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Smoke gets in your eyes

Primary Care Blues

Cornelius Rubeus

Monday, 30 July 2012

Dan_Brett_blog.jpgMy first patient this morning had a large incisional hernia following surgery performed in April 2011. I had to inform this self-employed plumber, currently unable to work, that it can’t be fixed on the NHS - being one of the many procedures ‘not normally funded’ by his local PCT, in the absence of what they consider to be ‘significant functional impairment’.

The next patient was brandishing a letter from the NHS Stop Smoking Service, asking me to prescribe ‘Champix’ (which I always think sounds like a posh dog biscuit…). He also has no significant functional impairment as far as I am aware – collects his job-seeker’s allowance every two weeks without fail.

£84.3m was allocated nationally to stop smoking services in 2010/11. (This figure itself was up by almost £500,000 on the previous year).

The numbers who are attempting to kick their smoking habit has trebled in the past ten years to 788,000 – but the NHS Stop Smoking Service’s published success rates are actually down - to 49% at four weeks in 2010/11, from 53% a decade ago. What sort of a meaningless measure of success this is anyway, with quit rates dwindling away to only 6% at one year – funnily enough, exactly the same as you might expect from will power alone!

There is no doubt that smoking is one of the leading causes of statistics.

What can’t be hidden from, sadly, is the fact that the number of smokers has remained steadfastly and depressingly fixed in recent years – nearly a quarter of all men and a fifth of women are classed as smokers.

Rather than admitting to the abject failure of the programme, binning it and freeing up valuable resources for other vital areas of the NHS – policy makers will firstly tell us how many smokers are dying every year (making anyone who argues against what they are doing sound uncaring / irresponsible), then actually boast about how much of our money is being wasted on stop smoking services!

So it’s “No” to hernia repairs; and “Yes” to mind-bending, potentially suicidal behaviour inducing, Champix dog biscuits…

Think I’d better take myself off for a long walk…. Gggggrrrrrrr… Down boy…!

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Cornelius Rubeus

Dr Rubeus is a hardworking, jobbing GP who trained in the North of England and now works in an inner city setting. He feels passionate about the changes affecting primary care and is not afraid to voice his views. He has his patient’s best interests at heart and wants General Practice to remain as the bedrock of the NHS for years to come.
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