If you've visited your GP recently, you may have seen the NHS 'It's your choice' logo before. Please don't snigger at the irony.
Anyone who chooses to enjoy tobacco (and who doesn't lie to their doctor to avoid the rigmarole) will have endured, at some point, the lectures from their GP when visiting their practice for anything from an in-growing toe-nail to a broken tibia.
The problem is that, to the NHS, you are just a number.
PSA Targets (from the Department of Health Public Service Agreement, 2004):
• Reduce adult smoking rates to 21% or less by 2010 (currently on target nationally)
• Among routine and manual groups to 26% or less by 2010 (currently not on target nationally)
Ever eager to be the bully's best friend, the Lib Dems think we aren't being hectored enough.
The Liberal Democrats have called for an end to the smoking cessation element of the quality framework (QOF).
[Norman Lamb MP] described payment for telling patients to quit smoking as 'crazy'.
'There should be payments when people actually quit, and nothing less,' he insisted.
Really? Like these paid by Warwickshire PCT, for example?
GPs and Pharmacies are reimbursed for service delivery (inflation still to be applied for 09-10):
£10.50 for each client setting a quit date
£40 for each client still quit at 4-week follow-up
£10.50 for each client not quit at 4-week follow-up. No additional payment for those not followed up at 4 weeks.
Pharmacies only - £3 per supply of NRT
So, these paid-for stages, what happens in them then, I hear you ask.
Contact 1: Plan strategy for quitting, including assessment for drug therapy including carbon monoxide test, access to nicotine replacement therapy, Zyban® or Champix®
Contact 2: Possible quit date
Ensure access to NRT, Zyban® or Champix®. Carbon monoxide test
There seems to be a lot of reference to NRT and Champix there. Not much about willpower and Allen Carr, though (note 500+ reviews and a 5 star rating). I wonder why?
Could it be that other PCTs are like Warwickshire?
Joint working with Pfizer around targeting of clinics/drop-ins
Joint working with Pfizer to develop more effective recruitment campaigns in N&B, also targeting health professionals to refer more and more effectively.
If it surprised you to learn that your GP is being paid bonuses for giving you the third degree, perhaps it won't be as astounding to know that Pfizer profit from NRT in general, and are the sole supplier of Champix.
Of course, if you stand your ground and state categorically that you don't wish to quit, there is always the ultimate threat from the healthist lobby.
Well, the smoker prevalence simply MUST come down to that arbitrary 21% ... one way or another.