Tuesday, 4 December 2012

Liverpool Care Pathway – The Anecdote As Evidence

This is published in the public interest for information -

In a response to Baroness Knight of Collingtree, Lord Howe dismissed the complaints of the aggrieved relatives and families of LCP victims as anecdotal evidence (They Work For You.com).

In the Chief Nursing Officer's Bulletin, Jane Cummings was pleased to report the anecdotal 75% satisfaction response in the ONS/DH national survey of bereaved people, published in July 2012. 

May we respectfully point out to the honourable gentleman and to Ms. Cummings that you can't have it both ways. Either you accept anecdotal evidence or you don't.

As for the anecdotal 75% satisfaction response in the ONS/DH national survey of bereaved people, published in July 2012, the details of this are here -

Statistical bulletin: National Bereavement Survey (VOICES), 2011

Key findings

  • The National Bereavement Survey (VOICES) 2011 achieved a response rate of 45.7 per cent, a comparable response rate to other postal surveys of the bereaved exploring end of life care
  • The overall quality of care across all services in the last three months of life was rated by respondents: 12 per cent as outstanding, 30 per cent as excellent, 33 per cent as good, 14 per cent as fair and 10 per cent as poor
  • Being shown dignity and respect by staff was highest in hospices (87 per cent ‘all the time’ for hospice doctors and 80 per cent for hospice nurses) and lowest in hospitals (57 per cent ‘all the time’ for hospital doctors and 48 per cent for hospital nurses)
  • For those who expressed a preference, the majority preferred to die at home (71 per cent), although the most commonly recorded place of death was a hospital (53 per cent)

Ms. Cummings, it appears incumbent upon us to point out that it is more accurate to state that the anecdotal 75% satisfaction response to the ONS/DH national survey of bereaved people, published in July 2012 applies to just 45.7% of the total number of people actually surveyed. It's not looking so good.

All the responses are the perceived responses of the observers, those who stood by and watched the proceedings. That is the real difficulty. The most important persons, the actual recipients of the treatment, can give no response. They are dead.

The responses obtained are extrapolations derived from the original questions to produce the results as above -

Copy of questionnaire, reminder letter, information leaflet and reply slips (3 

Details of responses to the questionnaire can be found here - First national VOICES survey of bereaved people: key findings report

Details of the extrapolated findings can be found here - National Bereavement Survey (VOICES), 2011, published : 03 July 2012

As for the majority of people who did not respond to the survey, perhaps they were of the opinion that no death is "good"; it is a grief that you have to work through.

Grief is a natural human condition. It is the emotional loss experienced at the loss of another. The act of feeling is to experience the human condition. And yet, even this, is reduced to a medical condition to be prescribed for. 

Apathy and indifference are keys to control. The social predictions of 20th century science fiction are coming to fruition.


  1. This comment has been removed by the author.

  2. Excellent post. Grief is natural and necessary. It's lack of grief and grieving, fear of grief and emotion that are pathological, not grief. I recall Dame Cicely Saunders writing about being overwhelmed by, what she called, something like pathological grief on the death of her husband or partner. She wrote of it as an alien emotion that she felt had to be controlled and escaped from.

    What do we read in the endless Eolc booklets? Avoidance and spin. A hundred demented abbreviations and crazy fomuli that skirt around the word 'death' and which do everything possible to avoid mentioning it. Death is euphamised and sanitised as some insane 'pathway', an 'EoLC' opportunity, a 'journey', a trip to Liverpool!?!. And where death is mentioned it's normally sanitised as a 'good death'.

    This newspeak is not just Orwellian, it pythonesque: This parot is not dead, he's just resting...don't mention Death!

    Death and grief, the most unmanageable of human experiences, must be insanely managed, sanitised, controlled and negated by some God like white coated automatons. But then it must hard for the Eolc cult to face up to the reality of what they are doing...and what the doing of it is doing to them.