Smoke and Mirrors
I'm back, and it seems that the world has gone even more bonkers than it was when I left it a few days ago (Ok, technically I was on a programming course in London, but I didn't buy a newspaper or watch the news so essentially I existed in a kind of news limbo where the only relevant information was that pertaining to Coldfusion syntax).
It appears that the NHS wants to stop treating people who smoke. Or the government wants the NHS to stop treating people who smoke. Whatever. The grounds for this seem obvious, and even admirable. Smokers are more likely to be unhealthy, and it's obviously of their own choosing, so why should be bother to treat them in preferance to the nice, healthy person next on the waiting list?
Well, as somebody who enjoys the occasional cigarette or twenty throughout the week, I'll tell you exactly why:
1. Discriminating on account of lifestyle is dangerous. You can certainly argue that the smokers ailment is self-inflicted, but what about somebody who breaks his leg playing football on a Sunday? Or somebody who hammers a nail through their finger whilst doing DIY? Or somebody who crashes a car because they drove a little fast? Or somebody who was drunk and fell over and cut their head? Or those who have high cholesterol because they ate to many fried breakfasts? I could continue like this, but I think you get the point. If we stop treating those who have injuries or other ailments that could have been avoided we would have to turn away half the patients. I suspect this would be greeted with delight from the NHS management, however.
2. Tax. Smokers pay a lot of tax. Cigarettes are cheap to make (a packet in Kuala Lumpur last time I was there, for example, cost under £1, compared to over £5 here. Interestingly "duty-free" cigarettes are still very expensive here. £25 for 200 in the shop at Heathrow, or £5 on the plane. This goes to show that the "duty" tax is only a triffling part). Now bear in mind that the Malaysian government does also charge tax, and you can see that our government must rake in well over £4 on the sale of each packet. Lets say that 5 million people each purchase a packet of cigarettes each day. I've no idea if this is accurate or not, but frankly I don't have the time to do the research right now, so it'll do. 5 million times £4 is, obviously, £20 million. Per day. Multiply this out by the year and we get over £7 billion. Even if I'm out by 50% and only 2.5 million buy a packet per day (easily possible in a population of over 60 million) then it's still over £3.5 billion. This sum, added to NHS coffers, would rather help cover the cost, don't you think?
3. National Insurance. We all pay it (well, those of us who bother to work do) and this entitles us to treatment on the NHS. No more needs to be said on this point.
4. Death. If smokers die younger this is great news for the pensions system, which is a huge drain on state resources and will only get worse with an aging population. Less people around, means less pensions payments to make.
5. The Hippocratic Oath. I can't say I've ever actually studied the text of the oath taken by doctors, but I'm reasonably sure it doesn't include words to the effect of "pandering to the whims of penny-pinching senior NHS management and government ministers, and refusing to treat people they don't think are deserving of it." Rather, I'm sure it includes a promise to treat any and all to the best of their abilities, regardless of circumstances.
Given that the NHS is only staffed by 4 doctors, 12 nurses, and 7 million managers these days, it makes a bit more sense to weed out the detritus in the headcount, stop spending fortunes on pointless things, and just get on with the job of fixing people, rather than dreaming up schemes to stop doing so.
It appears that the NHS wants to stop treating people who smoke. Or the government wants the NHS to stop treating people who smoke. Whatever. The grounds for this seem obvious, and even admirable. Smokers are more likely to be unhealthy, and it's obviously of their own choosing, so why should be bother to treat them in preferance to the nice, healthy person next on the waiting list?
Well, as somebody who enjoys the occasional cigarette or twenty throughout the week, I'll tell you exactly why:
1. Discriminating on account of lifestyle is dangerous. You can certainly argue that the smokers ailment is self-inflicted, but what about somebody who breaks his leg playing football on a Sunday? Or somebody who hammers a nail through their finger whilst doing DIY? Or somebody who crashes a car because they drove a little fast? Or somebody who was drunk and fell over and cut their head? Or those who have high cholesterol because they ate to many fried breakfasts? I could continue like this, but I think you get the point. If we stop treating those who have injuries or other ailments that could have been avoided we would have to turn away half the patients. I suspect this would be greeted with delight from the NHS management, however.
2. Tax. Smokers pay a lot of tax. Cigarettes are cheap to make (a packet in Kuala Lumpur last time I was there, for example, cost under £1, compared to over £5 here. Interestingly "duty-free" cigarettes are still very expensive here. £25 for 200 in the shop at Heathrow, or £5 on the plane. This goes to show that the "duty" tax is only a triffling part). Now bear in mind that the Malaysian government does also charge tax, and you can see that our government must rake in well over £4 on the sale of each packet. Lets say that 5 million people each purchase a packet of cigarettes each day. I've no idea if this is accurate or not, but frankly I don't have the time to do the research right now, so it'll do. 5 million times £4 is, obviously, £20 million. Per day. Multiply this out by the year and we get over £7 billion. Even if I'm out by 50% and only 2.5 million buy a packet per day (easily possible in a population of over 60 million) then it's still over £3.5 billion. This sum, added to NHS coffers, would rather help cover the cost, don't you think?
3. National Insurance. We all pay it (well, those of us who bother to work do) and this entitles us to treatment on the NHS. No more needs to be said on this point.
4. Death. If smokers die younger this is great news for the pensions system, which is a huge drain on state resources and will only get worse with an aging population. Less people around, means less pensions payments to make.
5. The Hippocratic Oath. I can't say I've ever actually studied the text of the oath taken by doctors, but I'm reasonably sure it doesn't include words to the effect of "pandering to the whims of penny-pinching senior NHS management and government ministers, and refusing to treat people they don't think are deserving of it." Rather, I'm sure it includes a promise to treat any and all to the best of their abilities, regardless of circumstances.
Given that the NHS is only staffed by 4 doctors, 12 nurses, and 7 million managers these days, it makes a bit more sense to weed out the detritus in the headcount, stop spending fortunes on pointless things, and just get on with the job of fixing people, rather than dreaming up schemes to stop doing so.
posted by Nej at
1:31 pm
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