Examination of Witnesses (Questions 460-473)
PROFESSOR SIR
LIAM DONALDSON
24 NOVEMBER 2005
Q460 Dr Naysmith: Does
that apply to mental health institutions and hospices?
Professor Sir Liam Donaldson:
Certainly mental health institutions are a bit more difficult
because the place is somebody's home and that is an area that
is currently being looked at and studied.
Q461 Dr Naysmith: What
should the policy be in respect of hospices?
Professor Sir Liam Donaldson:
I think those should be the same as in the rest of the hospital
premises.
Q462 Dr Naysmith: So we
are prepared to have some exemptions in terms of mental health
institutions, are we not?
Professor Sir Liam Donaldson:
I am not sure whether there should be a full exemption, but it
is something that needs to be looked at more carefully before
a final decision is taken.
Q463 Dr Naysmith: How
should nurses who visit people in their homes be protected?
Professor Sir Liam Donaldson:
I do not think they should smoke.
Q464 Dr Naysmith: I mean
when they are visiting in other people's homes.
Professor Sir Liam Donaldson:
I do not think a nurse should smoke in somebody's home.
Q465 Dr Naysmith: I mean
when it is people in the home who smoke, and nurses are going
in to take care of them.
Professor Sir Liam Donaldson:
I am so sorry. I think that is a very difficult area to regulate.
I guess the pragmatic solution to that in the short term would
be for the healthcare worker to ask, if they objected, to go into
a room where somebody was not smoking.
Q466 Dr Naysmith: Should
National Health Service staff be role models and not smoke at
work? Is there any kind of pressure you can bring to bear on that
if you agree that is the case?
Professor Sir Liam Donaldson:
I absolutely think so. If you look at the position of football
managers, and they are not a breed that you would necessarily
point to as role models and some of them are smokers, it would
be very rare to see them smoking in a public situation or in a
televised football match and I think healthcare staff should adopt
the same position.
Q467 Dr Naysmith: My final
question, though I think other people may want to come in: do
you think public opinion in England would support a comprehensive
ban?
Professor Sir Liam Donaldson:
I do, from what I have seen of the evidence from surveys and also
from the consultation exercise, yes.
Q468 Jim Dowd: In response,
if I understood you correctly, to Paul's question about growing
health inequalities as a feature of a partial ban, is that what
you said: you feared growing health inequalities if there was
a partial ban?
Professor Sir Liam Donaldson:
Yes, because more pubs which do not serve food are in the northern
parts of England where there are more health inequalities.
Q469 Jim Dowd: The logical
conclusion of that then is that a partial ban is worse than no
ban?
Professor Sir Liam Donaldson:
To my point of view, the complete ban is the . . . .
Q470 Jim Dowd: Sure—nobody
disputes that—but one of the features of this issue, and
I think in response to Mike's question you were saying that you
regarded this as a step on the way but that what you actually
wanted will come to pass perforce one way or another?
Professor Sir Liam Donaldson:
Yes.
Q471 Jim Dowd: The Secretary
of State herself has said that we are going part of the way, and,
I think, reading between the lines, there is probably a similar
line of thought, but the issue is between a partial ban and no
ban, and a lot of us as part of this inquiry are reaching our
own conclusions on the way it has to go, but is a partial ban
worse than no ban?
Professor Sir Liam Donaldson:
In some respects it is. In respect of health inequalities; obviously
in other respects, in creating some completely smoke-free premises,
it is more positive; so it is a mixed position really.
Q472 Chairman: Would you
measure health inequalities on the basis that if you stopped smoking
in most places their health would improve; in the places you do
not stop smoking inequalities grows because you have taken that
type of action in some areas but not all? Would that not be a
better way of looking at this?
Professor Sir Liam Donaldson:
Yes, I think that if you have smoke-free everywhere there would
probably be a disproportionate gain in those northern areas, because,
after all, nicotine is an addiction, it gives people longer breaks
and intervals between smoking and therefore more are likely to
give up.
Q473 Chairman: Could I
thank you very much indeed for coming along this is morning and
giving us such an honest appraisal of the situation as you see
it, and wish you all the best for the future.
Professor Sir Liam Donaldson:
Thank you.
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