Hev you gotta loight boy?

Ken at the Militant Moderate is greatly exercised because, according to The Times, child smokers as young as 12 are to be given nicotine patches on the NHS. He is concerned that this is being funded whilst diabetics have are denied the best treatment:

Diabetics don't have a choice as to whether they have their disease or not. It's a genetic condition that afflicts them for the rest of their lives, and gives them pretty serious potential problems. It's just flat-out wrong that those who choose to break the law get funded to treat the problems caused by their conscious choices, whilst those who are ill through no fault of their own have to make do with second-rate care. Flat-out wrong.

Public health measures like helping people to stop smoking have a much greater effect on illness levels than does treating individuals. The greatest health advance in Britain was not the establishment of the NHS or the discovery of antibiotics: it was the provision of clean drinking water. We Liberal Democrats have grasped this in our policy, even if we are not as worried as we should be by the conflicting claims of public health and individual liberty.

I am less worried by the conflict Ken raises: in many ways it is reminiscent of the last days of the Second World War when it was realised that the most efficient way to use the newly discovered drug Penicillin was to treat servicemen suffering from venereal diseases. That way great numbers of men could quickly be sent back to the fighting. This also caused people to ask why we should treat those who behaved immorally when others were suffering through no fault of their own.

What did strike me about The Times report was this paragraph:

Doctors and nurses wishing to prescribe children nicotine therapies do not need to have parental consent if they judge it unnecessary. According to General Medical Council guidance, a GP must assess a child’s capacity to agree or refuse treatment and make a judgment based on each individual case.

No doubt there are cases where it is right not to tell the parents, but these will be few. Yet the guidance given here fits in with the long-term project of the professional left to replace parental authority with the authority of the state, as mediated through the caring professions.

It may sound enlightened to treat juvenile smoking as a medical problem rather than one of discipline. Yet such approaches often rest on shaky theoretical foundations and can turn out not to be in the child's best interests. Think of the way bad or boisterous behaviour is diagnosed as ADHD and treated with Ritalin.

Meanwhile I remain convinced that the thing most likely to stop a 12-year-old from taking up smoking is the thought of what his Mum will say if she finds out.