Tuesday, 9 February 2016

Liverpool Care Pathway - A Renegade State

When the law is but lip service then is democracy not served but made mockery and betrayed.

May was was talking to her family. May remonstrated with the physician not to pull her about. The physician ignored her and spoke directly to the family instead.

“She has pneumonia,” he said.

The physician departed and returned to say he had consulted with his LCP team. He informed the family that May was dying.

The driver was set up. In 18 hours, she was gone.

May was not asked.

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

Due process is observed and they do nothing.

Nothing is all they have to do for we are nothing and everything is dismissed as anecdote.

They do nothing because they know they can.

There were voices that had cautioned restraint...

This is the BMJ from 2008, eight years ago 
A recent study has shown that health care professionals in a hospice setting are wrong 50% of the time when predicting patient survival. Such is the pressure to roll out the LCP nationwide that many patients, especially the frail elderly, are at risk of having their lives shortened prematurely. That may suit economists and politicians with eyes on the balance sheet rather than the patient, and it may suit those who resent having elderly bed-blockers on their wards, but it is not good medicine. Poor end of life care undermines the trust between doctors and their patients. 
It is surely time to put the LCP on hold until all the concerns that have been raised online at http://www.bmj.com and elsewhere have been carefully considered. It is time for those who advocate sedation without hydration at the end of life to examine their motives. It is time for the medical profession to take collective responsibility for end of life care, for this topic is far too important to be left to palliative carers and the Department of Health. We must not allow ourselves to be driven by individuals or organisations with vested interests or by quasi- governmental committees meeting behind closed doors. It is time to say enough is enough! 
Yours truly, 
Dr Gillian M Craig.
E mail: craig.gm@clara.co.uk.
The years rolled on and Version 12 was rolled out and the LCP and other Pathways continued to take their toll.

A medical holocaust proceeded as EoLC went into overdrive...
Liverpool Care Pathway - The Voice In The Wilderness
Whatever happened to plain and simple life care...?
Liverpool Care Pathway - The Killing Wards
There was a Review that achieved much little than it took place and only took place because the groundswell of what had been dismissed as 'anecdote' in parliament was seized upon by Denise Charlesworth-Smith and held aloft as a battle standard  to demand justice for her own father.

Then, in a Government Press Release dated 26 June 2014, it stated:

When the Review was published last year, the Minister for Care and Support announced that people who have a complaint – even where a complaint had already been pursued – about the care given to a dying patient on the Liverpool Care Pathway should have access to an independent assessment of their case should they want it. That message is reinforced today.
New approach to care for the dying published - Press releases - GOV.UK
New Priorities for Care launched as the new basis for caring for someone at the end of their life.
Plain and clear, the words: “even where a complaint had already been pursued”.

May's daughter, Jane, took May's case to her MP.

The Under Secretary of State for Care Quality has responded to the MP, but not within the spirit of the intentions of the wording of the government Press Release.

Surprise, surprise.

Mr. Gummer is fully aware that, in pursuing a complaint, the complainant will be invited to take the matter further to the PHSO. That is all part of the NHS complaints process.

Mr. Gummer knows this full well, or should do. It is wholly unacceptable but he has responded thus that, firstly, the complaint was resolved locally and, secondly, because the PHSO is an ‘independent’ body this constitutes the ‘independent assessment’.

That being said, this does not resolve the whole fundamental principle of obtaining consent to treatment.

They cherry-pick what they wish to respond to and ignore or overlook what they do not wish to respond to.

If you persist, they deny everything.

Mr. Gummer, as Under Secretary of State for Care Quality, is fully aware that consent is a fundamental principle and that this was a major issue raised in the LCP Review that permissions were not obtained.

May had capacity to be asked. This is stated to be so and admitted in correspondence with the Trust. Why, then, was she not asked her permission to be placed on the Liverpool Care Pathway?

The MP has responded with an apology to Jane that this is not the answer she wanted but that is that.

Your Member of Parliament is your representative. To whom else are you to turn to if your MP turns away?

The official guidelines do clearly state that permission must be sought. The Trust, the PHSO, an anonymous 'very experienced medical professional' and adviser to the Ombudsman, the Under Secretary of State, the MP, all have disregarded this authoritative opinion and official NHS guidance. They are not prepared to comment on this nor permit May's daughter to challenge.

The fact is, if facts need repeating and evidently they do, that May was put on the LCP without her permission.

What have they to say to that?


They Do Nothing because they know they can.

This is the continental model, the omnipotent and anonymous authority Kafka confronted in works such as "The Castle" and "The Trial".

May's daughter is suffering her own trials.

Jane has not gone onto the optimum regime for her CLL TP53 aberation because of conditions for funding imposed by the CDF (Cancer Drugs Fund).

The CDF has recently come under scrutiny from MPs...

This is ABPI 
“What is needed is a wholesale reform of NICE, which, along with NHS England, needs to develop a longer-term sustainable solution to the evaluation and commissioning of cancer medicines. We therefore look forward to the upcoming consultation on the Cancer Drugs Fund and remain committed to working with all parties to achieve a more joined-up system which allows many more NHS patients to benefit from life-enhancing medicines.”
The BBC has asked: How do we pay for innovative drugs?

As if in answer, the HSJ has headlined: Fifteen trusts asked to pay executives more than prime minister.

HMOs have also had considerable scrutiny of late in the corridors of power.

A Houses in Multiple Occupation Bill is currently in debate in Northern Ireland.

HMOs have attracted debate at Westminster.

Debating Clause 85 of the Housing and Planning Bill in a Public Bill Committee on 26th November 2015 concerned Licences for HMO and other rented accommodation.

Here is Brandon Lewis Minister of State (Communities and Local Government) - As I have outlined, we want to ensure that the licence [HMO] is granted only to a landlord who can demonstrate that they are a fit and proper person to operate a house in multiple occupation.

More recently, the Planning (Community Right of Appeal) debate was heard in Westminster Hall on 20th January 2015 also concerning HMOs and predatory landlords who are disregarding the planning rules.

Social landlords, for whom no prerequisite of licence is required but must still adhere to HMO Management Regulations, are granted leave from having to jump through the hoops...
Liverpool Care Pathway - Litigating The Litigants

Liverpool Care Pathway - No Confidence In Confidentiality
Social Landlords are registered charities. They present a shop window of window dressing which conceals not a pretty picture.

When are these so-called charities to be brought to account?

The Metro reported on Friday...

We have read about LATCs (Local Authority Trading Companies)

The  Smart Alecs at Age UK have set up Age UK Enterprises Limited as the "commercial arm" of Age UK. Essentially, it’s a smart ALEC (Arms Length External Company)...

See -
Liverpool Care Pathway - When Justice Must Be Bought And Those Who Seek It Punished
Liverpool Care Pathway - When Creep Comes To Slide
This is 'partnership working'. Slip is come to slide and creep is come to spread and mutual profit is the justification of reason.

Where will all this lead?

You scratch my back; I'll scratch yours.

This is Age UK 

Commercial partnership with E.ON

Age UK has a longstanding commercial partnership with E.ON.

When customers contact us, they are signposted to E.ON and offered a choice of all four E.ON tariffs and many choose the one year tariff or variable option, however many prefer the reassurance of a fixed tariff for two years.

The long term Commercial partnership includes a typical commission to Age UK of £10 for each customer.
Is this within the remit of a charity to muscle elderly vulnerable people into signing up with companies with which it has a commercially beneficial relationship?

AGE UK has partnered with another 'charity', a pro-euthanasia outfit, the 'charitable arm' of the Voluntary Euthanasia Society which re-branded as Dignity in Dying.

See, for instance -
Liverpool Care Pathway - Doing The Addition
AGE UK Enterprises Ltd also sells branded Insurance provided by Ageas Insurance Ltd.

Ageas brands include Castle Cover, Express Insurance, Kwik Fit Insurance, RIAS, and Tesco Underwriting Ltd. Tesco Underwriting Ltd is jointly owned by Aegas and Tesco Bank.

This is a tangled web. Is this but an appearance of competition?

It is likely a mutually lucrative relationship.

According to Third SectorAge UK income is currently £159m. This ranks 9th in the tables and Age UK pays 38 staff in excess of £60k. Tom Wright, Age UK CEO, earns up to £190k.
"Charities want dynamic, superb chief executives to drive and fulfil their missions," he says. [David Fielding] "If you're too restrictive and sanctimonious on salaries, you will struggle to recruit and retain the best possible leaders."
Third Sector
This is 'justified' to recruit and retain the best possible leaders who have come up with ideas for innovative income generation such as badgering donors and driving them to suicide and employing crews of chuggers to aggressively accost passers by in the street.

And what happens to all that information you give when they sign you up as a donor? If you don't opt out, will you be opted in?

Positive liberties; negative rights.

This is Collaborate 
Collaborate is a new data source of prospective donors for UK charities. Collaborate is part of the Abacus Alliance database, the largest single source of transaction data in the UK. Actual transactional histories are modelled to predict future behaviour. There are two solutions available: non-contribute and contribute.
Concerned about sharing your donor data? This solution allows charities to access a sub-set of the Abacus Alliance in order to:
  • acquire new donors
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  • £130 per thousand

  • By contributing your shareable donor records you can:
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  • acquire new donors
  • reactivate lapsed donors
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  • £70 per thousand

  • With over 17 years’ experience, Abacus has become the standard for high-level consumer targeting in the UK.
    Medialab is an industry leading direct response media agency, with a track record for delivering market beating results within the charity sector with a core focus on new supporter acquisition through data driven media planning and innovation solutions. They work with more than 30 charity clients directly and many others through long-standing agency relationships, including Macmillan, Age UK and Save the Children.
    In 2012, Lord Shawcross took over the helm at the Charity Commission and was very critical of the fundraising tactics being employed in the Third Sector...

    Liverpool Care Pathway - The Likely Customers

    The Express carried a report on excessive and exorbitant remuneration...

    Nine executives at Cancer Research UK earn more than the Prime Minister, including chief executive Harpal Kumar, who pockets up to £240,000 a year.
    Kumar, 50, lives in a luxury £1.6m home in north-west London and does not have a mortgage.

    Peter Wanless, CEO of the NSPCC, earns a staggering £162,000 per year – £40,000 more than his predecessor Andrew Flanagan.

    Last year he pictured sipping champagne, and boasted on Facebook: "This was taken while I was 'working' on a visit to Jersey."

    The NSPCC was among the charities that asked Olive Cooke, 92, for money before she killed herself last month.

    Cooke, a poppy seller, was inundated with requests from charities she felt were "taking advantage" of her generosity.

    The mother-of-three was struggling with her finances after being diagnosed with cancer.

    A spokesman for the NSPCC said: "We have thousands of long-term supporters, who are committed to helping end child abuse, of which Olive Cooke was one."

    Other high earners include Amnesty International's Salil Shetty, who pockets a salary of up to £210,000, and Tom Wright of Age UK, who earns up to £190,000 a year.
    Where will all this lead?

    Sir Stephen Bubb, chief executive of Acevo (Association of Chief Executives of Voluntary Organisations), has accused William Shawcross, the chair of the Charity Commission, of being out of touch when he criticised charities that rely on state funding...
    Liverpool Care Pathway - Either, Or... Else
    Are these the makings of the Corporate State...?
    Liverpool Care Pathway - The Palliative-Medical Complex
    Supplemental  reading -
    Liverpool Care Pathway - A True Story
    Liverpool Care Pathway - Responses Will Be Answered

    Liverpool Care Pathway - A True Story Supplemental

    Liverpool Care Pathway - A True Story: The Next Generation

    Liverpool Care Pathway - Jane's Story

    Liverpool Care Pathway - Don't Call The Ambulance! 
    Liverpool Care Pathway - Bringing It On Home

    1 comment:

    1. I started this partition https://petition.parliament.uk/petitions/109115 to stop the LCP.