Friday, 8 February 2013

Liverpool Care Pathway - Three Steps To Heaven

This is Baroness Neuberger, appointed 'independent' chair of the Review into how the Liverpool Care Pathway is used in practice.

Julia Neuberger is writing for The Washington Post in 2010. She confirms the Communitarian ethos.

The Washington Post article argues that end of life care in no way rations health care in the United Kingdom.

"What it does is to recognise that, at some point, we must die, and that heroic measures become pointless and cruel if they are not working."

This is NCPC:
End of life care accounts for a high proportion of NHS spending. The Demos think tank has estimated it as at least a fifth of NHS costs and a total of about £20 billion
There is considerable scope for improvement using interventions such as early identification triggers, advance care planning, co-ordination of care and effective multi disciplinary team (MDT) working.
[Commissioning End of Life Care]

The EoLC Programme in the UK, described by the NCPC as an umbrella but which is more like a web, is all about selecting and identifying via numerous methods recorded in these pages - from the GP 1% campaign, to the Six Steps To Success, to Psychometric testing - candidates for grooming [The article calls it counselling] to accept palliative care and deny themselves the possibility of curative care. 

They need to do this to secure a viable and financially stable health service. 

The EoLC Programme is all about grooming patients into accepting palliative in place of curative care options. This will save the NHS £billions and secure the NHS an "Affordable and Sustainable" future.

"Affordable and Sustainable." These are the buzz words everyone who is anyone is using. 

Simon Stevens was Tony Blair's advisor on NHS reform. He now heads up United Health.

This is United Health -

Working together, we can 
ensure that quality health care 
is accessible to all Americans,
and that it is affordable and sustainable - not a burden to future generations.

"Affordable and Sustainable." The web the NCPC calls an umbrella is international.

United Health is buying into Medicare policies.

This is US liberal commentator and blogger Matthew Yglesias writing on Slate 

"...not only is this health care spending on the elderly the key issue in the federal budget, our disproportionate allocation of health care dollars to old people surely accounts for the remarkable lack of apparent cost effectiveness of the American health care system. When the patient is already over 80, the simple fact of the matter is that no amount of treatment is going to work miracles in terms of life expectancy or quality of life."

Here's more Communitarian reasoning from Mr. Yglesias -

"Read Frakt for a bit of an account of how this arises operationally, but what I think is more important is that it arises on a meta-level because we have such a fragmented health care system. When your health care spending is all in one bucket, then at any given level of spending you face a question about how to allocate it. And when allocating spending between young and old, you're cross-pressured. On the one hand, older people have more need for health care services which militates in favor of allocating spending to them. On the other hand, providing health care services to younger people generally offers better value in terms of years of life and quality of life saved. A 25 year-old who's in a bad car accident can, if found in time and treated, still live a very happy and healthy life. If you're 95 and get into the same car accident, then treatment is going to be much more difficult, recovery will be much less complete, and in the grand scheme of things you're not going to live very long anyway."

Julia Neuberger
Neuberger is a trustee of the British Council, Jewish Care, and the Booker Prize Foundation, as well as founding trustee of the Walter and Liesel Schwab Charitable Trust

Proposed health-care reform legislation includes a provision that allows Medicare to pay for "end-of-life" counseling for seniors and their families who request it. The provision -- which Sarah Palin erroneously described as "death panels" for seniors --

End of life care in no way rations health care in the United Kingdom.

What it does is to recognise that, at some point, we must die, and that heroic measures become pointless and cruel if they are not working.

Hospice programmes in the United States also recognise that, but the funding under the present system is limited and probably does not allow those who wish to die at home to have sufficient support. The hospice movement is hugely popular in the United Kingdom. It started, in its modern form, as something out of the Christian tradition, founded as it was by Dame Cicely Saunders, who was a devout Anglican. However, people of all faiths support hospices, and the North London Hospice, which provides home care as well as impatient care, is a multi faith hospice (as opposed to non-denominational). It has volunteers of all faiths and patients of all faiths, and it caters to their spiritual needs. End of life care recognises pain that is physical and deals with it. But it also recognises emotional and spiritual suffering, and, at its best, can allow people to die comfortably, alert, having made their peace with family and friends, made their peace with God, and said their goodbyes. I have never understood why this should be regarded as anything other than wonderful, and, having watched both my parents receive end of life care at home, I know I would not wish to die any other way, if I get the choice. So highly regarded is end of life care and the skills that go with it in the UK that it is now- finally- being extended nationwide beyond cancer, AIDS, and Motor Neuron disease to all those who are dying of whatever cause.

For years, the British public has been softened up to accept dying as a positive life option.

The EoLC Programme is now stepping this up. The programme of grooming counselling mentioned in the Washington Post article is under way.

The brave stands made today by folk such as Mr. Tony Davie will come to be viewed as acts of selfishness. The slippery slope is already a rush into oblivion.

1 comment:

  1. Sorry I find this unbearable to read and probably have not got it right. I just saw the words about those over eighty. My father is ninety five and we all love him and enjoy his company. He is not in a hospital, but of course, he sure is a little old man. Are we expected to believe that it is all right to kind of discard him, and hand him over to those experts who know better than us?

    NO NO NO.....