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Consultants refuse to accept GP referrals for smokers

Consultants at one hospital have announced that they will refuse to accept GP referrals of patients who smoke.

Vascular surgeons from Edinburgh Royal Infirmary have defended their right to demand that patients stop smoking before accessing certain kinds of treatment.   

The hospital, part of NHS Lothian, has argued that medical intervention for vascular disease could be avoided altogether if patients stopped smoking and adapted to healthier lifestyles.

Mr Zahid Reza, a consultant vascular surgeon at ERI, said that his clinic was refusing to accept GP referrals for patients who continued to smoke, unless it was an emergency.

He told the Scotsman: ‘Evidence shows that they would not do well with the treatment. In around 80% of cases, a smoker’s condition will improve just simply by stopping smoking and making other lifestyle changes.

‘Some patients have written to their MP demanding to see a consultant. I have written back to the MP to explain our position.’

NHS Lothian have denied the existence of a ‘blanket ban’ on refusing referrals, saying that each patient is treated on a case-by-case basis. However, Dr David Farquharson, medical director at NHS Lothian, said that some kinds of surgery had a lower chance of success, and that the chances of complications arising during surgery were higher for patients who smoke.

He said: ‘The best option can actually be to refer a patient into smoking cessation, fitness and diet intervention programmes to help them change their lifestyle, which will in turn improve their condition and if necessary the outcome of any medical intervention.’

But patient groups have attacked the decision, describing it as ‘shocking’.

Dr Jean Turner, a former GP who heads up the Scotland Patients Association, said that she was ‘extremely disappointed’.

She added: ‘You should not refuse to see anybody and certainly not penalise patients who are smoking. It is very God-like and highly unfair to refuse to see people referred from general practitioners.

‘If I was a GP I would be very angry. It’s not for a doctor to make a judgment. Doctors are there to see if they can help and relieve symptoms.’

A Scottish Government health spokeswoman said that a blanket ban on surgery for smokers was ‘not acceptable’ and denied that either the Government or NHS Lothian had proposed such a ban.

She added: ‘Smoking is never good for you. Patients who continue to smoke need to think very carefully about the increased risks involved, if surgery is being considered as a treatment option.’

Readers' comments (42)

  • Neurosurgeons refuse to accept head injury patients of fast car drivers, sportbike riders, horse riders ...etc. You get my drift. The justification behind such a policy would be similar to barring smokers from being offered certain therapeutic interventions. The real reason is that damage sustained from such activities is self inflicted. So a moral judgement is being made and the condition the patient has is self inflicted and is punishment for their perceived indulgences. This attitude is veiled behind terms such as that outcomes of therapy would be worse compared to say (righteous) non smokers.

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  • Along all the discussion, the main question has been forgotten: "should a consultant refuse TO SEE a patient because of a wrong lifestyle"???
    The response must be NO!!!
    The GMC should do his job by sanctioning the consultant who would refuse!!!
    If he does not, the Daily Mail, RT etc..., would jump on that case!!
    First the patient is not responsible of having started to smoke, and fall into that very strong addiction... It still is a profitable authorised business...and a few time ago everything was done for the person to start smoking! Like free tobacco to soldiers..adverts etc..
    Secondly, if he suffers from pain, or his life is in danger, everything must be done to help him...
    Thirdly, the patient is not a medical professional and his fundamental human right is to ask and to be seen by a doctor, and if the dr feels the need to get a consultant advice, this cannot be refused, and has to be done in a correct delay if necessary.
    The funding of Health is not the problem of the doctors. This is a political choice between public spending things, a choice between the construction of a nuclear submarine and a sufficient number of consultants/hospital beds in England..
    The only first obligation for the doctor is to deliver the best quality and up to date medicine, without discrimination of any kind, race, religion, nationality, or lifestyle.. Funding comes secondly!!
    Dr Jean-Marie Sandor

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