A note from your correspondent in Ireland

Flew in to Cork yesterday morning.

It was grey, damp and foggy, much like East Anglia. Actually, it was worse. It was so foggy we couldn't see anything until we landed on the runway.

The taxi driver assured me it was perfectly safe. "They only cancel landings when you can't see the car park," he said, pointing at an area shrouded in mist.

Last night, before dinner, we visited a pub overlooking the River Lee. Not for the first time I was impressed by the ingenuity of an Irish landlord.

There were two smoking areas. One was genuinely outside but it had a large well-covered section. There were chairs, large wooden tables and ashtrays throughout.

The other was effectively a room between the pub and the outdoor area. It was warm and completely enclosed, apart from the entrance to the outdoor area.

I'm now on a train, proceeding at a gentle pace to Dublin, and it's really rather pleasant.

I have just been served a freshly made chicken and stuffing sandwich with crisps, baby tomatoes and lettuce (on a plate!) plus a complimentary glass of orange juice - with ice.

I can read the papers, work on my laptop and enjoy the rolling hills and green fields. I believe it's called multitasking.

Once in Dublin I'll get a taxi across town followed by another train to Greystones. Expected time of arrival in one of my favourite places is 5.30pm.

There's a very cosy wine bar directly across the road from the station. You'll find me there at 5.32.

Discrimination or sensible risk avoidance?

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.

Letter of the week, I kid you not

I have just opened a letter that reads:

Dear Mr Clark,

I heard one of your members speaking on the Jimmy Vine Show (sic) today. I could not believe my eyes (sic) when he said that people should be allowed to smoke in and on NHS premises including hospitals! No, seriously, he did, I kid you not.

Now, as a single mother of five daughters with five different fathers, I am up for a bit of challenging the 'system'. However, I think you would agree with me that what he said was idiotical. Which, ipso facto, makes him an idiot.

Do you agree? I would love to know your views on this.

Thank you and best wishes.

[Name and address supplied]

You couldn't make it up.

As it happens "one of your members" was me and my correspondent means the Jeremy Vine Show which replaced the Jimmy Young Show several years ago.

Then again, I'd give anything to listen to Jimmy Vine. He sounds a hoot.

PS. To listen to the interview between me and Jeremy click here.

Victoria Coren on John Diamond and Nigella Lawson

Declaration of interest.

I've never met them but I like Victoria Coren and her brother Giles.

I liked their father Alan too. And I love Nigella Lawson.

Alan Coren, a brilliant humourist and former editor of Punch (which I enjoyed reading when I was a teenager), was a supporter of Forest for many years until he developed lung cancer.

After he was diagnosed he asked us to stop writing to him. I may have sent him one final note, expressing sincere sadness for his illness, but we removed him from our list, as requested.

A couple of years ago I invited Victoria – a professional gambler – to speak at a Forest/Free Society debate entitled 'Risk and the Pursuit of Happiness – Is smoking, drinking, gambling good for you?'.

She declined.

I wanted to invite Giles as well but I lacked the courage to ask. Given his powerfully expressed anti-smoking opinions it seemed like a red rag to a bull.

Also, I didn't want him to think we were taking the piss or being insensitive to the nature of his father's death.

Anyway, this is a roundabout way of drawing your attention to one of the best articles I have read in a long, long time.

If, like me, you have been following Nigella's recent travails, and if you read her first husband's extraordinary column in The Times when he was dying of throat cancer, it's a must read, full of empathy, insight and friendship:

A most treasured Diamond ... Nigella Lawson's first husband was a brilliant man who adored her and who led me astray (Observer)

It's a far cry from the comment said to have been made by an Irish broadcaster and reported here: Viewers' fury at Alan for Nigella 'bitch' quip (Irish Independent).

Having recently seen Philomena (lovely film, warmly recommended), I imagine there are some people in Ireland and elsewhere who think Philomena Lee was a "stupid bitch" as well.

Times change but some people remain exceedingly quick to judge others' behaviour.

Dan and Phil

Dan Donovan, who designed the Forest Christmas card (see Friday's post), was in Dublin this week.

He was filming a short video which we will post online in the New Year.

Dan is also a musician and while he was there his sound engineer took a picture of him standing next to a statue of the late Phil Lynott.

I'll be in Ireland myself this week. Should be fun.

I must be mad

Writing for Conservative Home this week LBC presenter Iain Dale declared:

I must be mad. I have just accepted an invitation to give a lecture on the NHS to 50 doctors, surgeons and consultants from a London hospital in late January. Why on earth can’t I just learn to say “no”? I don’t do a lot of speeches nowadays ... So when this invitation came in my instinct was to say “no” on the basis that it would involve too much preparation time, and that I wasn’t enough of an expert on the subject.

But then I thought, well, that’s never stopped me before and, frankly, I have learned a huge amount about the NHS from all the time I spend talking to people about it and getting them to give their experiences on my radio show. So I’ve chosen as my title 'The NHS: Things That Need to be Said'. That should give me enough rope to hang myself ... All ideas welcome.

This struck a chord because I recently received an invitation to speak at the Policy Forum for Wales Keynote Seminar: Improving health and wellbeing - public health programmes, legislation and integration, also in January.

Other speakers, I learned, are:

• Dr Sara Hayes, ‎Director of Public Health, Abertawe Bro Morgannwg University Health Board
• Rhianon Urquhart, Senior Health Improvement Officer, Caerphilly County Borough Council
• Professor Stephen Monaghan, UK Board and Executive Member, The Faculty of Public Health (Royal Colleges of Physicians of the UK) and Consultant in Public Health Medicine, Public Health Wales
• Dr Graham Moore, Research Fellow, DECIPHer UKCRC Public Health Research Centre of Excellence, Cardiff University

There will also be a "senior representative" of the food and drink industry.

Like Iain my instinct was to say "no". But I hate saying "no", so I said "yes".

I must be mad.

Happy Christmas, comrades

Here's the 2013 Forest Christmas card designed by Dan Donovan.

The concept and salutation were inspired by Pat Harrold, a general practitioner in Co Tipperary, Ireland, and a lecturer at the University of Limerick medical school.

Two weeks ago Dr Harrold wrote:

We Irish are good at many things. We are world leaders in literature, music and, occasionally, rugby. Lately we have become famous for tobacco control. Ireland became the first country in the world to ban smoking in public places after some groundbreaking research into the health of Galway bar staff. We are now set to become one of the first countries to ban tobacco branding. This means that the box of twenty will have a plain cover and you can only tell the different types by the lettering. The boxes will look generic, rather like the government products in the old Soviet Union.

Well, that got me thinking because I've never forgotten visiting the food hall at GUM, the largest department store in Russia, in 1982 and seeing row upon row of tins with plain, unbranded labels.

It was the same in smaller shops, although a great many shelves were half empty and the queues outside were testament to severe food shortages.

The contrast with our own shops and supermarkets could not have been greater yet Dr Harrold seems to be endorsing Soviet-style packaging for tobacco.

Is he serious?

Anyway, we're sending the Forest card to several hundred MPs and journalists and I hope they get the message.

Plain packaging is a backward step with disturbing political connotations.

Doesn't that bother them?

Ireland: key findings in poll on plain packaging

James Reilly, Minister for Health in Ireland, will today present his proposed Bill for plain packaging to the Irish parliament's Health Committee.

As luck would have it, Forest Eireann recently commissioned a survey from established Dublin pollsters Red C and the results have been published in Ireland this morning.

They make for interesting reading. Here are the key findings:

• Nine out of ten think plain packs are not the best way to stop young people smoking

• More than half the population thinks health education in schools would be most effective in reducing smoking rates.

• Of four policy options considered in the poll, mandatory health education in schools (51 per cent), tackling the illicit trade (23 per cent) and banning adults from buying cigarettes for children (14 per cent) are all considered more likely to work than plain packaging (9 per cent).

• Given a list of four issues the Minister for Health should prioritise in 2014, plain packaging ranked last on just 4 per cent.

• 45 per cent want the Minister to prioritise the health budget overspend, 32 per cent childhood obesity, and 18 per cent under-age drinking

The poll consisted of a random sample of 1,002 adults who were interviewed on the phone by Red C between 18-20 November.

It will be interesting to see whether the survey gets any media coverage.

Full press release here.

Update: Well, fancy that. Tobacco control has a poll out today too.

The Irish Times has a report here - Two polls offer two different perspectives on plain packaging Bill.

The Journal covers both polls too but the headline favours the pro plain pack survey:

Over two-thirds in poll support plain cigarette packaging

Update: The Examiner has a report of both polls too. Again, the headline highlights the pro plain pack angle:

Backing for Reilly's tobacco plain package bill

Funny, that.