I hate smoking as much as the next upright citizen, but even so I think my hospital has gone a little far in its righteous campaign against the filthy habit. After all, we in the National Health Service have much to thank smokers for: first they pay a lot of tax, then they die early. As everyone knows, it is people who live a long time who cause the NHS most problems, since medical costs rise exponentially with age. If there were any justice in the world, therefore, smokers would get a tax rebate.
Well, smokers are now about as welcome in my hospital as alcoholics in Saudi Arabia. We used to have filthy little rooms on each floor in which smokers could indulge in their foul inhalations and exhalations, but they were closed in the name of purity. Now smokers are allowed to subsidise the NHS only outside the building, in the car park or the ambulance bay.
Every morning, therefore, there is a kind of dawn chorus of hackers and coughers as they stand outside the building, with their first fag of the day in one hand and their drip stand in the other. It isn't a very edifying sight but evidently it brings joy to the heart of the ayatollahs of health promotion.
Some unlucky souls, of course, are unable to smoke outside the hospital because they are physically incapable of getting there. Why don't they go in a wheelchair, you may ask, to which the answer is obvious: my hospital operates a no-wheelchair as well as a no-smoking policy.
The official objection to wheelchairs is pragmatic rather than ideological, however: the patients kept stealing them, so now they have to hire them at £20 a month, plus £20 for delivery and £20 for collection after use. Since smoking is a habit more frequently encountered among the poorer than the richer sections of the community, the hospital's no-wheelchair policy goes to prove the truth of the old music hall adage: it's the rich what gets the pleasure, it's the poor what gets the withdrawal effects.
Unfortunately, not all the poor and disabled smokers take it lying down, as it were. They frequently become agitated, angry, aggressive, abusive and even violent when told that they cannot have a cigarette. The management lays down the rules, but the nurses take the flak.
Needless to say, anybody who behaves badly towards nurses just because he is told by them that he can't have a cigarette, in bed or anywhere else in the hospital, is a pretty poor specimen of a human being. But the fact is that most people in the vicinity of my hospital smoke and we must take people as we find them, not as we would like them to be. So grim is life in a British slum that a fag is one of the few pleasures people have. For many, cigarettes are the meaning of life.
The nurses tell me that 90% of the unpleasantness caused by patients in our hospital is the result of conflict over smoking. And it cannot be said that the evangelical fervour of the management is really working. A lot of illicit smoking goes on in the lavatories and in the corridors, and it seems to me doubtful that a single person has given up smoking long-term as a result of his punishment (for that is what it is) in our hospital.
The other day, the security men told me that if the management caught someone smoking in the corridor, they - the security men - were held to blame for the outrage to public morals and decency. Indeed, one security man had been threatened with dismissal if he failed again to put out a patient's fag. Is it not typical of our age that one group of people - the security men - should be held responsible for what another group of people - the smokers - do? Yet their legal powers to prevent a person from smoking must be doubtful, to say the least.
As to our hospital's no-smoking fervour, what does it signify? It is management's attempt to prove the strength of its humanitarian benevolence at no financial cost. Others, of course, pay a non-monetary (and therefore non-accountable) price. If the policy causes misery to the patients - well, so much the better, for between abstract benevolence and sadism there is often a thin line.
