Hospital ‘death pathway’ bribes will be scrapped
Cash bribes to hospitals to put patients on to the controversial Liverpool Care Pathway will be ended, families have been told.
The disclosure means that the NHS payments – which amount to at least £30million – are likely to be stopped later this year.
A Health Department inquiry is underway into the Pathway, which was originally developed to ease the last days and hours of dying patients.
Care Minister Norman Lamb spoke to families of Pathway patients in Leeds in the first of a series of meetings designed to feed their views into the inquiry, which was launched in February and will report in the summer.
One of those at the meeting was Alyson White, who said her grandmother Marion Haigh died over a period of 12 days after Bradford Royal Infirmary withdrew fluids and food. The family said 82-year-old Mrs Haigh, who had early stage cervical cancer, was eating and drinking before being put on the Pathway.
Miss White said that Mr Lamb acknowledged that people were ‘terrified’ of the Liverpool Care Pathway. She added: ‘He is appalled that people feared they were not getting cared for but put to death in hospital. He said he would definitely be looking to stop any form of financial payment to hospitals to put patients on the Liverpool Care Pathway.
‘He said that most definitely he didn’t believe that hospitals should be gaining from patients dying on the LCP.’
Payments to hospitals to hit targets were first revealed by the Daily Mail last autumn. Some have been paid hundreds of thousands of pounds a year for reaching targets for LCP deaths.
For example, the hospital trust in Blackpool was last year paid £450,000 in return for ensuring 35 per cent of patients who die in hospital are on the LCP. Families have protested that relatives who were not dying have been placed on the Pathway.
Tory MP Fiona Bruce has told how she saved her father’s life when she pulled him off the Pathway. She had already seen her mother die an ‘agonising’ death when she was put on an end-of-life pathway after brain surgery two years earlier.
Miss Bruce said her 83-year-old father was admitted to a hospital, which she did not name, suffering from an unidentified illness that left him ‘weak and frail’. After a few days, a nurse had ‘almost casually’ told her: ‘He has not long to live. We are putting him on the Liverpool Care Pathway.’
Miss Bruce told a meeting in Parliament there had been ‘no discussion, no explanation, no consultation’ between the family and the hospital staff.
She said that her mother’s ‘heart-rending’ death after being deprived of food and fluids – without her family being consulted – had left her with a sense of ‘terrible guilt’.
The Congleton MP contacted her sister and they insisted their father was removed from the Pathway. He was placed in a nursing home. ‘Now, well over six months later that elderly man is very much alive, eating well, getting up when he wants and resting when he doesn’t, enjoying visits from his family,’ she said. ‘He is looking forward to his 85th birthday.’
An end to payments for Pathway targets would free hospitals from the suspicion of taking money in return for the deaths of patients.
Analysts believe the inquiry will also recommend that no patient should be put on the Pathway without either their own consent or that of their closest family.
Another likelihood is a change of name so the tainted title of Liverpool Care Pathway is no longer used.
Mr Lamb said: ‘It is important that I respect the independence of this review but I have already made clear that I have serious concerns about the use of financial incentives and that they should only ever be used if they demonstrably improve patient care.’
Seven-year-old girl’s vital op put on hold at scandal hit Leeds General Infirmary
A girl of seven faces an agonising wait for heart surgery after operations were suspended at a scandal-hit hospital.
Sienna Singleton was expecting an ‘imminent’ admission to Leeds General Infirmary. But its paediatric unit has been shut since Thursday night after it emerged that its mortality rate may be twice the national average.
Sienna, who needs a third major operation to treat a congenital heart defect, must wait to find out if the unit will reopen or if space must be found at a specialist hospital elsewhere.
Her mother Kerry, 33, from Doncaster, said: ‘Sienna has been telling everyone that she cannot wait to have her heart surgery. ‘She comes home from school every day and says “Has the hospital rung yet?”. She knows it will make her better.
‘We are worried about the future. Sienna loves the infirmary, she knows the staff and the hospital and she feels safe there. We don’t want to travel to Newcastle or Liverpool and be treated somewhere unfamiliar. It must be even worse for those children who had dates for surgery this week.’
Like many others, Sienna’s parents now face an agonising wait to find out if the unit will re-open or if space must be found at one of the other specialist hospitals across the UK, including London and Birmingham.
It comes amid shocking allegations from other parents of botched operations and poor treatment at the hospital’s cardiac unit.
There were also concerns that relatively junior surgeons had been left in charge of the unit after a senior surgeon was banned from operating on children while ‘aspects of his practice’ were investigated.
But MPs and some parents have claimed the decision to suspend surgery at the unit was politically-motivated and ‘suspicious’ timing.
Yesterday, a spokesman for the hospital said: ‘I would love to say that no operations will be delayed but, inevitably, when you are being transferred between centres, it is likely that some operations will be carried out later than scheduled.’
GPs given licence to make a fast buck out of taxpayers. This isn’t reform, it’s corruption
As everyone knows, the NHS is Britain’s sacred cow because it stands for certain values that the public believe form the essence of a decent and civilised society.
You really do have to wonder, therefore, if somewhere deep in the bowels of the Department of Health lurks someone with a secret agenda to destroy the NHS by stealth through one cynical, self-serving and destructive ‘reform’ after another.
At the weekend, it was reported that certain members of the new NHS commissioning groups, which will design and commission health services in England and come into operation this week, have a financial stake in private companies or organisations which can then bid for lucrative contracts with the NHS.
More than one-third of the GPs who sit on these bodies, along with many practice managers, have a stake in such firms. In one case, a clinical commissioning group awarded a deal worth £150,000 to a company created by the group’s chairman.
It beggars belief that the Government has introduced this travesty into the NHS in the guise of a reform. For in any other walk of life, such an institutionalised conflict of interest would be called by its proper name — corruption.
You just cannot have a situation where people running an organisation stand to rake in personal profit from contracts awarded by that organisation.
And what a honey-pot this is. For these commissioning groups will control an annual budget of no less than £65 billion.
The groups claim there are no conflicts of interest because board members will not take part in any decisions related to their companies. This is, to put it mildly, disingenuous. The fact such a board member may notionally leave the room when a contract award is decided does not alter the fact that he will still make a personal profit from a decision taken by his own board.
The very idea of health service staff financially profiting from commercial NHS decisions is not just a cause for concern because it is potentially corrupt. It is in itself deeply repugnant.
For it strikes at the very heart of what the NHS is supposed to be all about. Paid for out of general taxation to deliver health care equally to all, the NHS is emphatically not about making a profit. It is a public service, and its staff — from the highest administrator to doctors and nurses and the lowliest porter — are all public servants. As a result, they are not supposed to profit financially from the service other than to draw a salary.
Making any kind of profit on the side is in effect to siphon off public money into their own pockets.
Whatever happened to altruism? For disinterested public service, in which private self-interest is nowhere and the public interest is all, is the fundamental principle upon which the NHS is founded.
But in truth this principle has been foundering now for many years.
The root cause is the never-ending attempt to remedy the massive problems of the NHS without honestly acknowledging that these are fundamental — and fatal.
Instead of admitting that the NHS could no longer bear the burdens being placed upon it, previous governments introduced an ‘internal market’ to open it up to a measure of competition and thus make it run more efficiently.
Accordingly, this new round of reforms is intended to allow companies, charities and other health providers to bid for contracts.
But this attempt to graft the market onto public service was always doomed to fall heavily between two stools by not delivering the one while undermining the other.
Indeed, the market has already destroyed another basic NHS principle: that politicians are accountable for its performance.
It introduced arm’s-length administration — of which commissioning boards are but the latest example — on the specious grounds of loosening top-down controls and making the service more responsive to patients.
In fact, this was a wonderful way for politicians to wash their hands of responsibility for the NHS as it staggered from disaster to disaster — calamities created in large measure precisely because the buck seemed to stop nowhere.
For example, the NHS watchdog, the Care Quality Commission, has been worse than useless; according to one of its non-executive directors Kay Sheldon, it has been declaring hospitals with high mortality rates to be safe for fear of rocking the boat.
When the balloon eventually did go up in the scandal of widespread abuses at the Mid Staffordshire Trust, almost no one was fired as everyone passed the parcel of responsibility around in ever-widening circles.
And the man at whom the buck should have stopped, the shameless NHS chief executive Sir David Nicholson, is even now still in his post — ready to preside over the next catastrophe.
There is systematic neglect of and cruelty towards elderly or otherwise particularly vulnerable patients. Horrified staff who tried to blow the whistle on what was going on were gagged. And now NHS staff are using taxpayers’ money to feather their own nests.
If altruism and accountability have disappeared from the NHS, what then is the point of it?
What, indeed, can possibly justify the holier-than-thou opposition to private health care, on the basis that this introduces antisocial profiteering into a system which embodies the disinterested ideal of public service, when the Government is now enabling NHS staff themselves to make a fast buck from the taxpayer?
The brutal fact which successive governments have refused to acknowledge is that far from serving as the sole possible guardian of altruism in health care, the NHS has for years been destroying it.
For at the very core of the NHS sits not altruism but self-interest, since the service is controlled by politicians whose ultimate aim is not to preserve people’s health but to get re-elected.
While private health care and social insurance systems — to which the NHS is supposedly morally superior — are directly accountable to the patients who pay for them or select insurance plans to suit them, in the NHS staff instead look upwards to their political paymasters.
As a result, NHS patients have next to zero leverage over the care they receive — which is why so many staff have got away with acts of unspeakable callousness and worse towards those patients who are particularly helpless.
For sure, there have always been and still remain many NHS staff who are motivated by the highest ethical principles, believing as they do in the ideal of health care available to all free at the point of use.
But that ideal is amply fulfilled by social insurance systems, where everyone pays towards a health service provider — the system used in many European countries, where the standard of basic care is vastly superior to the NHS.
In the NHS itself, altruism is being steadily beaten out of its staff by the toxic cocktail of inappropriate managerial remedies for insatiable public demand, the erosion of the ethic of disinterested care within both nursing and medicine, and top-down power without responsibility, of which the latest egregious example is the commissioning groups’ distasteful money-making cottage industry.
Time, surely, to put this sacred cow out of its misery at last.
Return of the one-off junior High school exam ‘is unfair to girls’ as they are better suited to modular assessment
So British girls cheat more than boys?
A return to final GCSE exams will discriminate against girls, teachers warned yesterday. They said girls are better suited to ‘modular’ assessment, involving coursework, because they are less confident when sitting exams.
Education Secretary Michael Gove last month confirmed a move to end-of-course tests to cut down on retakes and drive up standards.
But there is concern this could favour boys’ ability to learn and cause girls’ performance to drop.
Since GCSEs were introduced in the late 1980s, girls have consistently outperformed boys. In 2012 boys gained C grades or higher in only 65.4 per cent of papers, compared with 73.3 per cent for girls.
The Association of Teachers and Lecturers’ annual conference yesterday heard the reforms could have a ‘considerable’ impact on girls.
Geoff Venn, a former chief examiner in chemistry, said: ‘If we go back … to pure single exam at the end of the course, will this have a considerable gender impact on the results that we get?
‘Is it going to be discriminatory against girls? I have a strong feeling that it will be.’
He added that girls’ academic improvement since GCSEs were introduced is ‘going to be lost’.
The Department for Education said there was ‘no clear evidence that girls struggle with end of year exams’.
Sausages ARE safe after all: Relax about the recent scare – unless you’ve eaten one banger a day for your whole life!
Another comment on the Rohrmann rubbish
Can eating just half a pork sausage – or a ham sandwich – a day really trigger an early death? That was the warning from experts earlier this month – that processed meat is a major factor in developing two of Britain’s biggest killers, heart disease and cancer.
Eating more than 20g a day increases the risk of dying young from these diseases, according to the results of a European study.
Study leader Prof Sabine Rohrmann, from Switzerland’s University of Zurich, said: ‘We estimate three per cent of premature deaths each year could be prevented if people ate less than 20g of processed meat per day.’
To put this into perspective, one Tesco Finest British Pork Sausage weighs about 75g, and a rasher of back bacon is about 35g.
So your average fried breakfast would send you spiralling over the limit and towards an early grave, if you believe the headlines.
The main focus was meat that has been preserved or had something added to extend its shelf-life. Bacon, corned beef, sausages, salami, doner kebabs and meat pies count as processed.
Scientists quizzed nearly half a million people, including the British, for more than a decade about their eating habits.
The results initially appear pretty damning about the health dangers of processed meat. But what do our experts think?
Professor Tom Sanders, head of nutrition and dietetics at London’s King’s College, says we shouldn’t rush to bin our bangers just yet.
The scientist points out that this study does not calculate actual deaths in Britain from processed meat. Instead, it estimates the likely chance of dying from cardiovascular disease if you eat these foods.
Its main finding is that anyone who eats a lot of processed meat (160g plus – the equivalent of two-and-a-half sausages) every day – is 72 per cent more likely to die from heart disease than someone who eats a moderate amount (less than 20g). But eating it in moderation doesn’t pose a great health risk.
Processed meat cannot be singled out in this study as the only trigger for stroke and heart attack deaths, says Prof Sanders. Other factors such as smoking, diet and lack of exercise could be equally to blame. The people quizzed for this study in ten countries included smokers.
‘Smoking is such a potent factor,’ he says. ‘Those most likely to smoke ate the most processed meat and less fruit and vegetables. People who eat a lot of fatty, processed meat also have a lot of unhealthy behaviour, eating chips and drinking sugary drinks. The message should be to look at your overall diet, not just if you have the odd bacon butty.’
Just one in eight Britons on sickness benefit is truly too ill to work: Almost a million drop benefits claim to avoid new test
Just one in eight people claiming sickness benefits has been found to be too ill to do any sort of job, it has emerged.
And almost 900,000 have dropped their claim to the taxpayer-funded benefits rather than undergo a new medical test as part of the Coalition welfare reforms.
Official figures released yesterday ahead of a string of changes to the tax and benefit system suggested the Government’s strategy is already having a dramatic effect.
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Only 232,000 – one in eight of those tested so far – have been deemed by doctors to be too unwell to do any sort of work.
Another 837,000 who did take the test were found to be fit to work immediately, and a further 367,300 were judged able to do some level of work.
Some 30 people were claiming they were unfit to work because of blisters, while 60 cited acne and 2,110 said ‘sprains and strains’ rendered them unfit for employment.
The figures showed that 878,300 people – around a third of the 2.6million who were claiming incapacity benefit – have chosen to drop their claims rather than face a medical. A Department for Work and Pensions document said 1.44million Incapacity Benefit reassessments have so far been carried out by doctors.
Ministers say they are evidence of a ‘wasted generation’ of people who went on to benefits under Labour, and were never given any incentive or support to get back into work.
A series of controversial reforms to the benefits system comes into force this week.
These include an end to housing benefit subsidies for people in taxpayer-funded housing with spare rooms, an overall benefits cap limiting household claims to no more than £26,000 a year to match average salaries and a new personal independence payment to focus disability benefits on the worst off.
Working-age benefits and tax credits will rise by just 1 per cent from the start of the tax year on April 6 – the start of a three-year cap that represents a real-terms cut.
Conservative chairman Grant Shapps said the system of welfare dependency created by Labour was ‘evil’ and accused the party of using sickness benefits to ‘hide the unemployed’. He said Iain Duncan Smith’s new universal credit, which is to replace all the main out-of-work benefits, would ensure people are always better off if they take a job or increase their hours rather than continuing to depend on the state.
He told Sky News: ‘These are very big reforms – in fact the biggest since the war.
‘I think it’s really important we do have a system where people are supported into work, and where when somebody works, they always know they’re going to be better off than someone on benefits. That’s what this incredibly large reform, the universal credit, will achieve.
He added: ‘I think it’s completely unfair when people can’t work out whether they’d be better off or worse off if they work more than 16 hours or 24 hours or 30 hours, the various different limits which were in place with different benefits.
‘What we want is a system where people just know they will be better off if they’re working. And that’s what the universal credit will deliver.’ Mr Shapps said the welfare system had become ‘literally cruel, even evil to people’.
He added: ‘Nearly a million people have come off incapacity benefit before going for the test. They’ve taken themselves off. My big argument here is this is not these people were trying to play the system, as much as these people were forced into a system that played them.’
A coalition of churches, however, accused the Government of perpetuating myths about poverty in an attempt to justify welfare cuts.
In a joint report, the Baptist Union of Great Britain, the Methodist church, the United Reformed church and the Church of Scotland said that the ‘systematic misrepresentation of the poorest in society’ was a matter of injustice. Economic Secretary Sajid Javid last night wrote to Shadow Chancellor Ed Balls ahead of this week’s changes asking him to say whether Labour – which has opposed every significant spending cut – would reverse them if elected.
Mr Javid insisted the Government was ‘reforming the tax and benefit system so that it works for hardworking people’.
The letter added: ‘But since you became Shadow Chancellor, Labour have opposed every single saving we are making to live within our means. Your only economic policy is more borrowing, more debt – more of how you got us into this mess in the first place.
‘And yet your opposition so far has not included any firm commitment as to whether you would actually reverse any of this Government’s decisions after the next election.’
Mr Javid asked whether Labour would reverse a string of measures that have a combined saving of £5billion a year for taxpayers.