Now sick babies go on death pathway: Doctor’s haunting testimony reveals how children are put on end-of-life plan
Until now, end of life regime the Liverpool Care Pathway was thought to have involved only elderly and terminally-ill adults.
But the Mail can reveal the practice of withdrawing food and fluid by tube is being used on young patients as well as severely disabled newborn babies.
One doctor has admitted starving and dehydrating ten babies to death in the neonatal unit of one hospital alone. Writing in a leading medical journal, the physician revealed the process can take an average of ten days during which a baby becomes ‘smaller and shrunken’.
The LCP – on which 130,000 elderly and terminally-ill adult patients die each year – is now the subject of an independent inquiry ordered by ministers.
The investigation, which will include child patients, will look at whether cash payments to hospitals to hit death pathway targets have influenced doctors’ decisions.
Medical critics of the LCP insist it is impossible to say when a patient will die and as a result the LCP death becomes a self-fulfilling prophecy. They say it is a form of euthanasia, used to clear hospital beds and save the NHS money.
The use of end of life care methods on disabled newborn babies was revealed in the doctors’ bible, the British Medical Journal.
Earlier this month, an un-named doctor wrote of the agony of watching the protracted deaths of babies. The doctor described one case of a baby born with ‘a lengthy list of unexpected congenital anomalies’, whose parents agreed to put it on the pathway.
The doctor wrote: ‘They wish for their child to die quickly once the feeding and fluids are stopped. They wish for pneumonia. They wish for no suffering. They wish for no visible changes to their precious baby.
‘Their wishes, however, are not consistent with my experience. Survival is often much longer than most physicians think; reflecting on my previous patients, the median time from withdrawal of hydration to death was ten days.
‘Parents and care teams are unprepared for the sometimes severe changes that they will witness in the child’s physical appearance as severe dehydration ensues.
‘I know, as they cannot, the unique horror of witnessing a child become smaller and shrunken, as the only route out of a life that has become excruciating to the patient or to the parents who love their baby.’
According to the BMJ article, the doctor involved had presided over ten such deaths in just one hospital neonatal unit.
In a response to the article, Dr Laura de Rooy, a consultant neonatologist at St George’s Hospital NHS Trust in London writing on the BMJ website, said: ‘It is a huge supposition to think they do not feel hunger or thirst.’
The LCP for children has been developed in the North West, where the LCP itself was pioneered in the 1990s. It involves the discharge to home or to a hospice of children who are given a document detailing their ‘end of life’ care.
One seen by the Mail, called ‘Liverpool Pathway for the Dying Child’ is issued by the Royal Liverpool Children’s NHS Trust in conjunction with the flagship children’s hospital Alder Hey. It includes tick boxes, filled out by hospital doctors, on medicines, nutrients and fluids to be stopped.
The LCP was devised by the Marie Curie Palliative Care Institute in Liverpool for care of dying adult patients more than a decade ago. It has since been developed, with paediatric staff at Alder Hey Hospital, to cover children. Parents have to agree to their child going on the death pathway, often being told by doctors it is in the child’s ‘best interests’ because their survival is ‘futile’.
Bernadette Lloyd, a hospice paediatric nurse, has written to the Cabinet Office and the Department of Health to criticise the use of death pathways for children.
She said: ‘The parents feel coerced, at a very traumatic time, into agreeing that this is correct for their child whom they are told by doctors has only has a few days to live. It is very difficult to predict death. I have seen a “reasonable” number of children recover after being taken off the pathway.
‘I have also seen children die in terrible thirst because fluids are withdrawn from them until they die.
‘I witnessed a 14 year-old boy with cancer die with his tongue stuck to the roof of his mouth when doctors refused to give him liquids by tube. His death was agonising for him, and for us nurses to watch. This is euthanasia by the backdoor.’
Alder Hey confirmed that children and babies are discharged for LCP end of life care ‘after all possible reversible causes for the patient’s condition are considered’.
‘There is a care pathway to enable a dying child to be supported by the local medical and nursing teams in the community, in line with the wishes of the child patients, where appropriate, and always their parents or carers.’ Alder Hey said children were not put on the LCP within the hospital itself.
Teresa Lynch, of protest group Medical Ethics Alliance, said: ‘There are big questions to be answered about how our sick children are dying.’
Woman delivers nephew in hospital car park — AND gives him kiss of life after his mother wrongly sent home while in labour
A woman was forced to deliver her nephew in a hospital car park and then give him the kiss of life after doctors sent his mother home prematurely.
First-time mother Kirsty Brook, 30, had been to hospital on November 13 fearing she was in labour, even though her baby wasn’t due for another five weeks.
But staff told her she simply had a urine infection and sent her home at 2pm that day.
By 8pm it was clear Ms Brooke was indeed in labour, so her sister, Michelle Brook-Lomas, drove her to hospital.
However baby Harry was in such a rush to enter the world that she was forced to deliver him outside the entrance of Calderdale Royal Hospital in Halifax, West Yorkshire.
And moments after delivering the little boy, she realised he wasn’t breathing.
Quick-thinking Ms Brook-Lomas, a former childminder, wiped the mucus from her tiny nephew’s mouth and gave him the kiss of life. Seconds later he began to cry.
Medics rushed baby Harry into the hospital to check him over before reuniting him with his mother and father Mark.
Baby Harry, who weighed 6st 3lb, was kept in hospital for five days and spent the first 24 hours in an incubator with oxygen and a heat lamp.
Ms Brook, of Huddersfield, West Yorkshire, has now hit out at her treatment, saying the outcome could have been very different if it wasn’t for her sister.
She said: ‘I feel disgruntled about it. I was a first-time mum, I didn’t know what was going on. I didn’t know the difference between contractions and a water infection.
‘It felt like they were trying to fob me off, as if they were saying ‘don’t be silly, you’re not in labour’.
‘It was surreal, like it was happening to someone else. I just wanted to get to the hospital. ‘Thankfully Michelle was there or else Harry may not have been here today. She was brilliant.’
Full-time mother-of-three Ms Brook-Lomas, 34, who used her baby first-aid training from her former job as a childminder, said: ‘I had asked Kirsty a few times if she wanted me to pull over as we drove to hospital but she said “‘just get me there”.
‘As we were approaching the hospital she said she wanted to push and when I saw the car park, I just did a handbrake turn across four spaces near the entrance, jumped out and Mark raced in to get the midwife.
‘Kirsty was in the back seats and I talked her through it. It all happened within minutes.
‘When the baby arrived he had mucus in his mouth so I wiped it out. He wasn’t breathing so I gave him the kiss of life, then he started crying and I gave him to Kirsty to do skin-to-skin.
‘The medics came and the umbilical cord was cut before he was taken inside.’
Ms Brook said: ‘I was overjoyed when Harry started to cry. We all were. It wasn’t the birth I was expecting.’
‘I felt my waters break that morning, but the hospital put a baby monitor on me, checked me over and sent me home.
‘The pains kept getting worse and by about 8pm I went to my sister’s home and she suggested I have a bath.
‘When I got out we timed the contractions at three minutes and phoned the hospital and they said to come in.
‘I saw the doctor who sent us home the next day and he said to me “I’m so sorry, I haven’t got X-ray eyes. I honestly believed you had a water infection”.’
Baby Harry is now back at home with his parents. His mother added: ‘He is wonderful. We are over the moon.’
The British government minister who thinks that lessons in porn are acceptable: MP says schools are free to teach children despite impact of images on youngsters
Schools are free to give lessons in pornography, an education minister has admitted despite concerns about the impact of hardcore images on children.
Campaigners have warned that growing numbers of youngsters are hooked on graphic films found online.
David Cameron is preparing to make it easier for parents to block online porn from new computers.
But Liz Truss insisted lessons in porn can form part of ‘age appropriate’ studies.
Some teaching unions have called for students to be taught about porn from the age of 10.
But an alarming study last month revealed children as young as 11 are becoming addicted to internet pornography giving them ‘unrealistic expectations’ of sex.
Counsellors at Childline also report a surge in calls from youngsters traumatised after seeing adult images online.
However, Ms Truss backed teachers to discuss porn in the classroom. She said: ‘The Government wants all young people to have high quality, age appropriate sex and relationships education.
‘The current non-statutory programmes of study for Personal, Social, Health and Economic (PSHE) education, which include sex and relationship education, can provide opportunities for schools to teach about pornography.’
PSHE, which includes sex and relationships education, is not compulsory in England unlike other parts of the UK.
Ms Truss’s admission that pornography can be taught as part of PHSE lessons will alarm parents and children’s campaigners.
While lessons on pornography would focus on the impact and dangers of graphic images online, they could backfire by alerting children to what can be easily accessed on the internet.
David Cameron is ready to take action to curb online porn. Anyone buying a new computer or signing up with a new internet service provider will be asked whether they have children when they log on for the first time.
Those answering ‘yes’ will automatically be taken through the process of installing anti-pornography filters and a series of questions about how stringent they want restrictions to be.
It follows a series of alarming cases of boys watching porn before attacking other children.
In June this year a 14-year-old boy who raped a nine-year-old girl after watching hard-core pornography online was spared jail.
His lawyer said the boy, who was just 12 at the time of the attack, wanted to feel grown up. Sean Templeton, defending the boy, said: ‘There is a real risk that young people are growing up with a skewed view of what sex is and sexual activity.’
Ms Truss was responding to a parliamentary question from Tory MP Andrew Rosindell, who said how children find out about pornography was a matter for parents not teachers.
‘This is a matter for parents to make a judgement on,’ Mr Rosindell said. ‘I don’t think it is a matter for school teachers.
‘There is a general concern across the country that these things are becoming far too accessible for young people and the moral side of this needs to be upheld.
‘Guidance on young people is something that is something we need to ensure is there, rather than let this sort of thing become too prevalent.’
Last month the National Association of Headteachers (NAHT) called for porn to be taught in lessons from the age of 10.
Policy adviser Sion Humphreys said: ‘Children are growing up in an overtly sexualised world. ‘That includes easy access to porn and they need the skills to deal with it.’
The union called for teaching about the impact of pornography to be included ‘as part of a statutory Personal Social Health Education (PSHE) programme’.
‘Evidence suggests 10 isn’t too young to start lessons on pornography, but it wouldn’t be a full on lesson but the grounding would be laid down.’
The National Union of Teachers said referring to issues of porn in lessons is a step too far and that schools should only talk about it if asked by students.
Tory MP Chris Skidmore, a member of the Commons select committee, said any lessons on pornography would have to be handled sensitively.
‘It is much better for schools to take control of this issue rather than simply allow children to find images on their phones in the playground.
‘It would be naive to think that you could just prevent children getting access to these images.’
Jon Brown, head of the NSPCC’s Sexual Abuse programme said: ‘It’s a good thing for children to learn that porn does not mirror real-life and gives a distorted view of sex.
‘As long as this is explained in an age-appropriate way, with the consent of parents where necessary, it can help children form healthy relationships based on care and respect.’
Now SNOW is set to fall as Britain faces coldest winter for 100 years
Definitely global cooling
Britain will shiver tonight as temperatures plummet in the first taste of what promises to be one of our coldest winters for a century.
The cold snap is expected to last until the end of the week, creating dangerous conditions on the roads and adding to the misery of those already battling floods.
Temperatures could fall to as low as minus 3c (27f) in some places, with snow already falling in the Pennines.
The torrential rain which has deluged the country for the last week is expected to ease at last but the clearer skies, coupled with northerly winds, will send the mercury plummeting.
Tonight’s cold snap heralds a freezing winter ahead with long-range forecasters warning that temperatures could fall to as low as minus 20c (4f) in some areas through December and January.
They fear snow blizzards could close roads and shut down rail networks across the country as winter takes hold.
The cold, drier spell that starts tonight could be only a brief respite from the rain. More heavy showers are expected to return early next week, causing more misery to those trying to combat flood damage.
‘The weather will be much colder and drier across most of the UK today,’ said Meteogroup forecaster John Lee.
‘Northerly winds and clearer skies will make it feel much colder and we can expect widespread frost overnight when temperatures drop below freezing.
‘Wintry showers will bring sleet, snow and hail to higher ground tomorrow and there’s a risk of heavy snow showers in northern Scotland on Friday.
Local authorities say they are prepared for a harsh winter and have taken steps to avoid a repeat of two years ago, when a lack of gritters and snowploughs caused roads and transport networks to grind to a halt.
The Local Government Association, which represents councils in England and Wales, said councils had stockpiled 1.3million tons of road salt and had ‘hundreds’ of gritters on standby.
‘Keeping the country moving is a community effort,’ said Peter Box, chairman of the LGA’s economy and transport board.
‘Councils will be treating as many roads as they can and have also installed and filled thousands of extra grit bins for people living in side streets, villages and housing estates.
‘They’ve given equipment to parish councils, community groups and snow wardens who have volunteered to grit hard-to-reach areas, and farmers will be helping out on country lanes.
‘Highways, street-cleaning and park staff could also be drafted in to help clear snow and ice around places like shops, schools and sheltered accommodation.’
He said councils would be using social media, including Twitter feeds and Facebook pages, to keep people up to date about how weather is affecting their area.
The Left will never learn
The Laffer curve has been well-known since the says of Ronald Reagan and even JFK knew of it, though not by that name: Beyond a certain point, higher taxes will DECREASE government revenue
Around two thirds of Britain’s highest earners deserted the UK after the 50p top rate of tax was introduced, according to figures.
While some 16,000 workers declared an income in excess of £1million in the 2009/10 tax year to HM Revenue and Customs, that number dropped to just 6,000 after then Prime Minister Gordon Brown brought in the new tax rules.
Tax paid by the top earners fell from £13.4billion before the top tax rate came in to £6.5billion in 2010/11.
It is thought that many of the highest earners moved abroad or reduced their taxable incomes to avoid paying the new levy. Many are said to have avoided paying the new rate either by bringing forward payments or delaying them, by moving earnings abroad or by choosing to work less.
Many now appear to be returning to the UK, with the number of £1million plus earners rising again to 10,000 since Chancellor George Osborne announced that the top tax rate would be reduced to 45p from next April as part of the Budget earlier this year.
But while Conservatives used the figures to claim that Labour’s decision to increase the highest rate of tax actually lost Government revenue, Ed Miliband highlighted separate figures to accuse ministers of handing Britain’s rich a tax break worth more than £100,000 yesterday.
Mr Miliband claimed that new figures showed that 8,000 people earning more than £1 million this year would gain an average £107,000 each as a result of George Osborne’s budget decision to cut the top rate to 45p for those earning more than £150,000.
Addressing workers at a sheet metal factory in Stevenage ahead of next week’s autumn statement on the economy, Mr Miliband said they were paying the price for the Government’s decision to stand up for the ‘wrong people’. ‘David Cameron and George Osborne believe the only way to persuade millionaires to make work harder is to give them more money.
But they also seem to believe that the only way to make you work harder is to take money away,’ he said. ‘Cut your tax credits, squeeze your living standards, get rid of some of the services on which you rely, and put up VAT. That’s where the money is coming from for the millionaires’ tax cut.’
Mr Miliband faced embarrassment earlier this year after wrongly claiming that all millionaires would receive a £40,000 tax cut.
In fact the tax cut relates to earnings, not wealth – and critics pointed out that the Labour leader has assets worth well over £1 million.
Tory sources hit back strongly at Mr Miliband’s latest claim, suggesting that the introduction of the 50p rate was an ‘ideological move’, which had cost the country billions of pounds.
Tory MP Harriet Baldwin, who uncovered the figures suggesting that the 50p tax rate had seen the number of those claiming to earn more than £1million drop, said: ‘Labour’s ideological tax hike led to a tax cull of millionaires. Far from raising funds, it actually cost the UK £7 billion in lost tax revenue.
‘We have taken tough action to clamp down on tax avoidance and make sure those with the broadest shoulders bear the biggest burden.
‘That’s why in every single year of this Government the rich will pay a greater share of our nation’s tax revenues than in any one of the 13 years that Labour were in office.’
An HMRC report into the tax concluded there was ‘a considerable behavioural response to the rate change, including a substantial amount of forestalling (deferring income to avoid the tax).’
Mr Osborne insisted on slashing the 50p rate, arguing that it made Britain uncompetitive and deterred entrepreneurs from coming to the UK.
He had wanted to scrap the top rate entirely for anyone earning more than £150,000 a year, but that move was blocked by the Liberal Democrats.
Many Tories believe the cut will lead to higher tax receipts in future, arguing that the wealthy will have less incentive to avoid the lower rate.
The Lib Dems also blocked his plan to reduce the top tax rate to its previous level of 40p, claiming that it would send out the wrong signal at a time when the less well off were being asked to contribute more to paying off the deficit.
Labour will hold a Parliamentry debate today to criticise the reduction of the top rate with senior coalition figures thrashing out next week’s Autumn Statement which sets out Government tax policy for next year.
Call a truce, before centuries of free speech are brought to an end
With MPs eager to take power over the press, the Prime Minister must lead them back from the cliff edge
For years, Britain’s politicians have wanted to pass judgment on whether the press has been abusing its freedom, but they have encountered a basic constitutional obstacle: the newspapers are not theirs to control, and haven’t been since the Licensing Act lapsed in 1695. In the intervening centuries, our country has developed a raucous, hugely popular and uniquely disrespectful press. Jeremy Paxman tells how he was drawn into the trade after being told that the relationship between a journalist and politician should be that between a dog and lamp post. For generations, the lamp post has put up with this. Now it wants its revenge.
In America, free speech is protected under the first amendment to the constitution. In Britain, our liberties have been protected by convention – but they are being heavily undermined. Once, we would have deplored the Bahraini state’s actions and asked what kind of regime imprisons people for what they say, as opposed to what they do. Today, we know the answer – as does the teenager recently arrested by Kent police for posting a picture on Armistice Day of a burning poppy; as does Petra Mills, found guilty of racial abuse for calling her neighbour a “stupid, fat Australian”. An American is free to say what he pleases. A Briton is not.
Given that the state is busily arresting bloggers and Twitterers – and even disputatious neighbours – freedom of the press all of a sudden starts to look rather anomalous. And when Lord Justice Leveson produces what is likely to be a 200-page J’accuse against our newspapers next week, dozens of Tory MPs have decided what they want the consequence to be. About 70 – including 42 who signed a letter to the Guardian – are pushing the Government to impose a statutory remedy, and No 10 is now briefing that poor David Cameron may have no option. Unless he regulates the press – or, ahem, “protects” press freedom by defining its parameters – then his MPs will rebel.
It is not quite clear at what stage Conservatives stopped thinking that freedom of speech is important, but we have a useful point of comparison. Five years ago, the then Labour-dominated Culture, Media & Sport Committee made a powerful declaration in a report. “Statutory regulation of the press,” it concluded, “is a hallmark of authoritarianism and risks undermining democracy.” This was a point of principle: you can’t have a little bit of state control, any more than you can be a little bit pregnant. Either the press is free, or it must operate within parameters defined by the state.
Inside Downing Street, there is a suspicion that the press are simply hysterical. “Some journalists say their parents fled the Nazis to get away from the kind of press regulation we’re looking at,” says one No 10 insider. There is genuine bafflement. The Leveson report will not propose that politicians dictate the terms of debate, but may suggest government “underwrites” some new system of regulation designed to protect victims. And everyone, journalists included, must obey libel and other laws anyway. Where is the problem in adding some more?
Lord Justice Leveson famously assured Michael Gove that he does not “need to be told about the importance of free speech”. But when the Education Secretary mocked the judge this week for his “truth-telling” skills, he made a deadly serious point. Throughout the inquiry, the judge seemed not to grasp a very important principle: that for a government to prescribe regulation for the press establishes a hierarchy of power – it puts the politicians in charge. It also creates a tool of political control, which can be ratcheted up later. MPs might speak softly, but they would be carrying a very big stick.
Some won’t even wait for Leveson. In the past few weeks, as editor of The Spectator, I have been contacted by politicians wanting a quiet word about journalists who have displeased them. One Labour MP complained about something a writer said about him on Twitter. “Does The Spectator want to be associated with someone like that?” he asked. His implication – that the journalist should face sanction for annoying an MP – was repugnant. A week later, a Tory minister called asking me to take down an online article which criticised him. Did it contain any factual errors? No. But I might like to consider whether it was “over the top”.
Telephone calls like these simply didn’t happen a year ago. Now, our MPs are warming up for an era in which they feel they will – at long last – be the judges of what the press ought to be doing. Fleet Street ought to be outraged at the very idea. But, depressingly, some journalists say they could quite happily live with this set-up, as long as it hurts their rivals more.
Having spoken to some of the Tory MPs who signed the Guardian letter, I am struck by how little thought they have put into the matter. One fact: abuses such as phone hacking are already illegal, which explains why so many journalists will be standing in the dock over coming months. “But it is very Conservative to stand up to power, and the press is too powerful,” one Tory told me. A second fact: the press has never been less powerful, which is partly why it’s in this mess. When Margaret Thatcher was elected, three quarters of Britons read a national daily newspaper. That’s power. Today, just a third of us do. That’s a crisis.
If the press really annoys our MPs, they should just be patient. Should David Cameron win a third term – though a second may seem a stretch – there could be no more than a handful of newspapers left to hurl the brickbats or bouquets. On current trends, neither the Financial Times, the Guardian, the Daily Express or the Independent will last until the end of the decade. Their digital-only rivals will be even harder to regulate, especially those headquartered abroad.
And what about publications only put out on iPad? And given that no one even had an iPad three years ago, how do you regulate whatever comes in five years’ time?
As so often, it is the Mayor of London who best puts things in perspective. Picking up a gong at The Spectator’s Parliamentarian of the Year awards on Wednesday, Boris Johnson appealed for a ceasefire. The battle started, he said, with The Daily Telegraph’s investigation into MPs’ expenses and now looks like it may escalate into MPs ending Britain’s 317-year tradition of press freedom. Michael Gove, looking on, applauded warmly. The MPs who I saw at the Savoy Hotel bar afterwards said that they, too, wanted a truce – but how to calm down the others? Only one man is capable of doing so. This time, there really is no substitute for prime ministerial leadership.