Wednesday, 31 October 2012

Liverpool Care Pathway - No Gerrymandering!

Thanks go, once again, to Baroness Knight of Collingtree! The Baroness has raised LCP in debate in the House previously 

Liverpool Care Pathway – And Plausible Denial

The Baroness is listed to speak once more on Monday -

Parliament UK

Monday 5 November at 2.30pm

*Baroness Knight of Collingtree to ask Her Majesty’s Government what procedure will be adopted in carrying out the proposed NHS inquiry into the Liverpool Care Pathway.

We hope and we pray that she will be rewarded by her efforts.

WE hope and we pray that she will not be thwarted at every turn as have we.

It is not just the procedure of the proposed inquiry that needs to be looked at; it is the matter of who is to conduct it. Would you ask the fox to investigate the raid on the chicken house? An independent inquiry is called for.

Such an inquiry should be awarded a broader remit to look into the intrusion and spread of the CQUIN payments system across all areas of care. The Mail continues to draw attention to the CQUIN system in the hospital setting but, as has been reported in these pages, this now extends into District Nursing. CQUIN is, no doubt, also involved in the spread of the GP death lists and the use of LCP in St. Mungo's and elsewhere.

An independent and thorough investigation into the intrusion of the CQUIN payments across all care services is demanded now!

We commented previously that, despite her good efforts, the Baroness was
bamboozled with flaccid, blatant denial of what is patently – and well-known to be by its victims - the truth!
We hope and we pray that she will not be so demeaned and dismissed in her attempts to debate the conduct of the proposed inquiry.

From experience, they will pout verbatim the textbook response! 

A letter is reproduced below, sent in response by a representative to her petitioner. What appears in this letter - and this is really quite typical - is the sort of flaccid and limp response the Lady Baroness may expect to encounter in her debate. That is quite clear. At a glance, much of what the representative has written has been 'lifted' word for word from LCP resource documents and DOH statements concerning LCP.

And these people represent us? Really? Really!

The letter follows -

Elizabeth Truss MP
Member of Parliament for South West Norfolk
The Limes
32 Bridge Street, Thetford, Norfolk IP24 3AG
01842 757345

Dear Denise

Thank you for your email, I am extremely sorry to read of the death of your father earlier in the year. My office has no record of you calling either the Westminster office or the constituency office.  You highlight concerns about the The Liverpool Care Pathway (LCP). LCP is an established and respected tool that provides clinicians with an evidence-based framework to guide the delivery of high quality care for people in the last days or hours of their life, to ensure that they die with dignity and respect and minimum distress.

The LCP requires senior doctors and nurses involved in the patient’s care to agree that death is very likely to be imminent and that being placed on the LCP would reduce patient distress, discomfort and pain. That decision should involve the patient if possible, and family members if not. A clinician should always choose the best approach to care for an individual patient, whether curative, palliative, or a mixture of both. The LCP is just one option for managing this care. To ensure it is used properly, the LCP emphasises the importance of staff receiving appropriate training and support in its use as well as accessing relevant end of life care training and education programmes.

However ministers recognise that some people who have been on the LCP have received poor care. The LCP is not of itself a guarantor of the best quality care. It has consistently been made clear in the guidance for implementation of the LCP, or similar tools, that they are in no way a replacement for clinical judgement, and should not be treated as a simple tick box exercise. Rather, the LCP is a useful framework to guide the delivery of care, complementing the skill and expertise of the practitioner using it.

Best wishes

Elizabeth Truss MP

The concluding paragraph implies an acceptance that second-rate care has occurred, does occur, but that this is not an issue and may be tolerated. If it was an issue, the honourable member of Her Majesty's Parliament would surely raise it in response to her petitioner's letter.

This is the very real worry, that LCP may not be questioned in itself and that anything untoward in its connection occurs only through the manner of its application, not the actual application of the LCP itself. In other words, it is the driver, not the vehicle.

And that is the very real worry, that this shall be the finding and the outcome of all these ongoing investigations, both official and journalistic.


  1. I've been writing to the Baroness about the many problems with the LCP and I've set out why it's so important that the Inquiry into the pathway is a fully independent one. The LCP cannot be investigated by those with any vested interest in the multi-million pound palliative care industry, which cannot be allowed to investigate and police itself.

    It's very clear from the Baroness's reply that she is well aware of this and is not about to be bamboozled by anyone. She is absolutely determined that the Inquiry will uncover the truth and that it will be carried out by an independent individual from outside of the industry.

    However, there is a far bigger obstacle to first overcome: the Baroness states that she has been shocked to be notified that there will not be an Inquiry! Thankfully, Baroness Knight is a lady who does not take no for an answer. She is absolutely determined to persuade the Minister to instigate an independent Inquiry into the LCP. I believe she will succeed, too.

    Go, Baroness Knight! We love you baby!

  2. The Baroness has a fiery reputation.

    "She served in the Women's Auxiliary Air Force during World War II."

    "She served as a councillor on Northampton Borough Council from 1956–66, where she was whip. Knight unsuccessfully contested the parliamentary seat of Northampton in 1959 and 1964 for the Conservative Party. She was elected Member of Parliament (MP) for Birmingham Edgbaston in 1966, which she held in successive elections until 1997."

    "Knight was a member of the Parliamentary Select Committee on Race Relations and Immigration, 1969–1972, on the Select Committee for the Council of Europe from 1977, Home Affairs 1980–1983, Lady Chairman of the Lords and Commons All-Party Child and Family Protection Group from 1978, on the Conservative Back-bench Health and Social Services Committee 1982 –, Secretary to the 1922 Committee 1983–1987."

    "She was President of the West Midlands Conservative Political Centre 1980–1983 and Lady Chairman of the Western European Union Relations with Parliaments Committee, 1984–1988. She served on the Council of Europe (1977–88), and as Chairman, British Inter-Parliamentary Union (1994–97)."

    "Knight was for over 20 years an active member of the Conservative Monday Club and was an outspoken opponent of the Official Irish Republican Army (OIRA)."

    (From Wikipedia) to be continued

  3. "Following the February 1972 Aldershot Bombing by the OIRA she called for legislation to outlaw the IRA, and attacked supporters and sympathisers on the mainland. In September 1973 she repeated her call for the banning of the IRA which, she said, was "at open war with Britain", and in December she stated that "it is the first duty of any government to protect its citizens".

    "In June 1974 Knight protested at the "arrogant IRA march" which had been held in London. She said it was: "an outrage and insult to the British people". In this she was supported by other Monday Club MPs John Biggs-Davison, who made representations under the Public Order Act to the Home Secretary, and John Stokes.

    Also in June she herself made a formal complaint to the Home Secretary about the "Terrorist International Rally" that had been held in Northern Ireland. She said it was: "highly offensive for international terrorists to meet in Britain and plot against us". (The IRA was banned in 1977.)"

    "In August 1974 she tabled a Question in the House of Commons asking the Secretary of State for Social Services to review payments to foreign visitors, stating that "anyone from Ireland or elsewhere must be made to understand that we have not the money to fund them".

    "In October Sir Keith Joseph, speaking in Knight's constituency, expressed admiration for her as "a brave woman who speaks up when others prefer discretion in public and speak their minds only in private."[citation needed]"

    "She responded "I believe my constituents sent me to Parliament to speak up, not shut up."[citation needed]"

    In November 1974 she called for the death penalty to be made available for IRA and all terrorists, moved an amendment to that effect in the House of Commons, and asked the then Home Secretary, Roy Jenkins, to step up activities against the IRA. Knight said that she had received more than 8,000 letters demanding capital punishment for terrorist killings and only 115 against it. John Biggs-Davison and Knight protested in parliament when the government decided to pay £42,000 in compensation to the relatives of men who were shot by the British Army on Bloody Sunday in 1972. She added that "these payments would seem to open up a completely new level of culpability. What compensation will the relatives of the victims of IRA killers in Birmingham get?".

    [edit] Stance on strikesIn December 1974 Knight protested in the House of Commons that single men on strike were receiving social security benefits on their own behalf for rent and hire-purchase payments. The following month she supported Harold Wilson's decision to intervene in the British Leyland strike by appealing to the workers.

    [edit] Stance on homosexualityKnight, along with David Wilshire, was responsible for introducing the Section 28 amendment to the Local Government Act 1988, which barred local authorities from "promoting" homosexuality. She was also an opponent of abortion, and supported successive attempts to reduce the time-period when the operation could be legally performed."