Monday, 4 July 2011

Liverpool Care Pathway - If There Is Nothing To Hide, What Is There To hide?

On the day of my mother’s arrival at Caterham Dene Hospital, the nursing sister - I make the assumption that this was her job title; she wore a dark blue uniform in contrast to that of the other nurses - took me aside and spoke to me in her office. She asked me, if anything should happen – not that it would! – do I want them to have my mother moved to ESH where there are emergency facilities. I thought nothing more of that. Yes, of course I do! That went without saying. In the context of what we now know, all that makes sense.

For three years, we repeatedly made the charge that there was/is a policy set in place at Caterham Dene Hospital to make no great effort to intervene to preserve life - by ommission, to ‘let them go’ and, by commission, to ‘help them on their way'.

For three long years, these charges were not responded to. For three long years, it was almost as if we had made no such charge at all.

Wait. Would not such a policy, were such a policy to exist, be euthanasia? And is euthenasia not illegal in this land?

We went further:
"It was the nurses at Caterham Dene whose actions and inactions, by incompetence or by design, connived to cause the death of my mother. Some might say that it was these nurses who murdered my mother; some might say that they were executing a policy of ‘letting them go’ and actually ‘helping them on their way’ as was expounded to me by that person I took to be a nursing sister who took me aside into her office!"
This charge, by implication, of murder went unremarked upon, also.

Only through PALS did we eventually learn that there is such a policy in use at Caterham Dene and it is called Liverpool Care Pathway.

If there is nothing to hide, what is there to hide?

The names of the nurses involved in the 'care' of my mother at Caterham Dene were, and continue to be, withheld from us.

In Legal and Ethical Issues for Health Professionals, George D. Pozgar states:
"Patients have a right to be informed of the names, qualifications, and positions of the caregivers who will be in charge of their care in the hospital. Patients have a right to know the functions of any hospital staff involved in their care and to refuse treatment, examination, or observation by any of them. These rights include:
1. Patients should know who is treating them by name, discipline, and role and responsibility in their care plan.
2. Patients should know the names of all consulting physicians and hospital designated care givers
3. Caregivers should identify themselves to patients by name, discipline, speciality, and identification badge of the treatment team."
According to Kaplan & Sadock:
"Patients have a right to know the position and professional status of persons involved in their care."
In Practice  and Patient's Charters throughout the UK, amongst the numerous rights listed, is 'a right to know the names of the doctors and other professional staff involved in your care.'

According to,
 'You will be told the names of the staff responsible for your care and how to contact them.'
We have been kept in the dark as to the names of the people responsible for my mother's care at Caterham Dene for three and a half years. This cannot be right.

What is there possibly to hide? They were just doing their jobs, following procedure under the Liverpool Care Pathway.

They have connived to use the Data protection Act to deny us the names of these people. George D. Pozgar, Kaplan & Sadock,, please take note!

If there is nothing to hide, what is there to hide?

It was Ms. Anna Walker, Chief Executive of the Healthcare Commission, who first set us on the pathway of applying to the NMC to seek reprimand for those responsible and justice for my mother.

We learned that the NMC is unable to achieve disciplinary action against individual members of staff and may seek only apology and explanation and recommend changes and learnings in acknowledgement of failings. In Ms. Anna Walker's words:

“…the Healthcare Commission has no authority to take disciplinary action against individual members of staff or clinicians. The powers conferred upon the Healthcare Commission in respect of complaints do not allow us to take or recommend such action. Accordingly, any concerns you may have regarding the doctors or nurses fitness to practice should be addressed to the General medical Council and the Nursing and Midwifery Council respectively.”

Thus did we pursue the case with the NMC.

Mr. B....... at the NMC required documents and information of NHS Surrey, imposing time limits and deadlines upon them in which to respond. Several extensions were requested and granted, through February, March and into April of of 2010. Finally, on Thursday the 15th April 2010, he again chased them up, this time leaving a message, with a view to contacting the legal team unless information requested was not sent through by the following Monday. A “bundle of papers” was delivered to NMC offices later that same day, in response!

Why did the Trust require extension after extension of deadlines to provide the documents required of them by the NMC? Why was that necessary? The complaint case was finalised, done; it would only be a simple matter to provide Mr. B....... with copies of reports, documents and correspondence already contained in the complaint file. Was the folder being ‘doctored’ and ‘sanitised’ during this time so that the identities of miscreants would remain concealed?

If there is nothing to hide, what is there to hide?

The terminally ill should not suffer parting from this world in pain if that is at all avoidable.

This was the ethic of the Marie Curie nurses tending to their charges that this parting should be made as gentle as it may be made. That is laudable enough. Outside of the hospice setting where the Pathway was devised, however, this death pathway has become a self-fulfilling prophecy. The treatment provisions under the LCP will quickly manifest the indications of the prognosis made.

We charged that nurses responsible for my mother’s care at Caterham Dene, by omission through neglect, and by commission, through over-zealous administration of morphine, did cause and bring about her demise. We charged that the Sister (I assume that to be her title) was actually stating a policy set in place of ‘letting them go’ and even ‘helping them on their way’ in taking me aside, inviting me into her office and saying what she said to me upon arrival at Caterham Dene.

Given certain outcomes, even the most innocent and innocuous of remarks may take on a sinister aspect. The remark of the person I took to be a Sister, who took me aside in her office at Caterham Dene, I have previously mentioned. The remark that one of the ancillary staff made I repeat here:

When I was turned away from the room my mother had been consigned to, this member of staff, mop in hand, commented without any prompt, “They turned you out.” I nodded in response. She replied, “They do that; they don’t let anyone in there with them.”

If there is nothing to hide, what is there to hide?

1 comment:

  1. The more I read of the appalling manner in which older patients are treated by the NHS these days, the more it chills me to the marrow.