patient liason service (I think).
I will be following this closely, as it is discrimination.
You have my support for what it's worth, and all the best to you.
What Sue says. Confront them with a choice of either supplying you with a home supply of oxygen, or failing that a written statement outlining the reasons for their refusal. Given that oxygen is not a flammable gas they don't really have a leg to stand on; it's just outright discrimination. I'm sure one of the 'no-win-no-fee' law firms would take it on and sue for compensation on your behalf.
My first point is that Peter was told it was "hospital policy" sounds like some pen pusher not a medical person.
Sooner or later in my opinion someone is going to die because of the jobsworths and it should be reported to the police as corporate manslaughter. If I was Peter I would get his partner or near relative to write to the Chief Executive and warn them they should anything happen the CE will be reported to the police.
This strikes as an example of iatrogenesis.
There are private suppliers of oxygen.
In the link below I spoke to the MD Bill Scott and they can supply oxygen direct to patients if they have a letter of authority from Peter's GP and/or Consultant if they have the courage to override the Managers at the hospital. They can do it I understand.
Also Bill mentioned a "Concentrator" which can be plugged into a mains switch which takes oxygen out of the air and concentrates it in a receptacle to be breathed in.
Under no circumstances can the kit be supplied without medical assent.
I hope that helps.
http://www.specialityoxygen.co.uk/rental-products/
Peter is a classic example of the child smoker the antis couldn't save so now discriminate against in hope they die a horrible death just so they can turn around and say : "Nahnahnahna - Told you so."
.It's not about health.
Good luck to him. Having paid a lifetime's tax on the product, and clearly being refused the care he needs in his older age, he should demand a rebate so he can take care of his own medical needs in the private sector that won't care if he smokes/smoked or not.
The NHS is disgusting. It neglects old people to death and looks for ways to discriminate against people with no rights. Nye Bevin would be turning in his grave.
"The doctors have said that they would not refuse an oxygen system to someone who lives in a property with an open flame such as a gas cooker, a gas boiler (pilot light) or an open fire yet suggest that a cigarette itself is more dangerous"
I never heard that oxygen is inflammable. And indeed it is not. Is this story real?
Good Luck Peter and please keep 'us' (Simon) updated. The hospital's decision is even more none nonsensical as anyone ,smoker or not, can buy oxygen on Ebay and masks/tubing etc etc
The Blocked Dwarf is correct you can buy them on Ebay.
With "Oxygen concentration is adjustable from 50% to 90%" it costs £198.00
http://www.ebay.co.uk/itm/NEW-1L-5L-90-LOW-NOISE-OXYGEN-GENERATOR-CONCENTRATOR-OXYGEN-ADJUSTABLE-LCD-e6-/200924398772?pt=UK_Health_Beauty_Mobility_Disability_Medical_ET&hash=item2ec80704b4
Excuse me for being the dimmo at the party here, but I always thought that Oxygen was flammable – highly so (hence all those warnings about closing doors and not opening up windows etc if there’s a fire in your house – isn’t that to stop the inward rush of oxygen from fanning the flames?). Please can any of you science-minded types on here explain further?
You can purchase a small cylinder of O2 at a hardware store, by the propane and MAP canisters and welding hardware, for around $5. An oxygen mask runs as cheap as $1. Screw the hospital and doctors, keep these by your bed in case of emergency.
@ Misty.
Oxygen is highly reactive chemically when in contact with flammable material at high temperatures. Thus, if oxygen in the atmosphere is in contact with, say, wood shavings, and the wood shavings are heated up to a sufficiently high temperature, a chemical reaction will take place. This reaction will spread through the wood shavings and the whole lot will 'burn'. Fanning the burning shavings forces more oxygen more quickly into the reacting materials and thus, literally, "fans the flames".
What Sue said - then take it through the internal complaints procedure demolishing their arguments and arguing your case, at every step demanding a response by a certain date (or else they'll stall forever). Then if no satisfaction complain to the Ombudsman:
http://www.ombudsman.org.uk/
"Smoking induced Emphysema"
"I am not complaining, it is entirely my fault"
"After so many years of addiction"
Erm...... perhaps I've become too cynical
"However, I have done some gas welding in the past and it is impossible to light the torch with a cigarette"
How much was "some" welding?
"The poor and deteriorating lung condition observed in the welder examined in this study was likely due to exposure to very high levels of potentially toxic metal fumes and gases for a significant number of years due to work in confined spaces." here
Details can be easily checked
I was a little sceptical about these sentences too Frank I have to say. However he does supply Simon with his name and address which can be clarified, and of course he has the name of the infirmary which has refused his request.
If the said infirmary was asked about its policy by Simon then his experience would be confirmed.
Several details here can be checked. I wonder if the health Secretary Jeremy Hunt is aware of any such practice within the NHS?
Maybe a FOI at some stage, or perhaps an editorial in Peter's local newspaper.
Yes, the detail is good, Dennis,
"Smoking since 11 years old" The only thing missing here is 'because of the glitzy packages'
No, I'm definitely too cynical