When my daughter was born, 27 years ago, smoking was already severely restricted inside hospitals. Each floor had a nicotine-stained room – smelling like an ashtray and never cleaned– where patients and visitors could indulge the habit in minimum comfort. Still, a birth is a birth, and a cigar is a cigar….

Which, these days, I would have had to smoke outside: probably huddling with others round the entrance, more likely in the car-park and sometimes hundreds of yards away on the actual public highway.

Fair enough, I suppose. The convenience of visitors who smoke shouldn’t be a priority of our national health service (though it’s one that private hospitals certainly bear in mind). And you can even understand that the NHS might see inconveniencing this minority as part of a wider campaign of prevention.

So, in that spirit, if they must, they can apply the same rules to the walking wounded who pass through their doors. And to their own staff. But, as Ben Spence points out in the Spectator this week – when it turns out that older patients are electing for difficult deaths at home, rather than in the strictest no-smoking hospitals – common sense and compassion dictate that different rules should apply.

If ever proof were needed that smokers smoke because they like smoking, then look at the pavements of our more lenient hospitals. Either side of the sliding doors, you’ll see people in wheelchairs, or on crutches and frames, some with mobile drips.

Plastering health warnings all over their cigarettes of choice hasn’t stopped them. Raising age-limits and taxes, neither. Nor the new branding bans, which around the world are reducing competition between companies and encouraging smuggling and piracy.

No, they must be treated like mediaeval lepers, hounded off the premises in their back-flapping gowns, forced to hobble onto main roads, where they can add a dose of diesel particles to the tobacco tar in their lungs.

In fact, Public Health England has just launched a campaign to achieve exactly this end. Perhaps the plan is to induce chills in sick smokers and kill them off quicker. It’s only surprising they don’t issue patients with bells and orders to shout ‘Unclean!’, as they weave through the traffic wardens issuing tickets on expired and outrageously expensive pay-and-display stickers.

No one is asking the NHS to provide super-ventilated pavilions, like those favoured by some smart Mayfair clubs (and conveniently overlooked ignored by Westminster Council). It shouldn’t be beyond the wit of hospitals to designate an outside space of minimum comfort for patients who smoke. But to punish them like this – even while offering the alternative of nicotine patches and gum – is a step too far. Literally.

by Winston Smith