A lonely death on the ‘care’ pathway: MPs demand action after another patient is chosen to die without doctors telling family
An elderly woman died alone after doctors failed to tell relatives they were ending her life on the controversial Liverpool Care Pathway. Olive Goom, 85, passed away with no one by her side after medics neglected to consult with her family about her treatment at Chelsea and Westminster Hospital.
Last night MPs, including Labour health spokesman Andy Burnham, called for an urgent review into the way the pathway operates.
Chris Skidmore, a member of the influential Commons health select committee, said: ‘These cases are disturbing, and if families have not been kept informed, that is wrong. It undermines the mutual bonds of trust which are essential in the NHS. We need an investigation into this breakdown of trust.’
As Miss Goom lay dying alone, staff reassured relatives on the phone just hours before her death that there was no urgent need to visit – even though doctors had already removed tubes providing vital food and fluids.
Her family discovered that she had died only when her niece went to visit her and found she was already being prepared for the mortuary. They said last night that they will never be able to stop feeling guilty that no one was there in her final hours.
The Mail has been contacted by several families who claim that relatives were put on the Liverpool Care Pathway – the controversial system designed to ease the suffering of the dying in their final hours – without any consultation.
Some said they found out that their relatives were on the pathway only after they happened to read their medical notes; and by that time it was too late.
The process involves withdrawing life-saving treatment and can involve the heavy sedation of a patient and the removal of tubes providing food and fluid. Thousands of patients every year are placed on the pathway, which was devised in the 1990s as a means of easing pain when it is impossible for a patient to recover and death is imminent.
However, critics say it is increasingly being applied to patients without their families’ knowledge and when they still have a chance of recovery.
Miss Goom’s niece, Marion Hebbourne, 68, last night told how her aunt was admitted to Chelsea and Westminster Hospital in London after she broke her humerus bone in a residential care home in February last year. Mrs Hebbourne made the 70-mile round-trip to visit from her home near High Wycombe on several occasions during Miss Goom’s stay in hospital.
But she had no idea that her aunt, who never married and had worked as a seamstress, was about to die on the pathway and had in fact been trying to find her a place in a nursing home closer to where she lived.
Mrs Hebbourne said: ‘My aunt was not well and she had a water infection, but I would not say she was close to death. We were preparing for her being released from hospital. On the Thursday I visited her and her speech was laboured but she recognised me and did not seem near death.
‘I told the staff that I was going to a wedding the next day but told them to contact me if there was any deterioration and that I’d take calls on my mobile.
‘On the Saturday I rang and asked how she was and asked if I should come in, but they told me that there were no worries. On the Sunday, I picked up my cousin and we arrived at the hospital at 12.15pm, which was a bit before visiting hours started at 1pm, but we went up to the ward to ask if we could see her.
‘When we got there, the nurse said, “haven’t you got our phone call? We phoned you about 11.15am” and we were asked to go into the relatives’ room.
‘She then told us, “unfortunately your aunt has passed away”. When I said surely I should have been called, the nurse said, “you knew that she was on the Liverpool Care Pathway”. I knew absolutely nothing, they had never mentioned it.’
Mrs Hebbourne added: ‘I wanted to spend the last hours and days of her life with her. They could have told me that I needed to come down and see her.
‘If they had talked it over with me we may have thought it was the best thing, but we were never told. I now have to live with the guilt that nobody from her family was there for her.’
Last night the Chelsea and Westminster Hospital admitted that doctors had put Miss Goom on the pathway without telling Mrs Hebbourne and apologised. A spokesman said: ‘We have implemented a number of recommendations to improve care for patients in the last days of life. Instead of a single tick-box for staff to confirm that relatives have been involved in discussions about end-of-life care, staff now have to specify what was discussed, when and with whom.’
Mr Skidmore said he would write to the Health Secretary today to demand an investigation into the pathway, to ‘restore faith’ in it.
Mr Burnham added: ‘I have looked carefully at the Liverpool Care Pathway and I support it. It is absolutely essential that it is properly communicated and understood by the family, and done in complete partnership with them. ‘I would call for a review to ensure that that happens in every instance.’
NHS tells doctors: You must treat all foreigners to protect their human rights… but you can still turn away BRITONS
New guidelines tell doctors across England they must register any foreign patient who asks for care otherwise it would be ‘discriminatory’.
These include asylum seekers, overseas students or tourists coming for a short holiday. Once registered, they will be entitled to the same NHS care as all other patients and can receive free blood tests, jabs and – in some cases – free prescription drugs.
In fact, the new rules will give overseas patients more rights than those living in the UK who can be turned away from surgeries if they live a few yards outside its catchment area.
There are also fears the ruling will make it even harder for local patients to get an appointment. Already half of patients cannot get an appointment with their doctor within 48 hours, according to the Government’s own figures.
Some family doctors are furious at the guidelines and describe them as a ‘charter for health tourism’. They say that such patients, once registered at a surgery, will also find it far easier to be referred to hospital for thousands of pounds of free treatment.
By law, overseas patients are not entitled to be treated at hospital – unless it is urgent – but staff rarely check on their backgrounds.
Until now, GP practices were not legally obliged to register foreigners and many turn away patients if they do not have passports or ‘proof of address’ documents. But the new guidelines issued to all doctors in England will change this.
One GP, who wished to remain anonymous, said: ‘I am not sure the British taxpayer should be paying for the world’s health treatment for free.’
And Tory MP Chris Skidmore, who is campaigning for tougher regulation on health tourism, said: ‘It is alarming that managers are passing these kind of diktats to doctors, many of whom are rightly worried that GP registration is effectively buying free treatment on the NHS.
‘This is not just about the money, vital though that is – we cannot have the NHS, paid for by taxpayers, being abused by people who pay nothing into the system and who are not eligible for free care.’ Mr Skidmore has obtained figures showing that health tourists currently owe the NHS £40million in unpaid medical bills.
In the last year nearly 3,600 ‘overseas visitors’ have had hospital treatment worth at least £1,000 a time.
National guidelines say it would be discriminatory for GPs not to treat health tourists.
NHS London, one of four strategic health authorities in England, has backed up this advice with further guidelines explaining they will ‘promote human rights and public health’.
Dr Vijayakar Abrol, a GP who practises in Edgbaston, Birmingham, said: ‘The guidance is not worth the paper it is written on. We do not have endless resources. Why should we give these patients – be they from India, Canada, the US or Eastern Europe – free treatment? ‘We cannot go to those countries and get free treatment ourselves.’
Last week an investigation by BBC’s Panorama found that staff working at GP surgeries were taking bribes of £800 to register health tourists on surgery lists. One manager, Asif Butt, who worked at a practice in Sparkhill, Birmingham, has since been suspended.
Some doctors say it is cost-effective – not to mention humane – to register overseas patients.
Dr Vivienne Nathanson, head of science and ethics at the British Medical Association, said it would be far cheaper to give patients insulin for diabetes, for example, rather than later treating them in A&E after they had fallen into a coma.
They also believe it could help prevent the spread of certain diseases such as tuberculosis which is commonly brought in by overseas patients.
BBC falls for junk science about alcohol
BBC bosses have been forced into a humiliating U-turn after wrongly claiming that cracking down on cheap alcohol would save the lives of tens of thousands of pensioners.
They have admitted that a Panorama investigation into alcohol abuse and the elderly used research supporting the introduction of minimum prices which was later discovered to be wrong.
The BBC1 programme, called Old, Drunk And Disorderly?, claimed the lives of 50,000 pensioners would be saved across England over ten years if a price limit were brought in.
Scotland is to introduce a minimum price of 50p per unit for alcohol next year.
Joan Bakewell, a former pensioners’ tsar under the last Labour Government, who presented the programme, told viewers: ‘We reveal new research which predicts raising alcohol prices could save the lives of thousands of pensioners.’
She also wrote in a newspaper: ‘With cheap booze available round-the-clock in supermarkets, there is evidence that if England follows Scotland’s lead, there could be 50,000 fewer alcohol-related deaths over the next decade.’
However, BBC bosses have admitted the figure was exaggerated, saying the real estimate is 11,500. It has ordered that the show be taken down from its online iPlayer service and re-edited.
The Corporation blamed Sheffield University for providing the wrong figures, pointing out that the university had ‘apologised unreservedly’.
In a statement, it said: ‘The School of Health and Related Research at Sheffield University emphasised the human error was wholly on their part and has apologised unreservedly to the BBC.’
In a statement, Sheffield University insisted the mistake did not impact ‘in any way’ on other work by its Alcohol Research Group, which has previously claimed that a 50p-per-unit minimum price in England would reduce alcohol consumption by 6.7 per cent.
No ‘victims’ veto’ on press freedom
Celebrity demands for British PM to back state regulation of the press have revealed the true mission of the Leveson inquisition
Being a victim of historical phone-hacking by the News of the World (deceased) entitles you to public sympathy (less so if you are a PR-hungry celebrity in the first place of course), and possibly to redress through the courts.
What it does not entitle you to is any sort of veto over the future of a free press in the UK. Yet that is what the celebrity anti-tabloid crusaders, and the illiberal campaigners who use them as voiceover artists, now clearly expect as a result of the Leveson Inquiry.
Hacked Off, the campaign for statutory regulation of the press, has written an angry letter to prime minister David Cameron demanding that he agrees to pass a new law to police the press if and when Lord Justice Leveson proposes it in his report, expected out next month. Anything less, it makes clear, would be a ‘betrayal’ of the victims whom Cameron promised to satisfy. The letter is signed by the usual celebrity suspects – Hugh Grant, Steve Coogan, Charlotte Church, Jude Law, JK Rowling, Max Mosley, etc – alongside more sympathetic figures such as survivors of the 7/7 London bombings and members of the Hillsborough Justice Campaign.
The outraged Hacked Off letter was written in response to press reports suggesting that Cameron might reject statutory-backed regulation even if Leveson backs it. In the most revealing passage, the signatories express their anger at backtracking remarks from the prime minister’s spokesman, suggesting that Cameron ‘had not intended to give a veto to any particular victims over the new system of regulation’. This is the ‘betrayal’ they are really talking about. They believe the prime minister promised to allow the victims of phone hacking an effective veto over the future shape of press regulation, and expect him to fulfil that pledge.
This ridiculous letter has done us all the service of spelling out what the entire Leveson Inquiry has really been all about. It was never about phone-hacking. That should have been left to the police to investigate (which they are doing on an irrationally grand scale). Instead, those historical offences linked with one (closed) tabloid newspaper employing a single private detective were turned into the pretext for Lord Justice Leveson’s judicial probe into the entire ‘culture, practice and ethics’ of the British media.
The Leveson Inquiry/inquisition has been a mission to purge the ‘popular’ press, using high-profile victims as human shields, high-ranking celebrities as voiceover artists, and high-minded talk of ‘ethics’ as a code for advancing an elitist agenda: the ‘ethical cleansing’ of the media. Thus the demand from the crusaders today is not for redress for the individual victims of specific offences, but for the government to set up a state-backed regulator to tame the entire press industry and wash the naughty newspapers’ mouths out with soap.
If it was not so serious it would be laughable to see the celebrity crusaders insist that Cameron must approach Lord Justice Leveson’s proposals with ‘an open mind’. There has been little sign of any such openness in their evidence to Leveson and public pronouncements, with Grant accusing the tabloid press of nurturing ‘a culture of pure evil’ and Coogan dismissing press freedom as ‘a lie’ made up by newspapers, while their snooty supporters in the liberal media declare that tabloid hacks are ‘a different breed’ and ‘not like us’. A more narrow-minded display of respectable bigotry would be hard to imagine.
Behind all the talk of protecting ‘ordinary people’, the elitism of the tabloid-bashing crusaders also shines through in the Hacked Off letter. Written in long-winded legalese by the campaign’s lawyers and academics, it refers to the celebrity signatories, without explanation, as ‘the Module 4 CPVs’. Who or what these might be, we ‘ordinary people’ can only wonder. It turns out to mean the Leveson Inquiry category of ‘Module 4 Core Participant Victims’, which might leave most none the wiser. This coded talk confirms that the letter is part of a closed elite discussion about how far to turn back the clock on the historic struggle for a free press.
What is most disturbing about this, as it has been all along, is not actually the antics of such risibly puffed-up characters as Hugh Grant or Steve Coogan. It is the extent to which the supposedly liberal-minded journalism academics and civil liberties campaigners who hide behind them have gone over to the other side in the culture war about press freedom. As ever, the shrillest voice demanding statutory regulation around the PR letter was not Charlotte Church but Brian Cathcart, the left-wing journalist-turned-professor of journalism who drives Hacked Off. Some might think that the way such people have abandoned the defence of press freedom in its hour of need is the ‘betrayal’ we should be worried about.
Campaigners for tougher press regulation have expressed their disgust that Cameron should be wavering on statutory-backed regulation for ‘political reasons’ to do with opposition within his government, and demanded that the new system of press regulation must be kept ‘free from politics’. What they mean, of course, is that politicians should intervene, but only to do as they are told and pass laws to set up a powerful new policeman of the press.
Nobody wants to see politicians regulating the press. But some of us think the idea of the press being policed by judges or ombudsmen or other unelected, unaccountable state-backed apparatchiks is just as bad, if not worse – at least we can still get rid of politicians if we object to what they do. Worst of all is the notion of a regulator handing an effective veto over a free press to any self-proclaimed victims of media misdeeds. That sounds like a sort of celebrity Star Chamber to decide what is fit for us to read and write, just as the King’s Star Chamber had to licence everything that was printed in the past.
It would be little wonder if the prime minister was having doubts about the prospect of statutory-backed regulation of the press. Setting up and operating such a system of indirect state interference could turn into a nightmare. This is of course Cameron’s own fault, having painted himself into the corner by setting up the Leveson Inquiry with carte blanche to give the press a kicking in the first place. In response to the letter, Cameron again indicated that he would agree to Leveson’s proposals so long as they were not ‘bonkers’ or too ‘heavy-handed’.
In any case, as we have argued on spiked, the ‘alternative’ proposals for a new system of ‘self-regulation’ are little better. They would set up an ‘independent’ regulator with more powers to investigate, expose and punish newspapers than those currently enjoyed by the ‘heavy-handed’ police teams.
All sides of the debate remain too much in thrall to the celebrity crusaders because they have accepted the central myth of the post-hacking furore: that the press is too free to be run wild and must be subdued and sanitised. It is high time those who care about the future of freedom of expression in our society raised a banner to declare that the press is not nearly free or open enough, even before a new regulator wades in.
Freedom of the press is for all, involving the right both to publish what you see fit and to read, see or hear all that you choose. That is far too important a liberty to sacrifice to anybody’s demands for special treatment and protection. There are many problems with the UK press. But the solution is never less freedom.
A free press must mean one that is free, not from being judged or subjected to the normal criminal law, but from being restrained or punished on the grounds of taste or ‘decency’ or offended feelings or outraged sensibilities. The misuse of our freedom by some is not an excuse for allowing the authorities to misappropriate it – or high-profile victims of phone-hacking to claim a veto over it. That would be seriously ‘bonkers’.
A day of judgment for Britain’s liberal bishops
The strangest thing happened last week, though few people noticed it. America officially ceased to be a Protestant country. According to the Pew Forum, the percentage of Protestants has dropped to 48 per cent, down from 53 per cent in 2007. That’s a huge shift.
But, before Catholics start punching the air, let me point out that the percentage of Catholics has been flatlining for years at 22 per cent. The big jump is in unaffiliated Americans, including atheists – up from 15 to 20 per cent. These “Nones”, as pollsters call them, are laying waste to the religious landscape of the United States. And Britain.
Here’s the question that intrigues me. Once the old, routine churchgoers have died off, and now that “None” is the default position for liberal-minded young people, what will the churches of the future look like?
We’re beginning to find out. More to the point, the clapped-out Anglican and Catholic bishops of the English-speaking world are finding out, too – and it’s giving them nightmares.
Those youngsters who once went to church out of obligation are now spending Sunday mornings in the supermarket or the gym (body worship is a flourishing faith). That means that the only young people in the pews are true believers who really want to be there.
If you’re a “go-ahead” bishop, vicar or diocesan bureaucrat, this is a scary development. You’ve spent your career reducing the hard truths of Christ’s teaching – such as the inevitability of the Last Judgment – to carbon-neutral platitudes. Suddenly, the 20-year-olds in your flock are saying: no thanks, we’ll take the hard truths. Eek!
In the Church of England, young evangelicals are embarrassed by the thespian agonising of Rowan Williams, the outgoing Archbishop of Canterbury. If there’d been a hand-wringing event at the Olympics, he’d have shattered all records.
In the Roman Catholic Church of England and Wales, the disconnect is even more stark. Young Catholics take their cue from the traditionalist Pope Benedict XVI, rather than from dreary bishops who only occasionally wake from their slumber to mumble something about renewable energy. (Remember Jack in Father Ted? You get the picture.)
Also – and I can’t tell you how much pleasure it gives me to report this – the Vatican has pulled a fast one by appointing two new diocesan bishops, Mark Davies of Shrewsbury and Philip Egan of Portsmouth, who are in tune with conservative youngsters rather than an English Catholic bureaucracy run by crypto-Marxist megabores trained in the public sector.
Bishop Egan has only been in his post for a few weeks, but already he’s been telling orthodox young Catholics what they want to hear: that they should adore the Blessed Sacrament, advertise their faith by making the sign of the cross, and even keep a rosary handy in the car. Cue barely suppressed shrieks from the old guard in Portsmouth, whose “director of liturgy”, the composer Paul Inwood, writes cod plainchant decked out in the harmonies of a 1970s cocktail lounge.
None of this should surprise us. When religions come under attack, they attract believers who invest in their more dogmatic, countercultural teachings – and who deliberately raise the degree of tension between themselves and society. There are few things more countercultural today than Bible-based evangelicalism or strictly orthodox Catholicism. For decades, Liberal bishops have droned on about how they wanted to draw young people back to church. But I don’t think this is what they had in mind.
About that drought — America is not the world
Britain’s wettest start to autumn for 12 years as South West continues to be battered by torrential rain
Britain is set to suffer its wettest autumn for over a decade with more rain and gale winds sparking further flood warnings.
After the UK’s wettest summer in a century, England and Wales are now on course for the wettest start of autumn for 12 years, the Met Office has said.
The southwest has seen five times the usual amount of rain so far this, drastically increasing the risk of floods for the forthcoming week.
The Met Office warned of ‘no let up’ with showers tomorrow and Monday, followed by blustery showers on Tuesday and rain for all on Wednesday – with a severe weather alert issued for floods in the southwest.
The outlook to October 27 said: ‘Continuing very unsettled with rain or showers for most parts, occasionally heavy, with strong winds.’
England and Wales were drenched by 132mm of rain from September 1 to October 10 and with no sun on the horizon, the UK is on track to push the September and October rainfall total to around 220mm. This is the highest since 2000, the wettest autumn on record, when 302mm fell.
St Mary’s, Isles of Scilly, has had 124mm of rain – compared to the 11-day October average of 27mm. Cornwall’s 107mm at Camborne is more than 300 per cent of the usual 34mm.
This autumn’s downpour is especially dramatic as a majority of the rain has fallen in the past three weeks. Met Office forecaster Dave Britton said: ‘The first three weeks of September saw relatively little rain.’
British Weather Services tweeted: ‘Three significant bands of rain will fall over the next week, with already high river levels and water tables.’
Met Office forecaster Charlie Powell said: ‘There’s no let up in the pattern, with bands of rain next week interspersed with drier periods.’
The Met Office added: ‘Ground in the South-West remains saturated and the threat of further heavy on Wednesday means the public are advised to be aware localised flooding is a risk.
UPDATE: “Data released by MeteoGroup showed that 14.25in of rain fell in June, July and August, making it the wettest summer since 1912. Britain saw just 143 hours of sunshine in the same period.”
BBC Arabist, Malise Ruthven, says that only “scholarly” criticism of Islam should be allowed
It’s a very long-winded article (in the NYT, unsurprisingly) but the last 3 paragraphs of it (below) seem to be the point of it. Ruthven burnishes his own scholarly status by using such hard words as “aniconic” and “docetic” but shows how much he really knows by approving of the term “Christianist” as a description of Pamela Geller. She is Jewish and needs no assistance from Christians or Christianity to form her opinion of jihadists. Ruthven is obviously far too grand to listen to or respect “ordinary” people
These contrasting responses suggest the possibility of a two-pronged approach to the free speech issues raised by images of the Prophet. “Insulting” the Prophet with the intent of stirring up hatred might be categorized as a form of “hate speech” comparable to anti-Semitism, racism, flag desecration, or Holocaust denial, which are forbidden by law in many countries (though not the US, where a proposed amendment protecting the US flag failed to pass by a single Senate vote in 2006), because the sacred image of the Prophet has become a fundamental part of how Muslim communities have come to define themselves. While in practice it may be difficult to draw the line between “insult” and “criticism,” if there is a distinction it must lie in intention.
In Britain, for example, the government’s effort in the wake of the Rushdie Affair to extend the race relations act in response to Muslims protests opened a legal minefield. It is now an offense (under the 2006 Racial and Religious Hatred Act) to display by writing or other visible representation material that is “threatening, abusive or insulting” with the intention of causing “harassment, alarm or distress.” Yet the law paradoxically protects the right to “insult and abuse” with a proviso stating that nothing in it “shall be read or given effect in a way which prohibits or restricts discussion, criticism or expressions of antipathy, dislike, ridicule, insult or abuse of particular religions or the beliefs or practices of their adherents.” Intention is clearly the key. Had he been required to defend his book under the 2006 act, Rushdie and his lawyers would doubtless have argued that the storm of controversy it raised was an unintended consequence of a misreading (mostly by politically-motivated parties) of his “serious” novel.
Critical analysis of the Quran that challenges the myths surrounding the primal figures of Islam is another story entirely: it is something that scholars of other faiths have been engaged in since the Enlightenment. Since the nineteenth century, Islamic scholars such as Sayyed Ahmad Khan and Chirag Ali have questioned the authenticity of many of the hadiths (verbally transmitted reports) on which the earliest chroniclers relied for their accounts of the Prophet’s life, exemplary behavior, and ministry. It would be utterly wrong for the law to discriminate in favor of (or effectively against) Muslims by insulating them from this process, because critical engagement—about science, religion, and politics—is a necessary precondition for communities to flourish in a cosmopolitan and increasingly globalized world.
It’s absurd to expect everybody to speak with academic precision and yet that is essentially what this guy is proposing. What about having one law for all and not a law that suits just a few?
Treating everyday speech as scientific or scholarly speech is a very common bad-faith ploy. For instance, if a man says: “Blacks are a criminal lot”, he will immediately be hounded as some sort of terribile bigot who is obviously wrong because some blacks are not criminal. But that is bad faith. That all blacks are criminal is unlikely to be what the speaker meant and instead of people trying to understand what the speaker is really saying he gets condemned.
If however, someone says that “the incidence of criminality is much higher among blacks than whites” he gets a pass. I know. I once said something similar and even got it published in one of the academic journals of sociology — of all places. But I did have some striking statistics on my side.
There is far too much “hunting” of people according to the way they express themselves. In a decent world one would try to understand what the average person was saying rather than pouncing on him with vile and superficial allegations because his speech is a bit careless. That someone has the background to speak in an academic way is no guarantee of wisdom, rightness or moral probity. The praise recently lavished on the unrepentant and disgusting Communist Eric Hobsbawm is evidence enough of that — JR