Liverpool Care Pathway - Active Killing...?

When 'choice' becomes the promoters' selling point, it's likely the wreath is being dressed up as a garland.



The NCPC is holding an exclusive Subscribers Forum on Wednesday 19th March. The big names in attendance include Wee Beelong. We are at a crucial stage. We are only half way there -

- Programme

2013/14 has been a crucial year for end of life care as well as NCPC & the Dying Matters coalition. It has marked the halfway point of the 10-year End of Life Care Strategy; NHS England has launched a process to “refresh” the strategy; we have had the report of Neuberger review of the Liverpool Care Pathway, as well as other landmark reports such as the Francis report; and the Government has said it will hold a review into the feasibility of a “national choice offer” to enable people to die at home.

A “national choice offer”. Now, there’s something to not let slip by.

They have set out to subtly alter our cultural perspective and they are succeeding. People who love and who love life accept the inevitability of death but do not ‘choose’ to die.

When people 'choose' to take their lives, surely, it is the pain or hurt of circumstance that has overtaken them which they find intolerable, not life itself. The good friend, the concerned stranger, the Samaritan, does not pass by and look the other way but stands between them and the circumstance they wish to escape, however dire, to bring them back from the brink.

No more; new standard bearers shout the 'right to die'. Both EoLC and euthanasia are become high profile priorities. In Belgium, the right to 'choose' death is to be extended to children. And 'choice' is become the selling point of those who press home the advantage.

The national choice offer was envisaged in a DoH consultation document published on 18th October 2010. Remember, this is Newspeak. This is Liberating the NHS: Greater choice and control –

“In end of life care, we will move towards a national choice offer to support people’s preferences about how to have a good death, and we will work with providers, including hospices, to ensure that people have the support they need.”

Therefore, we propose to establish a national choice offer for those people who choose to die at home (including a care home) to receive the support that they need. A lot needs to be done to improve end of life care services to make this possible, so we will undertake a review in 2013 to decide when this national choice offer could be introduced.

They have set out to support death and dying over life and living. They have done so because, underlying this imperative, there is an economic driver in the engine room. They have no choice, as they see it, but to limit life to secure an “affordable and sustainable” healthcare system “now and for future generations”.

The EoLC Strategy was published by the Centre for Policy on Ageing on 16^th July 2008. The EoLC Programme was born.

On 31st March 2013, following the Review, the EoLC Programme’s work came to a close. Search Engine links are being redirected...

The End of Life Care website has been archived 

The work of the End of Life Care Programme has now come to a close. Responsibility for this website has transferred to NHS Improving Quality (NHS IQ).

We are half way there. The strategy continues.

The Coalition carries on from where New Labour left off. This grand Strategy stands above politics, such is its imperative.

The Chairman of the Board, Tommy Hughes-Hallett, was tasked to lead a review to come up with creative funding ideas, both “fair and affordable” (sounds like Obamacare) for per-patient EoLC providing financial incentives to ensure home deliveries by the Macmillan/Marie Curie soul midwives.

This is from the EoLC Strategy 2nd Annual Report -

We are in an exceptionally privileged position for 2010/11 in that we have the balance of the £286 million still to invest.

The Coalition’s programme for government includes a commitment to introduce a per-patient funding system for all hospices and providers of palliative care. This is also picked up in the White Paper, Equity and Excellence: Liberating the NHS, with a commitment to review payment systems to support end-of-life care, including exploring options for per-patient funding.

To take that work forward Tom Hughes-Hallett, Chairman of our Implementation Advisory Board, has been invited to lead a review of dedicated palliative care funding and to come up with recommendations which are fair, affordable, and which provide the financial incentives to deliver the right care in the right place for patients.

The document mentions the “increasingly challenging financial climate” and, furthermore, that -

The Department of Health’s Quality and Productivity Challenge (QIPP) has been developed to help identify where and how the NHS can make £15-20 billion of productivity savings by 2014 while improving, or at the very least maintaining, quality. End of life care is one of the first twelve QIPP workstreams and Sophia Christie, Chief Executive of Birmingham East and North PCT, has been invited to lead it. QIPP is working with the strategy to accelerate work on the first steps of the end of life care pathway – identifying people who are approaching the end of life, and carrying out effective care planning with them.

The QIPP Challenge became Nicholson’s baby.

QIPPs...! Do I hear a quip there...? The QIPP CQUIN is the system of rewards for being good boys and girls. The more on EoLC, the merrier! Wow! Loadsa dosh to be made here.

The Review, far from putting a damper on their enthusiasm, has actually intensified their campaigning spirit. The EoLC Strategy is going into overdrive everywhere. Workshops abound.

Over in Cheshire, home of the Shadow Strategic Partnership Executive (previously called the Shadow Partnership Board), there are still places available on this one if you hurry -

- CE Education

The day includes symptom workshops, Liverpool Care Pathway update and specialist speakers. To book your place please email janetsmith@che.org.uk or telephone 01606 555698

Liverpool Care Pathway...?

Brendan Behan once said that there is no such thing as bad publicity except for your own obituary.

Well, Putin's efforts to rehabilitate Uncle Joe are famous - or infamous, whichever way you view it. And if you can rehabilitate Joe Stalin who murdered more people than Hitler, you can rehabilitate and revive any body - and anything. They've kept Lenin's decomposing cadaver going since 1924! It ain't over till it's over and, for some, it ain't never over.

Did the Review kill off the LCP? Is this "Toxic Brand", perhaps, not so toxic after all? Does the killing never stop?

This, too, is ‘Active Killing’...

This is Leigh Day –

In a ruling handed down today (24 January 2014) in the Court of Appeal, three Senior Judges have overturned an earlier ruling and agreed that legal action into the use of Do Not Resuscitate orders by a Hospital Trust, and across the NHS, should continue.

The verdict is the latest milestone in the case of Janet Tracey, a care home manager who died following the imposition of two DNR orders in her medical records, which her family claimed were without her knowledge or consent.

- Cambridge News

The Approved Judgement –

Old-age is, by definition, a ‘terminal illness’ in that as we approach advanced age we approach, also, our demise. Frailty accompanies old-age, but that does not mean we are going die anytime soon. Then again, we could drop dead tomorrow. That’s life; face it. Life is full of uncertainties and things which just cannot be predicted.

By definition, those of advancing years are going to be labelled as one-percent material and eye-balled for EoLC; with appropriate EoLC grooming, their care expectations will be downsized. This grooming is now going community-wide.

This is ehospice with news of an on-going project and focus groups –

In North-East London, they’re recruiting EoLC Champions.

East London Age UK last year partnered euthanasia charity, Compassion in Dying, to target local surgeries with Advance Decision leaflets.

The EoLC Strategy is going all out to further its corner. We are only half way.

Further reading - 

Liverpool Care Pathway - A Cost Efficiency

Liverpool Care Pathway - Changing Minds

Liverpool Care Pathway - Nottinghamshire Going For Gold

And, finally, some book ends...

This is Dying Matters with another event for your diary. The propaganda is relentless –

The Dying Matters coalition was set up by the NCPC in 2009 to alter our cultural perspectives and groom public opinion.

They are half way to achieving these goals.

The Strategy transcends politics.

The Strategy is global...

The WHO has made a "monumental decision". 

ehospice reports on a "historic development" to adopt a global EoLC Strategy.

The demographic imperative has long been a focus at the UN. This UN Policy Brief dates from March 2009 -

Here is discussed: What would it take to accelerate fertility decline in the least developed countries...?

March 2009...

The first Dying Matters Awareness Week from 15th – 21st March, the Inaugural Forum held on 13th May 2009, the Strategy embarked upon the EoLC Programme...

John Paul Holdren is a senior Obama advisor. Holdren co-authored 'Ecoscience' with Paul R Ehrlich in 1977. In this tome, is discussed a Brave New World of enforced Gatesian population control and a 'Global Regime'.

The following quotes are extracted from the work...

• "Adding a sterilant to drinking water or staple foods is a suggestion that seems to horrify people more than most proposals for involuntary fertility control..."
• "A program of sterilizing women after their second or third child... The law regulates other highly personal matters. For example, no one may lawfully have more than one spouse at a time. Why should the law not be able to prevent a person from having more than two children?"
• "Physiologist Melvin Ketchel, of the Tufts University School of Medicine, suggested that a sterilant could be developed that would have a very specific action -- for example, preventing implantation of the fertilized ovum. He proposed that it be used to reduce fertility levels by adjustable amounts, anywhere from 5 to 75 percent, rather than to sterilize the whole population completely."
• "If these relatively uncoercive policies should fail to maintain a low American birth rate, more coercive laws might well be written (see Chapter 13 for examples). At the moment, there might be little justification or public support for such laws, but if the resource and environmental situations are allowed to deteriorate, popular support might develop rapidly. There has been considerable talk in some quarters at times of forcibly suppressing reproduction among welfare recipients (perhaps by requiring the use of contraceptives or even by involuntary sterilization)."
• "The Planetary Regime might be given responsibility for determining the optimum population for the world and for each region and for arbitrating various countries' shares within their regional limits. Control of population size might remain the responsibility of each government, but the Regime should have some power to enforce the agreed limits."

The full text may be read and downloaded at Community Books -

We are half way there...