Wednesday, 26 October 2011

Liverpool Care Pathway - Telegraph Road

I am distraught and I despair that these events have befallen this family. The picture is of me and my lovely mum, murdered on the NHS (National-socialist Health Service). Murdered. Is that too strong a word? Her life was taken without her permission. By omission and by commission, actions taken and not taken conspired to end her life. She was kept in ignorance of what was proceeding before her very eyes, as were we. Was she, then, not murdered?

Maggie Willmore
*Les Doe.....Your story, sadly, reflects my own. Although currently investigating the euthanasia (or rather murder) of my dear Father in Law, 'courtesy of' misdiagnosis of cancer, followed by neglect, including dehydration, malnourishment and of course the administration of the 'favoured drugs of choice' morphine and midazolam, at Basildon Hospital. I can go back as far as 1972 with horror stories of the ESH...including one where they wrongly diagnosed my young sister as brain dead, they attempted to take her organs for transplant, following a road traffic accident. Huge battles ensued (I knew they were wrong) I brought in the press and try to deter the harvest, and kept vigil until I could get her out of there! My sister never was brain dead, and she lives a good life today. Imagine my fear when I was diagnosed with breast cancer in 2002...decided to take my chances elsewhere and refused treatment at the East Surrey Hospital, where I also lost my Mother, and very nearly my niece after a routine op. Might I suggest that you write to the Panorama program, as I have done, and ask that they consider making a program concerning the 'Sentence of Death' being served upon our elderly. My fear is that this story will all be forgotten in a few days, and the general public, per se, will not be fully informed of what actually happens to the elderly on admission to hospitals and nursing homes. I have researched and read so many horror stories like ours in recent days....but getting the real issues exposed is not easy unless you happen to be a specialist in the subject who writes to the Telegraph. Also, check out the websites: NHS Exposed and Dr Rita Pal. Dr Pal is a doctor who whistle-blew on her hospital, and refused to give morphine when she considered it unnecessary/wrong...and was proved right. Meanwhile, I empathise with you, I understand what you are/have been going through and I hope people like us will get justice for out loved ones....and maybe spare others from the same fate.

Les Doe
New laws, New guidelines. These only serve to put more easy power into the hard hands of the unscrupulous, the uncaring and the misguided. There is already a culture of ‘letting them go and an unwritten policy of actually helping them on their way set in place. That is, in anyones terms, euthanasia!

Lest we forget
: The holocaust grew its roots in the hospitals and the asylums of Hitlers Reich. The humane ending of a worthless life had its admirers worldwide in the 30s. Its protagonists hailed these bold new approaches, as do those of euthanasia today. Extraordinary, but it was out of that darkness of mercy killing grew the death camps. A slippery slope is ever a slippery and dangerous slope to tread.

Sentenced to death on the NHS

I write in regard to your leader article of 3rd September 2009, Sentenced to death on the NHS. What you cite as happening to patients with terminal illness happened also to my mother at Caterham Dene Hospital in 2007. All her medication was withdrawn, without our knowledge, and the only medical intervention was via oral morphine, commenced also without our knowledge. There was one very big difference, however. Mum was not terminally or seriously ill!

It is not only the terminally ill who are
helped on their way but the elderly, also. My mother fell easily within that category. Perhaps the elderly naturally fall within this category of the terminally ill in that, life expectancy being considerably less by comparison, old age may, in effect, be looked upon as a terminal illness!

It is a duty incumbent upon every medical person to protect life and to do no harm. And yet, there is already a culture of letting them go and an unwritten policy of actually helping them on their way set in place. That is, in anyones terms, euthanasia! Care Not Killing has warned that we are witnessing a very dangerous, slippery slope. That slippery slope is already with us and has been in place for a long time. The possibility of a new law in that respect in conjunction with these new guidelines, will only serve to put easy power into the hard hands of the unscrupulous and the misguided. 

My elderly mother went into Caterham Dene ostensibly for two or three weeks respite care; fundamentally, to
cheer her up’ as the visiting nurse put it. While there, they would also look into the persistent back problem her GP had put down to a posture problem, a result of inactivity. He had actually advised upon his visit the day prior to her consignment to Caterham Dene that she be assisted in walking about the room to get her posture back into shape! They would also continue to treat the skin condition that was causing her some distress but which the Consultant Dermatologist in East Surrey was satisfied was on the mend.

Upon admission, an x-ray revealed that she had suffered two crushed discs. So much, then, for her GP who, clearly, could not diagnose a drunk in a brewery! That Thursday, she was communicative and functioning. She was off her food but able to feed herself. By next day, everything had changed disastrously. 

Within the space of just two days, she was reduced to a condition of complete unresponsiveness; by the Saturday, she could not feed herself and was unable even to lift a beaker of orange juice to her lips. I am not certain that she was even aware of my presence as I spoon-fed her her meal!

Her pain killer, prescribed for the back condition, had been replaced by morphine. Morphine is noted for having such effects as sedation and producing extreme confusion, and particularly so in the elderly. I protested that my mother had always insisted she would never have morphine and expressed my concerns that, in an elderly person with a weak heart, the administration of morphine could lead to heart failure. The nurse just looked askance and calmly said that she had already administered two doses to my mother. 

In my presence, the nurse asked my mother if she would like some more morphine, offering it almost as if it were a treat. My mother was clearly confused, incoherent and in a state of semi-consciousness, just grunting responses, barely aware, as I have said, of my presence even. 

We subsequently discovered that my mother
s entire ongoing medication had been withdrawn, without our knowledge, and replaced with morphine, again, commenced without our knowledge. We were not even aware that this was a nurse driven hospital and that there was no doctor present at weekends.

Mum’s hearing aid was hanging out of her ear and the tube had been damaged. This would not have been at all helpful in the very necessary communication process to make her wishes clear and understood and yet it was insisted that she had assented to the morphine.

It must be significant that, following the Healthcare Commission report and the PCT
s review, recommendations were made in respect to the administration of analgesia that Caterham Dene were required to put in place! The Commissions GP advisor even expressed concerns about undated entries being entered on to the wrong notes and cast doubt upon the accuracy of blood pressure readings. In these damning words, negligence is admitted; the nursing adviser even refers to poor nursing practice. The Commission expressed concern that no learning has been identified’ by the Trust. 

The nursing sister spoke to me in her office on the day of my mother
s admission. She asked me, if anything should happen - not that it would! - do I want them to have my mother moved to ESH. I thought nothing more of that. Yes, of course I do! That went without saying. In the context of what we now know, that all makes sense.

They permitted my mother to present cyanosed on the Saturday and did nothing. I received a call early on Sunday morning to say she was suffering from heart failure and that they were getting the doctor. Still unaware of the reality of the situation, we thought they were actually getting the doctor at the hospital. No, they were calling Thamesdoc! An hour later, another call revealed that Thamesdoc were unavailable and so they had called an ambulance! Excuse me? 

To summarise: We were not aware, had not been informed, that this was a nurse-led hospital and that there was no medical doctor on site at the weekend. My mother had presented cyanosed, been left to deteriorate to a catastrophic life-threatening condition, - and they called Thamesdoc. My mother perished halfway between Caterham Dene and ESH, paramedics ramming tubes down her throat in frantic, vain attempts to revive her. This was reported to me in A & E in explanation of the very apparent bruising.

It is now plain that there is a policy at Caterham Dene to make no great effort to intervene to preserve life, to
let them go and even help them on their way.’ That is why there was no effort at all by nursing staff, as is now admitted, to monitor my mother’s status. This was not as a result of a failure in the nursing procedure, however. They were following policy in not doing so, to permit nature to take its course and even lend it assistance! 

Letters sent to the District Nurses Office to determine what had transpired were actually returned
refused’ by Royal Mail and the person to whom we had written and who had offered help transferred, or was transferred, elsewhere.


This culture has always been there amongst rogue elements of the profession, amongst nurses and doctors determined to play god. 

Back in 1984, my father collapsed one weekend and was taken into ESH. A lung cancer was diagnosed. For some years dad had complained of pain in his side. His GP had dismissed this as malingering! This applied to an old soldier of the 8th Army, proud to have been a Desert Rat! The diagnosis was eventually changed to arthritis. As it turned out, it had been cancer all along!

Dad was on a ventilator and was showing some improvement. Mum happened to remark that she didn
t know how she was going to manage after we got him home. She had in mind the years she had to care for her sick dad, bathing him and so forth, all on her own. It was just a remark. She had meant nothing by it. She would have managed’ as she always did with every calamity, great and small.

The nurse, who happened to be standing at the foot of the bed, darted off and went into the cubicle in the ward where the doctor was stationed. The new hospital was still under construction at that time; this was prior to its
official opening by Mrs Thatcher later that year. It is unfortunate that when odd’ events happen you do not put two and two together until afterwards and only then are those events seen in their true light. 

Next day, the ventilator had been removed. We continued to visit each evening throughout the week. On the Friday, dad insisted that we
have a break and come and see him again on Monday. This was so typically selfless of the man. Nevertheless, I had a feeling that I should go and see him.

The nurse was at his bedside spoon feeding him medicine when I and my young daughter arrived. I left Melanie in the cafeteria with a drink and some pencils to finish off her picture she had drawn for her granddad. I ventured into the ward area and the nurse said that I should contact anyone I should contact as it was unlikely he would last the night. Dad died late that night. 

It was only afterwards that the pieces all fell into place. That nurse had darted off to confer with the doctor and put in place the policy of helping them on their way. The ventilator was removed to let nature take its course. That same nurse it was who I discovered spoon-feeding him with morphine!


In 2005, my brother suffered similar treatment. 

John had been stricken with a cerebral haematoma and the doctor insisted that her patient would not come round. We were told that there would be no intervention should John succumb to infection following his operation and that we had no say in the matter, even though we were next of kin.

Our mother was outraged that they would just
give up on her son. But come round he did. We complained and they denied having said this. Ironically, we are still following the same arduous complaints process now in regard to mums untimely death, to seek some redress and justice for her against this vile and wicked culture that is set in place.

It took three years, but we have since discovered, through PALS, the nature of the ‘policy set in place' to which I referred in the above letter.

The ‘policy’ has been in place for decades. Only, now, it is given a name and follows a formal protocol.

The name of this policy is The Liverpool Care Pathway!

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