Thursday, 25 August 2011

Liverpool Care Pathway – A Policy Of Insurmountable Folly

In pursuit of our cause, we have been ignored, lied to, and our petitions have actually been returned ‘refused’ by Royal Mail! The Healthcare Commission report readily owned up to actual falsification of the documented record and listed a litany of failures.

The provision of hollow apologies from faceless administrators and to be informed that ‘learnings’ have been taken; the knowledge that recommendations have been made and that these have been required to be put into force - for example, in the dispensing of analgesics – this is not enough. In fact, this last recommendation only bears out what was observed to be the case, that my mother was plied with morphine!

The dismissive manner in which some of our complaints were dealt with left us aghast. The matter of the damage to my mother’s hearing aid was ‘remedied’ by the setting in place of a new procedure by which patient’s personal effects would be logged and documented on a special form drawn up especially for that purpose. A copy of this form was even provided to us for our apparent approval.

How may a hearing aid, a device essential for verbal communication to proceed satisfactorily or at all, be classed as just ‘patient property’ and how did the damage occur? That is no matter of any account, apparently.

We were advised by both The Parliamentary and Health Service Ombudsman Service and the Healthcare Commission that they are unable to achieve disciplinary action against individual members of staff. They recommended that we take our complaint to the Nursing and Midwifery Council (NMC) if we wished to pursue that outcome.

The complaint resided with the NMC for almost a year and a half before we were presented with the following gobbledegook of a response:

We are not empowered to undertake a general investigation into the performance or conduct of unnamed individuals at a particular institution or organisation where it is said that there have been general failings on the part of that institution or organisation or its staff in general.

Our hopes that justice might prevail were trounced because those responsible for this act of death by induction (murder) were following guidelines set out and laid down by the hospital trust as policy. Thus have they escaped the jurisdiction and oversight of any regulatory body.

We had suspected and quickly realised that there was some policy set in place. It took nearly four years for us to learn via PALS that this policy goes by the name of the Liverpool Care Pathway.

The Pathway is a set of processes and procedures put in place not for benefit of the patient but to protect the practitioner!

A Catalogue of Catastrophic Failure
To withhold the truth is a lie by omission and is as much a lie as if a lie were actually told - a lie by commission. Surely, public servants, those entrusted to administer public institutions, would never be involved or permit themselves to be involved in such deviousness?

Executives, managers, administrators, both in the NHS and those bodies with oversight of the NHS, at every and whatever level, are when all is said and done public servants, paid from the public purse. And yet, in our dealings with those we petitioned, we did encounter only deviousness and artifice.

The so-called ‘complaints process’ set in place, which we followed resolutely to obtain information and resolution to our concerns, was arduous, irksome and tiresome. Many times, we reached our wits end untangling the convolution of lies and misleading responses we received.

We have stated previously that this did not begin as a complaint, but that it has become one. We were well justified in asking: Were Dr Shipman’s misdemeanours also raised by family or friends and were their concerns also dismissed, in like frivolous fashion, by PCT and Healthcare Commission alike? Our own experience would suggest this to be the case.

In The Independent, it was reported that an inquiry into the Mid-Staffordshire NHS Foundation Trust reported last year that at least 400 patients may have died due to neglect and poor care.

The chief NHS regulator has apologised for missing clues to appalling levels of care at Stafford Hospital that developed into the worst health service scandal for a decade. Can any apology be apology enough? She is plainly clueless!

How many failings make a serious failing? How many serious failings make a major failing of care? 

How on earth may failings continue until they are virtually the routine unless they are not ‘failings’ at all but, in fact, the routine of policy?  

To be informed that failings have been acknowledged and that learnings have been taken is insufficient and inadequate and too late.

We need to know that those responsible have suffered stern rebuke; that they have offered contrition and remorse for what they did do and regret for what they did not. Only then may we walk away from this. Only then can come closure.

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