The NHS: a true story

The BBC this week reported that the NHS is 'failing to treat elderly with care and respect'.

I'm not sure how the ombudsman can make such a sweeping statement based on so few cases. Nevertheless, I can relate to the story, and here's why.

Ten days before Christmas my father, 80, fell and broke his hip. He was taken to hospital and given a partial hip replacement.

It is normal, I believe, for patients to be sent home within five days of such an operation. My father's situation is not normal. Apart from his age, he had a heart transplant 12 years ago, and for the past two years he has been on dialysis three times a week.

So we didn't expect him home immediately. No-one, however, thought he would still be in hospital nine weeks later. In this instance - and it's not the first time I have witnessed it - the problem is not the initial treatment, it's the aftercare, or the lack of it.

As a result of his accident, which has weakened him considerably, it is difficult for my father to get in and out of bed without the help of at least one trained nurse, and he can only walk very slowly with the aid of a Zimmer frame. Without the regular physiotherapy he was told he would get - and hasn't - his recovery has been painfully slow.

Anyway, the following story speaks volumes. For the past few weeks my father has been sharing a ward with a delightful man called 'Stan' (not his real name). Last week my father made his way, slowly and with the help of his Zimmer frame, to the toilet down the corridor. Somehow he locked himself in and rang the alarm bell.

No response.

He rang it again. Still no response.

Stan, however, did hear it and from his bed bellowed for a nurse to come and help.

No response.

Stan shouted again. Still no response.

Confined to his bed, Stan thought for a moment. And rang the police.

Slightly befuddled, he couldn't remember the name of the hospital, but the police worked it out, contacted the hospital, and eventually someone went to my father's aid.

It sounds funny but that wasn't the end of it. The following day Stan and my father were both given a severe telling off from the person in charge of the ward!

Thankfully, my father is due home on Monday. I shall be keeping my fingers crossed for Stan.

Paris fights to remain European capital of smoking

Maintaining my recent European theme, Peter Thurgood has written an article for The Free Society entitled 'Spot the difference: how Paris is coming to terms with the public smoking ban'.

The first thing I noticed was that almost every bar/restaurant, had outside seating, with patio heaters and a plastic awning around it. The second thing I noticed were the ashtrays on every table. Could this be the headquarters of the French Resistance? Whatever it was, I was determined to enter, and hopefully join up.

Inside the area cordoned off by the plastic awning, it was comfortable and warm, and the waitress accepted me and my smoking habit with a friendly smile and no irritating hand waving in front of her face, which we seem to experience in the UK. Other customers came and went, some smoked, some didn’t, but the atmosphere at all times was warm and friendly, just the opposite to the intolerance smokers are subjected to here in the UK.

I went to a number of other restaurants, bars, and cafes and, at a guess, I would say that approximately 80 per cent of them had this same type of plastic awning surrounding their outside seating area. In other words, the needs and comforts of smokers are well and truly catered for. Also catered for are the needs of the non-smokers who have the whole of the inside of the building ... in which to enjoy their self-imposed segregation, if they so wish.

I have written about this before, but Peter's article reminds me of the time that Forest sent a delegation of smokers to Paris in order to escape No Smoking Day in Britain.

We chose Paris because, in those days, the French capital thoroughly deserved the title 'European capital of smoking'. Our little group - which included Lord Harris of High Cross and Judith Hatton, authors of Murder A Cigarette, and Bob Shields of the Daily Record - travelled by Eurostar (which still had smoking coaches) and was met at Gare du Nord by representatives from a smokers' rights group in France.

Lunch took place at a restaurant used, appropriately, by the Resistance during the Second World War, and the entire day was a great success.

Whether Paris remains the European capital of smoking is arguable. In 2011 Prague and Budapest are obvious rivals, but read Peter's article and make up your own mind. Comments welcome.

PS. I wish I could find Bob Shields' report. With photographs, it occupied a double-page spread and was very, very funny. Unfortunately it was eleven years ago and I can't find a copy anywhere.

Belgium shows the way forward

I was in Brussels on Monday.

I go there several times a year and I can report that everything was completely normal. The trains ran on time, a taxi took me to and from my hotel without mishap. The shops were doing a roaring trade in (what else?) Belgian chocolates, and it was business as usual.

Today, however, I read that Belgium hits world record for lack of government (EU Observer).

Radio Free Europe confirms that:

At midnight tonight, Belgium will claim the world record for the number of days it has been without an agreement on a government, overtaking the previous record holder, Iraq.

February 18 will mark 250 days since June's inconclusive national elections in which the diametrically opposed New Flemish Alliance and the Francophone Socialist Party won the most seats.

Imagine the United Kingdom without a government for a similar period. Actually, I can. In fact, I think that government, especially Big Government, is over-rated and we would be much better off without it.

The idea that without a proper government a developed Western country cannot go about its daily business is nonsense, and insulting to all law-abiding citizens.

Like the Belgians we would just get on with it, I'm sure.

So, like many people today, I shall drink a toast to Belgium, the country that doesn't have or, indeed, need a government.

PS. We broke off from our meeting on Monday so the smokers could have a cigarette break. We were on the fifth floor of a modern office block in the centre of Brussels. In Britain they would have had to find a balcony - if one existed - or get the lift to the ground floor and stand outside. (It was a cold, damp day and that wouldn't have been very pleasant.)

This was Belgium, though. Separated from the boardroom by an internal wall was a small smoking room. It was narrow - like a walk-in wardrobe - but there was a large window at one end so it felt light and airy. There were also several comfortable chairs, some light maple furniture, and three large ashtrays that almost begged you to light up.

I sat there with one person smoking and I wasn't conscious of any tobacco smoke. (Perhaps I'm unusually tolerant or unobservant.) The room could have accommodated four or five people quite easily and I really can't understand why private companies in Britain are not allowed to provide something similar.

Why government has to stick its nose in and ban such an innocuous but useful facility is incomprehensible to me. What a petty little country we have become. Sadly, if tobacco control has its way, even well-ventilated smoking rooms will be a thing of the past throughout Europe.

Push for outdoor smoking ban begins

Following New York's decision to ban smoking in parks and squares, Five News last night reported the result of a YouGov/Five News survey on the subject.

"Some countries are clamping down on lighting up in the open and our survey reveals that 43 per cent of people in the UK think the smoking ban should be extended to all outdoor public spaces."

The Government, said Five News, has no plans to follow suit yet but does say that breathing in other people's smoke increases your risk of getting lung cancer by 24 per cent. "And our survey did reveal some pretty strong feelings."

Member of the public:

"It's breathing it in, or the smell that gets on your clothes. If you've got children in a buggy ... it's straight in their face. I think it's really inconsiderate."

Interestingly, the Roy Castle Foundation appears to be against an outdoor smoking ban. Interviewed by Five News, youth project manager Lisa Gill said, "Our concern is that parents and carers who are maybe motivated to protect their children within their homes by smoking outside would then move back into the home and start smoking in front of their children."

The suggestion by Five News that "breathing in other people's smoke increases your risk of getting lung cancer by 24 per cent" does of course refer to exposure to other people's smoke in a confined space over many, many years. It has no relevance whatsoever to smoking outdoors.

In truth, the risk of non-smokers getting lung cancer is so small that an increased risk of 24 per cent is, in etymological terms, statistically insignificant. To be significant the "increased risk" would have to be in the region of 200-300 per cent. Perhaps someone should tell Five News.

PS. Five News did contact Forest for an interview. Unfortunately I was in Brussels and unavailable.

Update: The YouGov website reports that "51 per cent support the idea of banning smoking in outdoors public places, such as open parks, beaches and pedestrian squares". Report here (but not the actual survey or the questions asked).

Smokers are voters too

Good luck to John Mallon who is launching Forest Eireann's 'Smokers' Manifesto' in Cork this morning.

The manifesto urges politicians to:

• respect the rights of adults who have made an informed choice to smoke tobacco in full knowledge of the health risks associated with this legal product

• acknowledge that the overwhelming majority of smokers are ordinary, decent, law-abiding adults whose habit does not affect their ability to make a positive contribution to Irish society

• relax the smoking ban so that pubs and bars can provide smoking rooms that allow adults to smoke in greater comfort without bothering non-smokers

• cut tobacco duty to tackle smuggling and reduce the temptation to buy tobacco abroad

• recognise the major financial contribution made by consumers who buy tobacco from legitimate retailers in Ireland

• review the use of public money to fund groups and quangos dedicated to persecuting adult smokers

• engage with the consumer so that one million smokers no longer feel ignored and disenfranchised from the political process

• treat one million voters [the number of adult smokers in Ireland] with the respect they deserve

The manifesto is being published in advance of the Irish election on Friday February 25.

My Spanish adventure

I think I'd like to move to Spain.

This week was only my second visit but the weather alone was enough to give it serious thought. Bright sunshine, clear blue sky, crisp, clean air and a mild temperature. Perfect.

The first time I went to Spain, eleven years ago, I attended a smokers' rights conference in Seville. Those four days did more than anything to convince me that working for Forest had a purpose, contrary to what some people might think.

I met people from right across Europe - Denmark, Germany, Belgium, Netherlands, France, Switzerland, Italy, Greece and Spain itself. Most of them smoked but they didn't make a big deal of it. It was as natural to them as breathing.

They were smokers' rights activists but, more important, they were ordinary, considerate people who knew the health risks and couldn't understand why they were being lectured and marginalised for having a perfectly legal habit. They were prepared to take a stand but they didn't rant. They were thoughtful and charming.

I liked them very much and I have harboured an ambition ever since to organise a similar event in London, if only to demonstrate the "normality" of smokers and their habit which doesn't, I'm sorry to say, come across on some online forums where many activists sound as shrill, obsessive and intolerant as the opposition.

Anyway, on Tuesday I flew to Madrid where I was met at the airport by Alvaro Garrido who runs Club Fumadores por la Tolerancia, the Spanish equivalent of Forest. Alvaro also organised the conference in Seville. We have kept in touch and I was delighted to see him again after all these years.

After I checked in to my hotel Alvaro introduced me to his colleague Javier Blanco. We had lunch at Casa Lucio, a traditional tasca in old Madrid, and afterwards they took me on a tour of the city - on foot and, later, by car.

The smoking ban, they told me, is generally being observed in Spain and there is little or no opposition to the new law among mainstream politicians. If I understood correctly, bar owners are waiting to judge the effect of the ban before taking any further steps. By then, of course, it will be too late for some.

Some bar owners, it was suggested, will draw a curtain or usher someone they know into a separate room to allow them to smoke indoors, but customers fear getting the owner into trouble. Sound familiar?

Interestingly, the law in Spain exempts private smokers' clubs. In truth there are only a handful of clubs in Madrid and not a lot more nationwide. They can't sell food and drink and they can't make a profit so don't expect smokers' clubs to pop up all over Spain any time soon.

Anyway, it was a very productive - and enjoyable - couple of days and I am meeting Alvaro again in Brussels tomorrow. We are working on a joint project but I won't tempt fate by saying what it is. Not yet anyway.

See also: Meet the Spaniards fighting to stub out authoritarianism (spiked), and Prohibido prohibir – Ban the bans (euobserver.com)

PS. At my hotel in Madrid I ordered an "All-Spanish" breakfast. According to the menu this consists of churros (water and flour batter sticks, deep fried in oil), torrija (milk soaked bread dipped in egg), mini-tortilla (potato omelette), cured ham on tomato, rubbed toast, slices of butifarra sausage, fruit salad, orange juice, jam, honey and butter.

It was delivered to my room at 7.00am and it won't surprise you to learn that I returned home a little heavier than when I left. (Thankfully, Ryanair didn't charge me for excess baggage but it's only a matter of time.)

Which reminds me, I don't think I saw anyone in Madrid who could be described as overweight, and none who might be called obese. Not one. How is this? If you know the secret please let me know!

Departure lounge

There will be little if any blogging for the next two days.

I am currently at Stansted waiting for an early morning flight to Madrid.

Saw Roxy Music at the O2 in London last night. Had to leave early to catch a train home but enjoyed the evening.

Got three hours' sleep before I had to get up and drive to the airport. Definitely in need of some strong coffee ...

Climb in a car, march off to war, but don't smoke in a bar

I was reminded this morning of the song Joe Jackson wrote in protest at the introduction of the smoking ban in New York City in 2003.

Joe moved to America in the Eighties and lived in New York for 20 years. On his website he explains that "The song was written to send up Mayor Bloomberg and the New York smoking ban, but also to help those fighting to get the ban repealed and to prevent similar bans elsewhere. All proceeds from CD sales and downloads will go to activist groups Forces, NYC Clash, and Forest".

Listening to it today it sounds as fresh and topical as it did seven years ago, but you be the judge:

In 20-0-3
a man drank a whisky
and a martini
or three, maybe four
He climbed in his car
and roared off at eighty
and that night he checked out
along with three more

So they cleared up the mess
but they didn't ban cars
and they didn't ban whisky or gin

[CHORUS]
So do what you want, or do what they tell you
It's the land of the free but don't take it too far
You can do what you want
You can smash up your car
But in 20-0-3 you can't smoke in a bar

In 20-0-3
a man ate a burger
and then ate another or two
Every day
at last he keeled over
but no-one could lift him
And there's millions just like him
and millions to pay

So they issued more warnings
but they didn't ban eating
and they don't ban potatoes or grease

[CHORUS]
So do what you want, or do what they tell you
It's the land of the free but don't take it too far
You can do what you want
You can live just on lard
But in 20-0-3 you can't smoke in a bar

In 20-0-3
a man joined the army
and soon he got shipped out
to fight in Iraq
He was caught in a crossfire
and lost his right arm
But they didn't ban bullets
or missile attacks

He's on his way home now
and who wants to tell him
he can't have a smoke with his beer

[CHORUS]
So do what you want, or do what they tell you
It's the land of the free but don't take it too far
You can do what you want
You can march off to war
But in 20-0-3 you can't smoke in a bar

Click here to listen.