Part 2

Yes it is.
Noble’s Hospital is registered to use the Liverpool Care Pathway and has been since September 2006 at the latest.  I was not able to ascertain the exact date.  Marie Curie’s database only goes back to 2004 and they only undertake audits bi-annually.  Noble’s Hospital sent information for inclusion in the 2006/07 audit which would have been based, I believe, on the quarter ended 31 December 2006.
Whilst it is called an audit I am not sure if it fits the definition of an audit.  Collated information would be more appropriate, in my opinion, as participating hospitals send information to the UK.  There is no obligation to do this and no local “audit” is undertaken.
I spoke with Marie Curie’s National Lead Nurse for the Liverpool Care Pathway the day the above article was published.  She confirmed that it had initially been developed for the care of terminally ill patients with intention of making death “as positive an experience as possible” for both the patient and their family.  It had been so successful with patients suffering terminal cancer that other hospitals had asked if they could use it.  She was also aware that not all hospitals had the same high standards as Marie Curie.  She explained that, like any tool, it was only as good as those using it and it demanded continuous training, assessment and monitoring. 
She went to say that it had expanded and now anyone with an incurable condition could be “eligible” for the Pathway.  Dementia, among others, is an incurable condition and she confirmed that a dementia sufferer is “eligible” for the Liverpool Care Pathway. 

I can understand the argument for using this for patients with a terminal illness but I think to include incurable conditions is going too far.
I am not saying that Noble’s Hospital is one of the hospitals that is using the Liverpool Care Pathway inappropriately, though three of the responses would indicate that this is the case, but I do feel that the general public should be aware of the situation.
However, I am saying that there are questions that should be asked.
•    Is it right to use it for patients with incurable conditions?
•    Who decided that Noble’s Hospital should use the Liverpool Care Pathway?
•    When did Noble’s Hospital start using the Liverpool Care Pathway?
•    Who is responsible for ensuring that it is used appropriately?
•    Who is responsible for the continued training, monitoring and assessment?
•    How many patients have been put on the Liverpool Care Pathway in each of the years since it started to be used?
•    How many times has that decision been reversed?

These, and many more questions, need to be asked.

It is reported that in 2007-08 16.5 per cent of deaths in Britain came about after continuous deep sedation, according to researchers at St Barts and the London School of Medicine and Dentistry, twice as many as in Belgium and the Netherlands.  This raises another question:
•    How many patients have died while receiving continuous deep sedation in each of the years since Noble’s Hospital started to use the Liverpool Care Pathway and what percentage of total deaths does that represent?

At the end of this article there is the link to Marie Curie which explains how the Liverpool Care Pathway should be used and links to just a few more of the articles that I have found about how the Liverpool Care Pathway  is actually being used.  Please take the time to read at least some of these.  Links do change sometimes as articles are moved or archived and if you are unable to access any and would like a copy please let me know as I have printed most of them.

This started out as a personal issue but because of the seriousness of this situation it has now been brought to the attention of the Liberal Vannin executive.  The executive have requested the Party Leader, Peter Karran MHK, to raise this issue with the Minister.  Peter Karran stated, “I have been a member of Tynwald since 1985, and a former member for Health, and I am unaware of any political decision to take such actions which are actually worse than euthanasia.  At least with euthanasia people are consulted on the actions that are to be taken.  This once again an example of where the Council of Ministers and the present political system is allowing public officials with no political mandate to make such serious decisions and changes to policy that affect such a vulnerable section of our society.”


This affects us all.  We all have elderly friends or relatives and we all, God willing, will be old one day.



Kate Beecroft
Party Chairman
Troutbeck
Strang Road
Union Mills
IM4 4NP
853352
kate@troutbeck.net