Terminally ill patients who fear being placed on ‘routine’ death pathway issued with opt-out cards by charity
Terminally ill patients have been issued with special cards telling doctors not to place them on a ‘care pathway’ that would hasten the end of their lives. It comes after doctors warned that hospitals may be routinely withholding food and drink from very ill patients so they die quicker to cut costs and save on bed spaces.
In response the anti-euthanasia charity Alert is distributing cards to patients to prevent this happening. The cards simply read: ‘Please do not give me the Liverpool Care Pathway treatment without my informed consent or that of a relative.’
The Liverpool Care Pathway, which got its name as it was developed at the Royal Liverpool Hospital in the 1990s, withholds fluids and drugs in a patient’s final days and is used with 29 per cent of hospital patients at the end of their lives. The practice is backed by the Department of Health.
However, in a recent letter to the Daily Telegraph, six doctors who specialise in elderly care warned hospitals across the UK could be using the controversial practice as routine to ease the pressure on resources. They added that in the elderly, natural death was more often free of pain and distress.
The group warned that not all doctors were acquiring the correct consent from patients and are failing to ask about what they wanted while they were still able to decide.
The doctors say that this has led to an increase in patients carrying a card stating that they do not want this ‘pathway’ treatment in the last days of their lives.
One of the letter’s signatories, Dr Gillian Craig, a retired geriatrician and former vice-chairman of the Medical Ethics Alliance, told the newspaper: ‘If you are cynical about it, as I am, you can see it as a cost-cutting measure, if you don’t want your beds to be filled with old people.’
The new opt-out cards are designed to work like a ‘living will’ to give the patient more say over their future treatment before they become too ill to communicate their wishes.
Elspeth Chowharay-Best, the honorary secretary of Alert, told the paper that the cards were being produced to answer ‘an urgent need’.
A Department of Health spokesman said: ‘People coming to the end of their lives should have a right to high quality, compassionate and dignified care.
‘The Liverpool Care Pathway (LCP) is not about saving money. It is an established and respected tool that is recommended by NICE (National Institute for Health and Clinical Excellence) and has overwhelming support from clinicians at home and abroad. ‘The decision to use the pathway should involve patients and family members, and a patient’s condition should be closely monitored.
‘If, as sometimes happens, a patient improves, they are taken off the LCP and given whatever treatments best suit their new needs.
‘To ensure the LCP is used properly, it is important that staff receive the appropriate training and support.’
NHS workers took 15 days off sick last year… compared with just SIX in the private sector
For once I am not too critical of this. If you work in a hospital, you are bound to catch things. Only a comparison with private hospital staff would be informative
NHS workers are taking three times as many days off sick compared to those employed in the private sector, new figures show.
The 1.04million NHS workers in England were absent from work for a combined 15.56million days between 2011 and 2012. This works out as an average 15 days each.
The sickness absence rate was highest among ambulance workers at 6.18 per cent for 2011 to 2012. Over the same period private sector employees had an average absence rate of just 2.8 per cent.
The higher paid the NHS worker, the fewer sick days they are likely to take, figures from the Health and Social Care Information Centre suggest.
Despite the high figures, they were keen to point out that sickness levels had fallen slightly in the public sector.
HSCIC chief executive Tim Straughan said: ‘This information is vital to estimating lost days within the country’s largest workforce.
‘Today’s report shows that generally, sickness absence has fallen compared to three years ago, with the sickness absence rate falling from 4.40 per cent in 2009/10 to about 4.12 per cent in 2011/12.’
He added that ‘other doctors in training’ had the lowest rate of sickness absence of 1.19 per cent.
Meanwhile another survey has revealed that sickness absence in the private sector has seen a ‘slow but sure’ decline.
The study by information firm XpertHR found employees took an average of just over six days off sick last year, equivalent to 2.8 per cent of working time, compared with 3.6 per cent in 2007.
The figures, based on a survey of 206 private firms, revealed the average private sector worker took 6.2 days off due to sickness.
The report’s author, Rachel Suff, said: ‘Reducing sickness absence levels, particularly in the public sector, has been a key public policy imperative in the UK for some years.
‘Figures show a slow but sure year-on-year decline in overall absence levels across all employers over the past five years, including the public sector. The difference is that the public sector’s drop has come from a higher starting point.’
A TUC spokesman said: ‘The average number of days lost to workplace ill-health has been falling for over a decade as a result of employers better managing sickness absence and increased presenteeism, which has been made worse by rising job insecurity as a result of the recession.
‘It is important that employers do not treat every instance of sickness absence as avoidable and potentially bogus.
‘Good employers allow their staff to recover and support them when they are off, rather than forcing them back while they are still ill. This negative attitude can prolong illness, spread diseases and cause stress throughout the workplace.’
More than 60,000 ‘bogus’ students came to UK last year as ministers are accused of having ‘bottled out’ on the issue
Mininsters were accused of having ‘bottled out’ on tackling bogus students last night – as it emerged some 60,000 may have entered the country last year.
The study by the MigrationWatch think tank, based on official figures, suggests more than one in four of all non-EU students entering the country last year were not genuine.
The figures will spur demands for a further toughening of the student regime, and reinforce opposition to Lib Dem calls for students to be removed from the immigration numbers altogether.
David Cameron, under pressure from Business Secretary Vince Cable and the higher education industry, is considering taking students out of net migration statistics.
That is despite his own immigration minister saying to do so would ‘destroy public confidence in the Government’s immigration policy’.
Students are thought to add around 75,000 to the UK population every year – with thousands staying on illegally.
A Home Office-commissioned study conducted thousands of interviews with applicants from around the world.
Applicants were tested on their ability to speak and write English, quizzed on whether they actually intended to study and not work, and asked if they intended to return home afterwards.
The results showed nearly half of all applicants from Pakistan should have been refused, nearly 60 per cent from India, one third of those from China and 62 per cent from Burma. The vast majority were applying to study at private colleges, but nearly one in seven were university applicants.
When these proportions are applied to the number of arrivals last year from each country, it adds up to more than 63,000 who could be considered ‘bogus’.
From this month around 10,000 such interviews will be conducted with suspect applicants. But it emerged the question of whether a student intends to return home has been dropped.
Sir Andrew Green, chairman of MigrationWatch said: ‘We now have clear evidence of abuse on a major scale.
‘Bogus students come here to work illegally and thus take jobs from British workers. If it is clear from the circumstances that a student is unlikely to go home, the visa should not be granted in the first place.
‘After all, many of the advantages claimed for foreign students depend on their going home after their studies. These half measures simply will not do. The government have bottled out on bogus students.
‘If they are serious about immigration they must face down the self-interested demands of the Higher Education sector and pursue the public interest.’
Higher education chiefs say the reduction in student numbers could cost the country billions of pounds in lost income.
Over the weekend, it emerged that London Metropolitan University had its licence to bring in non-EU students suspended because of Home Office concerns over its handling of applicants.
In 2000 around 54,000 non-EU students entered the UK to study but by last year this figure stood at 201,000
The numbers increased by 30 per cent in the first year of Labour’s disastrous points based migration system. As a result officials had to halt all applications from parts of the world because of the flood of questionable forms.
The concerns were backed by National Audit Office report which estimated bogus numbers may have been as high as 50,000 who actually came to work in the first year of points system.
Top British universities forced to introduce remedial maths classes
Top universities are being forced to give remedial lessons to maths students as A-levels and GCSEs have failed to prepare them for the rigours of degree courses, an official report has found.
Standards in schools have slipped so low that GCSE maths now amounts to little more than “glorified numeracy” while even those with top grades at A-level are woefully ill-equipped to study maths and science at university.
A combination of the “modular” A-level system, which allows pupils to bypass certain fields such as calculus, and a “race to the bottom” between competing exam boards are driving the problem, the House of Lords report has said.
Many pupils are even applying to study scientific subjects such as engineering and chemistry at university despite dropping maths at 16, meaning they arrive without even a basic knowledge of key fields like mechanics and statistics.
Some seventy per cent of first-year undergraduates studying biology, 38 per cent reading chemistry and economics and 20 per cent on engineering courses in 2009 had not completed an A level in maths.
In their evidence to the committee, Vice Chancellors including Prof Sir Leszek Borysiewicz of Cambridge reported that many maths and science students had to be given “remedial” classes upon arrival at university.
Lord Willis of Knaresborough, chairman of the Lords science and technology select committee which commissioned the report, said he was “absolutely gobsmacked” by the figures.
The calibre of maths students and general school leavers is so dire that all pupils should now be required to study maths to some level after the age of 16, he added.
“If we are talking about a world-class system, where mathematics is the cornerstone of virtually every science programme, then it is really quite amazing that we have so few students who have studied maths, literally, beyond GCSE and often, not even with a grade A.
“Part of [the problem] is the modulisation of A level, whereby there is no interlinking between the different elements of maths, but it is also because there is a race to the bottom at A-level by exam boards competing with each other about the ease with which students can achieve their grades.”
Prof Brian Cantor, Vice Chancellor of York University, told the committee: “We have to give maths remedial classes, often even to triple-A students.”
Professor Sir Christopher Snowden, vice-chancellor of Surrey University, added: “I think that in pretty much every university the issues over maths skills apply.
“This has been an issue now for many years within universities, partly due to the increase in the breadth of maths that is studied at schools but with a lack of depth. In some cases, for example, there is a complete absence of calculus, which is an issue in many subjects.”
Those wishing to study science, engineering or maths at university should be required to take a maths A-level, while those focusing on humanities subjects like English or classics should still study the subject to AS level, the committee said.
Pupils who leave school at 16 to enrol in apprenticeships or other educational programmes should take courses in maths appropriate to their vocation, for example a basic accounting course for people who may become self-employed, they added.
The report also recommended that universities shoulder some of the responsibility by introducing stricter entry criteria for science and maths degrees, making certain courses and key modules obligatory.
Lord Willis said: “When you have got the Vice Chancellor of Cambridge saying we have got young, bright, A* students coming in and we have to do remedial maths to get them to engage with engineering and physics, there is something seriously wrong with the system.
Power in the people’s hands to block wind farms: British government pledges to give communities more control
George Osborne is planning new powers to allow communities to block wind turbines as the Coalition row over green energy targets escalates.
Whitehall sources said the Chancellor was pushing for changes to the planning regime as part of a deal with the Liberal Democrats over the future of climate change policy.
There are 3,800 wind turbines across the UK, but at least 10,000 had been expected to be built to help meet Britain’s pledge to cut carbon emissions to 50 per cent of 1990 levels by 2025.
But more than 100 Conservative MPs have called for cuts in state subsidies for new turbines, and changes to planning rules to limit their construction.
One source said: ‘The Treasury is looking at how to change the planning process around turbines to try to give local communities more say, and potentially how they can share some of the financial benefits.’
Mr Osborne is offering to limit his demands for reductions in subsidies for onshore wind farms if the Lib Dems agree to compromise on inflexible climate goals.
He insists householders should not be faced with bigger energy bills and firms put at a disadvantage by Britain attempting to cut emissions faster than other countries.
The Chancellor points out that the UK accounts for less than 2 per cent of global greenhouse gas emissions, compared with 40 per cent from the US and China.
He argues that many renewable energy sources, such as wind and solar, are too expensive and wants a massive expansion of gas-fired power stations instead.
Applications for new wind farms have to be made to local authorities, and around half are refused. But under the existing system, energy companies often win on appeal to the Government’s planning inspectorate.
Campaigners took heart from a court ruling in May, in which villagers in Hemsby, on the edge of the Norfolk Broads, succeeded in blocking four 350ft turbines after a High Court judge agreed their right to preserve their landscape was more important than renewable energy targets.
In return for changes to allow communities more opportunities to prevent onshore wind farms, as well as financial incentives for those that do accept them, Mr Osborne is prepared to accept Lib Dem Energy Secretary Ed Davey’s proposed cut in onshore wind subsidies of 10 per cent, followed by a review next year.
From the Mail, May 30
The Treasury had been pressing for tougher cuts in the subsidies, though suggestions that they could be cut by as much as 25 per cent were dismissed.
‘We never tried for, nor were going to achieve an immediate 25 per cent reduction in onshore renewable subsidies,’ said one source. ‘This would be likely to be struck down in court.’
Sources said the Chancellor wanted to ‘rule out anything that might make gas investment unviable’ such as another renewables target.
He is pushing for a looser regulatory regime for ‘fracking’ – the fracturing of dense shale rock under pressure of jets of water, sand and chemicals – to extract gas. In the US, gas prices have fallen significantly as shale gas extraction has taken off.
‘Gas should continue to play a massive role in our energy needs for the future, alongside nuclear and some renewables, so we want to do all we can to secure investment in both gas and renewables generation, but also to bring down bills for businesses and consumers,’ the source said.
In a leaked letter to Mr Davey, the Chancellor has urged him to make a ‘clear, strong signal’ of support for ‘unabated gas’ up to 2030 and beyond, including a promise that consumers would benefit from falling gas prices.
‘Setting inflexible targets on the energy sector is inefficient,’ he writes.
Craig Bennett, director of policy and campaigns at Friends of the Earth, said: ‘The Chancellor’s pre-election pledge that the Treasury will become a “green ally, not a foe” has been completely trashed.’
‘Vile and tasteless’ toy?:
Toy guns are common so why not this one?
A [British] luxury department store has apologised for selling wooden toy versions of Soviet-era rocket launchers. London store Liberty was forced to pull the £23.50 toy from is shelves following a number of complaints, with some describing it as ‘vile’ and ‘tasteless’.
Available in baby pink, yellow or natural wood, the design appeared to be marketed at younger children. The toy was based on Katyusha rocket launchers which were first used in the Second World War by the Soviet Union. Recently, they have been used by Hezbollah militants to fire rockets into Israel and during the Libyan conflict last year.”