Tuesday, 25 November 2014

Liverpool Care Pathway - A True Story: The Next Generation

Is this a war of attrition that we wage, against an enemy insidious in its cunning...?

These pages reported last year a true story.

The story, The Big Kill, was related - for benefit of those too young to remember - in the style of the US 50’s wireless and tv serialisation, Dragnet. Only the names were changed to protect the innocent.

The Overkill -

What follows is also a true story. It is the story of May’s daughter, Jane. Her name, also, has been changed for she, also, is numbered among the innocent...

Jane is now undergoing chemotherapy in the very same hospital that took her mother’s life.

While fighting her own good fight with cancer, Jane continues to fight the good fight for her mother with the PHSO. This is proving to be a farce.

Jane’s case for her mother – after all these months – is still no further forward. In fact, it is at a standstill. The PHSO have responded, as they must to accord with their Mission Statement, but no action has thus far been undertaken.

The case is plain and clear. Permission had to be obtained from the patient to proceed and it was not. Why has not Jane’s case for her mother, then, proceeded?

The PHSO lacks the staffing capability.

What does this say then, about the NHS if the PHSO are so inundated with complaints that they do not have the staff to deal with the volume of complaints?

What springs to mind is our correspondence and dialogue with the CQC.

Particular reading -
Liverpool Care Pathway – The Audacity Of Hindsight
In 2011, the CQC Inspector informed us that there were budgetary constraints on the CQC and that at that time investigations were focussed on care of the elderly. I pointed out that such investigations could also incorporate investigation on the use of the LCP. Mr Jenkins acknowledged what I said but did not hold any hope of such a proposal being accepted.

Budgetary constraints.

It was not until November of 2012 that the ineffectual Review was announced by Norman Lamb. This was at the threshold of a brand new year, 2013, and only following a hard-hitting campaign by a national newspaper, which had itself been vilified for undertaking such a campaign!

Budgetary constraints. Is this why Jane’s case may not proceed?

Lord Carlisle
 called for doctors who put patients on the LCP without their permission to be struck off.

There are a multitude of them! Have any been even hauled before the GMC, let alone been struck off?

Jane is attending the chemotherapy suite three times a week. Last week, she had to attend early to send off her bloods.

Jane arrived at 11 a.m. quite prepared for the long wait that proceeded. At the county hospital where the cancer drugs are prepared, they had to get the dose right. It was a long wait, but the preparation is key to treatment.

At 4.30 p.m., the drugs arrived in the chemotherapy suite. The requisite checks were completed and the drip for the infusion was set up.

On Monday, I accompanied a client to the local pharmacy. I am in the habit of acquiring useful and appropriate leaflets for the scheme and one caught my eye –

The infusion was less than half complete when the line was removed and a saline bag set up to flush her through. It was approaching 6.00 p.m. and they were impatient to get off home to their dinners.

Jane was given her antibiotics but no Piriton. The uncomfortable reaction she gets manifests upon completion of treatment and this point was nowhere near.

Could no-one have stayed with her to complete the infusion? The drugs will not ‘keep’ and are specific to her treatment.

Apparently not. Previously, Jane has been sent through for observation to the ED when the reaction has been severe.

What means this grand reputation? Their purpose was persistent and present in the grooming of May’s family and the taking of May’s life...

Are we blinded by the light?

These drugs were thrown away. That was not good for Jane: she did not complete her treatment!

These drugs were thrown away. That was not good for the NHS: cancer drugs are notoriously expensive!

Jane's daughters have been attending with her and the strain has taken its toll with them, also.

The story so far -

Liverpool care Pathway - A True Story 

Liverpool care Pathway - A True Story Supplemental

Liverpool Care Pathway - Responses Will Be Answered
Additional reading -
Liverpool Care Pathway - On Pint-sizing Perceptions of Care And The Betrayal Of Trust

Liverpool Care Pathway - Self-Accreditation...?
Do they cast a glamour, do we walk in thrall that we are blinded by it all? 
Yea, though do I walk unto the glamour of the Spectacle, thine Brand and thine Image shall comfort me all my days!

Monday, 10 November 2014

Liverpool Care pathway - A Life Less Perfect, Or Just Different...?

Is a life less perfect one that is not the same? Does being different devalue life? Do we not diminish ourselves in making assumptions such as these...?

This is time for some Life Café.

This is the paper unafraid to state its case.

This is a report about what is paramount: to have a child 'less perfect' or to have no child at all. Or is this child just perfect anyway, because this is your child?

Is this child just different...?
During Miss von Roth’s first pregnancy, she and her managing director husband Paul Freshwater, 41, were told there was a one in 700 likelihood that Lukas had the condition. With Sophia, the chance was one in 24.

For healthy pregnant women in their 20s, the risk of Down’s is usually lower than one in 1,000. Miss von Roth claims each time doctors put her under pressure to have Chorionic Villus Sampling (CVS), an invasive further test.

But due to the risk of miscarriage caused by CVS – during which fluid is taken from the umbilical cord for analysis – she refused. Miss von Roth, who lives in Ashtead, Surrey, said: ‘After being given such drastic news – which turned out to be wrong – I spent my whole pregnancies obsessed my children might not be healthy. I couldn’t just relax and enjoy the experience.’

Recalling her pregnancy with Lukas, she said: ‘I was devastated when I got a phone call saying the test showed a higher risk of having a baby with Down’s syndrome.‘Doctors wanted me to undergo a CVS test, but I refused because by then I’d discovered the risk of miscarriage – around one to two babies in 100 – was higher than my chance of having a baby with Down’s.’
Miss von Roth’s children were not born different; they were born the same. This prompted comments –
I'm sure there are many cases like this happening to women. How come her story makes it to the papers? Am I missing something here..?
Yes, there must be many but it is necessary to print only one to make the point in argument against eugenicists such as Dawkins whose views also ‘made it to the papers’.

What does the NHS (National-socialist Health Service) consider the greater priority: the provision of life-extending drugs...

or to provide tests to design out perceived imperfections in the species?

This is some serious Life Café.

It is quite plain to see that the NHS considers the risk of losing a perceived healthy child is outweighed by the risk of conceiving a perceived unhealthy child.

In this case - as in the many other cases like this happening to women - this woman decided otherwise.

The NHS, 70 years in the making...

In 1941, the eugenicist, social architect and, latterly, Liberal MP, William Beveridge, was appointed to chair the committee set up by Arthur Greenwood which would call for a "cradle to grave" National Health Service.

Beveridge was one of those 'advanced' thinkers prominent with the Fabians in the LSE and an advocate of eugenics. Beveridge eugenicists created the NHS.

Fabian socialists provided the intellectual justification for the eugenics policy that led to the Australian child removal policies.

Beveridge favoured central planning. Under Bevan's charge, the State stepped in and, in line with the command and control policies of the time, the social architects commandeered the ship with their ideologues as stars to steer her by.

This is State Medicine.

Not ‘defective’ but different.

Both Right Wing and Left Wing have embraced the eugenics philosophy. It is clear why the Bard embraced the terms Up Wing and Down Wing!

Socialists – as well as National Socialists - championed the cause of eugenics and racial purity.

The Fabians Sidney and Beatrice Webb regarded eugenics as “the most important question of all”. Science was the religion of the time and the social scientists became its priesthood.

The Labour MP, Archibald Church, viewed those he saw as ‘defectives’ and ‘degenerates’ as “a misery to themselves”

The economist, John Maynard Keynes, served on the governing board of the Eugenics Society.

Eugenics was central to social planning and State Medicine is a tool, valued and valuable, an integral cog in a scientifically-planned society.

Are social scientists the new priesthood?

The post-war years saw a surfeit of 'advanced' thinkers in every field, redefining social values and what they perceived to be antiquated, 'Victorian' thinking.

These attitudes reflect through in today's, in the comments made by Warnock, Amis and Attali for instance.

Today, we have birth by induction and, via the EoLC Strategy and EoLC Programmes, the death lists and death pathways, death by induction. How better to complete this than by institution of the Communitarian Complete Lives system and the ultimate death plan with a pre-arranged appointment with death executed via the euthanasia bill set to go through parliament?

In the UK and across Europe, the social scientists are moulding our lives "without us being aware they are doing so" [Economic and Social Research Council].

In the manner, for instance, that the euthanasia campaign and its offshoot ‘charity’ has insinuated itself into Age UK via the EoLC Strategy, the Eugenics Society, in its affiliations, was “part of a complex web that enmeshed both pressure groups and politicians” [Ann Farmer - By Their Fruits: Eugenics, Population Control, and the Abortion Campaign, p.68].

Furthermore - as reported in these pages in regard to the multiple Kendall groups for instance - the society was also “closely involved in covert methods, making it appear that prominent individuals from different political perspectives were reacting independently to a pressing social problem” when, in fact, such independent citation was a fallacy.

Further reading -

Liverpool Care Pathway - The Insinuation Of The Unacceptable

Liverpool Care Pathway – An Innocuous Logic.
The ESRC (Economic and Social Research Council) back-end funds all manner of projects that affect us all. The ESRC has been funding research into 'terminal sedation until death' at Southampton University.

The ESRC funds research which "has an impact on business, the public sector and the third sector".

This is the Economic and Social Research Council -
Shaping Society
What we do

We are the UK's largest organisation for funding research on economic and social issues. We support independent, high quality research which has an impact on business, the public sector and the third sector. At any one time we support over 4,000 researchers and postgraduate students in academic institutions and independent research institutes.

What is social science?

Social science is, in its broadest sense, the study of society and the manner in which people behave and influence the world around us. 
Some social scientists argue that no single definition can cover such a broad range of academic disciplines. Instead they simply define the social sciences by listing the subjects they include. 
Social science disciplines

The main social science disciplines include:
  • anthropology
  • communication
  • criminology
  • cultural studies
  • economics
  • human geography
  • linguistics
  • law
  • political science
  • psychology
  • sociology
  • development studies
Each of these social science subjects uses a range of approaches to study society, including surveys, questionnaires, interviews and statistics. Like all sciences, social sciences evolve through the interplay of the ideas and theories of academics and the evidence that supports or refutes them.

How social science shapes our lives

Social scientists influence our lives usually without us being aware they are doing so. For example:
  • the role of governments in an increasingly market-based society has been determined by famous thinkers such as John Maynard Keynes and Karl Popper
  • it was an economist who came up with the idea of the National Health Service
  • the payment of billions of pounds of state benefits for the needy has been influenced by the work of social scientists.
Social science research findings continue to provide invaluable information whether you are a parent, a local councillor, a police officer, or a business executive.
This is a scientifically-planned society and the social scientists are beavering away, moulding our lives in plain sight, and yet do we walk unaware, the fool on the hill, teetering on the edge of oblivion?

This is -
Liverpool Care Pathway - A Perverse Symmetry
Is this fast resembling Huxley’s Brave New world?

Natasha Canfer, a Trustee of the National Gamete Donation Trust, writes in BioNews 

In July 2014, the Department of Health announced that it had awarded the National Gamete Donation Trust (NGDT) funding to set up an independent National Sperm Bank in partnership with Birmingham Women's Hospital (BWH). 
A world first, the National Sperm Bank is due to launch in October 2014. It will be based at BWH as the single NHS-funded hub, with spokes across England later on. Donor recruitment, information and availability for all of the other centres will be coordinated from one location. Birmingham Women's Hospital is ideally placed as a leader in its field and its location to offer an accessible and fully integrated donor recruitment, screening and banking centre with donors coming from its youthful and culturally diverse population.
What will they tell the children? Will they tell their children? The ‘lost children’ - those for whom no record was held - felt that they had lost their lineage.

Is this a Brave New World of designer children?

Scientific American asks -

"...will selection of traits perceived to be desirable end up diminishing variability within the gene pool, the raw material of natural selection?"
What gambit is this gamete priesthood playing...?

Are the Social Scientists gambling with our future?

Last thought -
Liverpool Care Pathway - The Side Effects

Saturday, 1 November 2014

Liverpool Care Pathway - Boiling Frogs, Sans Everything

In the beginning was the word.

Ten Months that shook the NHS

Almost fifty years ago, a book was published that shook the NHS and fired a blast that caused a stir of debate in the House.

The book: "Sans Everything" by Barbara Robb.

This recounted what was seen at the time as an unbelievable and extraordinary catalogue of abuse that, today, only appears frighteningly mundane. Like the boiling frogs, we have been slowly parboiled and conditioned into acceptance of the unacceptable and to walk in thrall, blind to suffering.

They waited long enough until they thought it was safe to act. Culture and attitudes have been doctored and groomed. It seems they can now get away with anything, even referring to a dementia sufferer as 'Mickey Mouse'.

The Mail has been running articles on the state of the NHS in Wales. According to the Mail, NHS Wales is dying on its legs. The Mail lays the pall of this appalling state of affairs at the door of the Reds in the person of ‘Red Ed’ and an NHS in the charge of Labour.

Mail Online published a damning report of error and mishap that is horrifying to read. Patients...
have been forced to wait months for vital cancer treatment.

Around half of Welsh cancer sufferers must wait six weeks or more for many scans and tests. Yet, across the border in England, less than a mile from my home town of Monmouth, the comparable figure is less than 6 per cent.Little wonder that 15,000 Welsh patients every year decide to travel to English hospitals for cancer treatment they are denied at home.

Or that thousands more are going private or even moving to rented accommodation in England to bypass long waiting lists for heart scans or hip operations.
What are statistics and what do they show? There are always techniques. In finance, it is called creative accounting.

There are methods, procedures and practices put in place, to massage and manipulate statistics and present reality in a more favourable light.

These are all box-ticking exercises, from sending out single paramedics in response vehicles to cut call-out response times and the creation of the Acute Medical Units to cut waiting times in A&E - and we all have our own tales to tell in those regards.

But this is policy, not politics. There is selection and exclusion, also, that is not extraordinary or particular at all and has been reported by the Mail.

This is Mail Online in November 2012 –
Doctors are withholding treatment from dying cancer patients because they do not think it worthwhile, a report warns.
They are refusing to send them to intensive care or offer life extending drugs as they believe such measures are ‘futile’. 
In some cases, patients have been put on the controversial Liverpool Care Pathway - where fluids and food are withdrawn - rather than on life support machines.
A report by the Royal College of Physicians today warns that the hospital care for some terminally-ill cancer patients is inadequate.
It blames a lack of communication between GPs, nurses, cancer specialists and doctors in A&E for causing delays in treatment that can result in unnecessary suffering.
But it also warns that some doctors are too fatalistic and refuse to provide life-extending drugs or even help patients with their breathing as they believe it pointless.
Some of these ‘delays’ are actually part of the box-ticking exercise. The focus of Trusts, the CCGs, is to be seen to be complying. Compliance is the new buzz word. The reality comes second place.

The Mail's focus is NHS Wales. They have picked up the ball and ran with it, not because it is 'news' but in response to the Labour leader's recent comments and to make political capital out of it.

This 'news' is not even new. The Times reported earlier this year -

The Times

Elsewhere in the UK -

The Scotsman
And the Guardian entered stage left -

The Guardian

"It's the same the UK over
For every patient it's the same;
It's the Docs what gets the pleasure;
It's the patients gets the blame..."

The Mail Online report continues -
Over the coming days, this series about the Welsh NHS will tell the stories of patients who have been failed by the service and it will expose the shocking extent of the crisis — one that shames the Labour politicians who control the health service in Wales.

Their testimonies detail a system in turmoil, where dreadful oversights in care, institutional neglect and instances of botched treatment have become routine. 
They also lay bare a woefully politicised culture of official cover-ups, where it has become common practice to smear critics and gag whistle-blowers. As well as the BMA’s damning assessment, there have been several other highly critical reports, from highly regarded bodies such as the Royal College of Surgeons and the College of Emergency Medicine (who warned last year, incidentally, that Wales’s A&E departments were ‘at the point of meltdown’). 
Official figures, too, show the Welsh NHS lagging behind England’s on a host of key indicators, most notably waiting times, and reveal that the Welsh Government has until recently been cutting NHS funding by 1 per cent a year, even as the rest of Britain increases it by the same amount.

Typically, the Welsh Government refuses to acknowledge the crisis and dismisses its critics irresponsibly as purveyors of Right-wing propaganda. But what else can you expect from what is effectively a one-party state?

For ever since devolution in 1999, when responsibility for health- care was given to the Welsh Assembly, voters in the Principality have elected only Labour administrations (albeit never with an overall majority).

As a result, the Welsh NHS has been controlled, without exception, by the Labour Party for 15 years. Its supporters also dominate every regional Health Board.

Despite these gross failings, Ed Miliband says that only Labour — under him as prime minister — can be ‘trusted’ to safeguard the British health service.
The Mail is intent on politicising the debate and continues -
Almost invariably, the whistle- blowers and aggrieved families of victims of the Welsh NHS find themselves facing a mixture of attacks and obfuscation.

For example, the children of Malcolm Green, a businessman who died at Withybush Hospital in Haverfordwest in 2012 after waiting five hours to be operated on while he was bleeding internally, have been refused access to a report detailing his final hours.
Despite learning that staff lied about his treatment and that a consultant chose to attend a meeting rather than operate immediately on the 82-year-old patient, they have yet to receive a proper apology.

A supposedly contrite letter from Trevor Purt, chief executive of the local Hywel Dda health board, had not even been signed by the health boss. When they tried to contact the Welsh Health Minister, Mark Drakeford, they were told to complain via a website.

Malcolm’s son John says: ‘The complaints process is deliberately fitted with barriers to stop people pursuing complaints and to make them give up. In the Welsh NHS, there is a disgraceful culture to try to cover up complaints.’Thankfully, there are those such as Labour MP Ann Clwyd who are prepared to speak out. She has suffered personally — her husband Owen, she says, died ‘like a battery hen’ after being kept on a trolley in a corridor at the University Hospital of Wales in Cardiff.

Her reward for highlighting an issue of grave public concern? She has been smeared by the Welsh ruling class.Though the hospital’s health board apologised ‘unreservedly’ about her husband’s care and said his treatment was ‘unacceptable’, Mrs Clwyd was publicly told to shut up and stop complaining by Labour Assembly member Lynne Neagle.

‘We have all had cases of problems with poor care, but I do not believe that it gives Ann Clwyd the right to denigrate the entire Welsh NHS and I wish that she would stop it,’ Miss Neagle remarked.

Miss Neagle’s attitude speaks volumes for the sense of entitlement and inscrutability that has been allowed to take root in a health service that many believe puts point-scoring over patient care.
The Mail claims that -
Things are very different in England, where health boards (often run by party political apparatchiks) were replaced many years ago by trusts in an attempt to get a degree of independence from Whitehall.

Though their performance varies, they are designed to be protected from party politics and are typically run by an eclectic mixture of local people, business leaders, medical staff and NHS employees. 
We are all well aware that the truth is otherwise. Waiting times are targets. 

We are all well aware from the outcome of the Mid Staffs inquiry that the English NHS (National-socialist Health Service) are pretty proficient with the magic mirrors and ‘re-coding’ figures.

We are all well aware of these 'apparatchiks' as the Mail appropriately describes them. The LKP Tweets on Twitter and Facebook chirping and chattering, actually pointing the finger that opponents of the LCP are part of some right-wing Catholic conspiracy theory.

No, Daily Mail, you’re right but you’re wrong: it’s not about politics; it’s all about policy.

The rush to be rid of the LCP is itself rescinded and the Pathway is revived and vindicated just as the apologists for Stalin seek to revive his memory for the glory days of the Soviet holocaust.

The Times
When neglect, ongoing and systemic, continues and has continued it is arguable that this may, indeed, be policy. The offence of wilful neglect appears ineffective and inadequate as either a castigatory or corrective measure. Is this neglect reckless and wanton or wilful and contrived, as in some vile intent and purpose?

Should those who perform these acts alone be castigated or should those who oversee their wickedness also be rebuked and receive just chastisement? Do these foot soldiers of abuse receive their just deserts or are they permitted to continue their pursuits in the vile treatment of those who exposed them?

Sir David Nicholson’s admission of failings was expressed with a regret that was so ‘bitter’ that he threw a £12K celebratory do to see himself off to bathe in the sunset of a £110K pension.

And the mail reports the boiling frogs are become senseless to sans everything -

Mail Online

Mail Online

 Mail Online picked up the ball on the NHS black hole in June -

 Mail Online is still running with the ball -

Is it all a case of I see no ships? Has life just been downgraded as an optional extra?

This is The Express -
A whistle-blower claimed 32-year-old James Harrison should have been taken to a hospital mortuary but he was instead left on the ground next to some bins.

The insider said the body was left until the next team of paramedics arrived for the following shift and blasted the incident as "totally wrong".

The source said: "Standard practice would be for paramedics to transport the body to the mortuary.

"But on the day the body was left on the station floor next to the bins for more than an hour, which raises serious issues of dignity and decency. 

"I have never experienced anything like this in my career, it was totally wrong."
Already, the cuts are biting hard -

The Telegraph
And the troops are up in arms over pay -

The Telegraph
What is to be done...?

We were only “half way there” but this is all coming together and, piece by piece, the jigsaw is being completed. Already, the DPP has relaxed the guidelines on ‘assisted dying’ and the Falconer’s Bill is ready to snatch up his prey.

Oh ye whose lot it is to be adjudged to have life of insufficient quality, beware. If there is a cost-cutting advantage to seize, an inheritance to gain, then your days may well be numbered.

Release the hounds CRITters!

In July, Greater Manchester Fire and Rescue Authority published a document proposing formation of a pilot Community Risk Intervention Team.

This is The Telegraph -

A plan to send fire crews and former soldiers to deal with medical call-outs has been criticised as “emergency services on the cheap” that could cost lives.Greater Manchester fire service is to recruit 30 people to provide assistance on two types of “low priority” calls, which it is claimed take police officers and paramedics off the road for several hours.The brigade has received an extra £3.67 million in government funding for the project. If successful, the pilot will be extended across the county next year.

What is to be done...?
Liverpool Care Pathway - What Is To Be Done...?

They are cutting corners to help fill that black hole.

For what shall it profit a man...?

This is the power of the word.

They used to call it price fixing; they now call it price matching. Another name for it would be a Cartel.

A scam no less outrageous are the deals presented by online comparison sites. There is no such thing as a ‘deal’. It is all about presentation. It costs what it costs. It’s all about profit margins that maintain profitability. Why won’t you get this ‘deal’ elsewhere? Come on, where does their profit come from?

It is all in the presentation.

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

Footnote reading -
Liverpool Care Pathway - A Cost Efficiency
Liverpool Care Pathway - Hard At Their Purpose
Liverpool Care Pathway - Active Killing...
Liverpool Care Pathway - Whatever Happened To The Family Doctor...?
Liverpool Care Pathway - The Prequel
Some further reading -
Liverpool Care Pathway - The Werther Defectives
Liverpool Care Pathway - When The Caring Had To Stop  
Liverpool Care Pathway - NICE One!
And some additional reading -

The book: “Semantography (Blissymbolics)” by Charles K. Bliss

This is the Power Of The Word

The most powerful weapon in their armoury is the power of language to motivate and to move. This realisation has been exploited by dictator and despot, by praetor and potentate to muster armies to their cause.