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The reality of the NHS is very different to that presented at the Olympic ceremony

The numbers dying under the state healthcare provider belies its image

By on Wednesday, 1 August 2012

London Olympics open

Having blogged about the lack of a Christian context to Danny Boyle’s extravaganza that opened the London Olympics, I was interested to note that his idiosyncratic scene of NHS nurses in starched caps and uniforms dancing around hospital beds also received some guarded criticism. As one reviewer noted, in the NHS today, sick people try to avoid hospital because of the danger of superbugs they might pick up there, and frail elderly people fear hospital in case they might die of neglect.

I blogged recently about the Liverpool Care Pathway (LCP). Subsequently there has been a report in the Daily Telegraph headed “Cards help patients opt out of “death pathway”. We learn that Alert, an anti-euthanasia charity, is handing out cards to terminally ill patients, to ensure that they have the choice to opt out of being put on the LCP if they wish. These cards operate like an organ donor card, giving seriously ill people some control of their future circumstances in advance of a crisis.

It is estimated that almost a third of hospital deaths are now associated with the LCP and its critics say it is becoming the routine NHS way of ensuring that the dying process is discreetly speeded up. Patients placed on it are put under heavy sedation; food and fluids are withdrawn. Members of the public have often cited its abuse in the case of sick relatives. It is widely perceived as being employed for economic reasons –to free up hospital beds occupied by elderly “bed blockers” –rather than for reasons of good medical practice. The wording on the cards produced by Alert states: “Please do not give me the Liverpool Care Pathway treatment without my informed consent or that of a relative.” Like advance directives, which give patients the right to refuse treatment under the Mental Capacity Act of 2005, the cards give those using them the right to question the LCP “treatment”.

Among those who have requested a card is Leslie Burke, aged 52, who suffers from cerebellar ataxia, a degenerative disease. He says, “All I want is to live my life from end to end and not have it ended prematurely under any circumstances.” We hear so much of well-publicised cases requesting the opposite, the right to die, that it is important to be reminded that many very sick people do not regard their lives as burdensome and dread the thought that men in white coats (or nurses in starched uniforms) might decide otherwise.

The practice of “palliative sedation” as it is sometimes called, is also being queried in Holland, where 12 per cent of deaths are accounted for in this way. The Royal Dutch Medical Association issued guidelines in 2005, insisting that “palliative sedation” was not a form of “slow euthanasia”, but simply normal medical practice, put in place in the last two weeks of life, combined with withdrawal of nutrition and hydration, to induce deep unconsciousness. But three Dutch authors of an article in the Journal of Medical Ethics have raised serious issues: how can doctors be sure that life expectancy is merely two weeks? They point out that “normal medical practice” should mean alleviating suffering, not deliberately ending life. Further, because palliative sedation is not considered a form of euthanasia, a doctor deciding to employ it does not need to consult with a colleague.

We might want to cling fondly to Danny Boyle’s romantic image of the NHS and forget that the reality, especially for those in hospital who are very sick or very old, is rather different.

  • Jennydot

    Danny Boyle’s point was it is under attack from Tory cuts and needs to be protected. More people die in America because they can not get access to any healthcare due to insurance costs.
    This Tory government has policies that are killing the sick, the diasbled and poor, the elderly too are underthreat. My own Grandmother who had never been ill in her life, died because she was seen as old, therefore they weren’t interested when she developed a heart condition aged 90…cuts to the health service and low morale is making people less caring. I have yet to see too many comments here about atos which is declaring thousands of seriously ill people fit for work, taking away their benefits, harassing them to death. Right now anyone that is sick, disabled, elderly or mentally ill knows that this government would rather we die, then live because we cost the country too much.

  • Philip

    On the contrary, spending on health in the last decade or so has doubled after inflation. Despite that, productivity has actually declined and our record for mortality amenable to health care ranks amongst Mexico, Turkey etc. I am not sure why the reference to the US. There, government spending on health has almost reached UK levels. A better comparison if you want to see private systems at work less distorted by government intervention than in the US would be Switzerland. But, more to the point, nobody in Europe copies our government financed, government owned, government controlled, government planned model. And the results of them not doing so are rather beneficial. In Germany about two thirds of hospitals are private. Of course, the great irony is that Great Ormond Street was founded over a century before the NHS was founded (as were all our great hospitals).

  • Judithjmidwinter

    ZZZzzzz……….

  • BTyler

    Then don’t read it?

  • AliB

    Please try and get a few facts right. USA spending is nearly twice that of UK as % of GDP, AND large numbers of the population get no health care as they cannot afford the insurnace. Large numbers also go bankrupt due to health care costs. Germany also spends more than we do. The NHS, is the most cost effective way of delivering a comprehensive service. IF Governments, and most especially this last disaster stopped reorganising the NHS and let it get on with delivering care it would be a ot better.   As for the Liverpool Care Pathway – it would be helpful if the Catholic Herald would try and understand that it is not in most people’s interest to have invasive interventions that fail to keep someone well, even if they might keep them breathing in thier dying bed for a few days longer. Stop scaremongering. You seem only too happy for doctors to play God as long as it is keeping people alive at any cost. Given that you believe in heaven why are you so keen to actively prevent a natural death?

  • Jonathan West

    The hospital superbug scandal was largely a confection of the media. I suggest you read Ben Goldacre’s book Bad Science to learn what was actually going on (you’ll also learn some fascinating things about the MMR hullabaloo). If old people try to avoid hospital for fear of superbug infections, then it is in all probability largely because of the misleading stories they have read in the media.

  • Philip

    I have the facts right. I said that GOVERNMENT spending on health in the US is nearly as high as in Britain. My point was that this is not a private health system with which we can compare our nationalised system. The US system is an incredibly badly designed and regulated mixed system.

  • botera

    I agree, it’s not perfect but try living in countries without healthcare.

    I don’t believe Boyle and Cottrell -Boyce would argue that the NHS was perfect, which probably explains the 1940s/50s uniforms of the NHS nurses : in its original, Beveridge form it was truly inspiring.Yes, not perfect today, but preferable to nothing, which is where libertarian conservatives want to take us.

  • Saul

    Patients are not routinely put on heavy sedation or needed, the LCP does not withdraw food and fluids, in fact it does the opposite …

  • Jonathan West

    Little more than a week ago, you wrote an encomium on Dame Cecily Saunders, the founder of the hospice movement. 

    http://www.catholicherald.co.uk/commentandblogs/2012/07/23/real-dignity-in-dying-has-nothing-to-do-with-euthanasia/

    If you had taken the trouble to read about it, you would have found that the Liverpool Care Pathway is an extension of the principles and practices of hospice care to those whose lives are nearing their end but are not in hospices. If you would care to educate yourself, try following this linkhttp://www.liv.ac.uk/mcpcil/liverpool-care-pathway/ 

  • Philips

    This article is a travesty of the truth. As a practicing catholic who was for many years a senior clinician, I am horrified at this article. It does not properly characterise the LCP but gives into scare mongering and polemic. The LCP is about giving dignity to those who are dying…a very catholic approach I would suggest !

  • Jonathan West

    That second link seems not to have worked It should have been as follows

    http://www.liv.ac.uk/mcpcil/liverpool-care-pathway/ 

  • jpct50

    The U.S. has the best healthcare in the world, bar none.  It is the looming Obama Care, based on the European model, that has us worried.  We are inundated with Canadians who come here to get procedures, that require years to get in socialist Canada.  No one is denied healthcare in the United States, not even those who live here illegally.  God forbid we should ever end up with something like the NHS. May God forbid it!

  • JabbaPapa

    dignity to those who are dying” !!!!!

    Dignity requires both awareness and truth.

    And respect and deference.

    And honesty and strength.

    Not tranquilisers and dehumanisation.

    The Catholic approach = thou shalt not kill.

  • paulsays

    Phillip how exactly as the US healthcare system been ‘distorted’  by government intervention?

    The US healthcare system is as unregulated and free-market as could be devised. Why do I get the feeling that you have no idea about the actual workings of the US healthcare ‘system’, and simply are guessing that it must be highly regulated – because of its immense failings?

    You can’t base your arguments on assumed facts Phillip.

  • paulsays

    You are wrong on so many counts I don’t think I have the patience to try and show you otherwise.

    Why not you wean yourself off Fox News, and then come back here for an adult discussion?

  • paulsays

    good on you

  • paulsays

    Libertarians ideas are so devoid of morality, I honestly can’t wait for people like Ron Paul to retire. There messages are so dangerous, and so very very immoral and unchristian.

    Both scary and sickening. 

    I hope Obama has at least got the ball rolling on a Christian solution to healthcare.

  • Jpct50

    Perhaps because patience is a virtue.

  • JabbaPapa

    I hope Obama has at least got the ball rolling on a Christian solution to healthcare.

    A Christian solution to healthcare does not involve promoting abortion and contraception, nor destroying the institution of marriage (the family being the primary locus where proper care will be received).

  • paulsays

    It is Christian to cover people for healthcare, rather then to let people die.

    Contraception and abortion obviously are not supported by many Christians as being covered, but at least things are rolling towards a system where people are not left without help.

    Obama’s health bill has nothing in it to do with the family, or ‘destroying’ it. No, because of proper healthcare, families are much more likely to be stable.

    Obama’s personal support of gay marriage is a different issue. If you want to debate that then we can, but it is a separate issue from healthcare.

  • Guest

    In reply to Paulsays

    The US federal government’s laws and taxation have greatly detrimentally affected medical outcomes in the United States.

    Federal government spending on health care in 2011 was $1,100 billion, or 7% of GDP.  (You can serach for statiscits to break it down by program.)  To put it in perspective this is more money spent on military, education, or highways and trade.

    This does not include the cash flow from states and local government to pay for health care.

    On top of that is the perverted system established and enforced by bizarre taxation policies which make health insurance obtained through your employer substantially more affordable than those obtained privately.

    And to top it off Obamacare is going to make it even worse.

    Books and tombs have been written describing the distortions of federal government intervention into US medical care.  It would be nice if not every comment discussion on very important policies around the world turn back to this election year bickering about US domestic issues.  Great Britain has its own very important domestic issues.

    But it is very unfair to spout off half truths, paulsays, and then accuse another commentor of basing arguments not on facts, when it is common knowledge that what Phillip says is true, and a quick amazon search can show hundreds of books written on the subject.

    My apologies to all the British readers for whom I regret using your time if you’ve read this aside.

  • Neilcooper

    For a publication that accuses the Gates Foundation of spreading ‘disinformation’ it seems somewhat hypocrytical that the author doesn’t just spread disinformation about end of life care in the UK but also, demonstrates very poor journalism and maybe in some well intentioned attempt to protect the vulnerable is actually creating an environment of fear for those who need care.  

    If people are being Euthanased in the numbers that are suggested do you not think that this criminal and morrally repugnant act would have been investigated.

    The truth is that the people who believe what they read in rags such as the Catholic Herlad and the Daily Mail are scare mongering and creating fear for our most vulnerable people at the end of life.

    There seems a lack of Christian love in some of the bile I read about on this subject, a love so often shown by non Catholics/Christians in the compassionate care they give to people who are dying. That is care by the way, not Euthanasia, by the back door or any other misinformed way.
    Shame on you and this publication… you bring Christ into disrepute!

  • x nurse

    it is clear to me that one of the culprits for this superbug is the liverpool  pathway they leave them to die lying in soiled beds, they say so that they do not cause the patient any distress what they mean its the easy way out when short staffed which is always, the nhs is going backwards not forward with the easy way out cost saving cruelty.

  • observer

    to saul, you either must be blind or you dont take the trouble to read the news, two professors, six top docters who work in hostpitals not down the coalmen, who condemn this starvation pathway, to do this to an healthy person it will kill them in 33hrs read the news and it will help you to talk sense hippocrit.

  • watchman

    to philips, i doubt it very much you are a catholic, how can two catholic professors and six top doctors be wrong against just you,     did you say you were a senior toilet cleaner. the LCP means sending whoever to an early grave, to stop bed blocking, less work, and save resources, in other words murder by the back door.

  • Mr75
  • Peter

     So what?  Why is her opinion of any greater import than anyone elses?  Guilty as she approaches her own death?  Or just seeking some attention? 

  • Shierly

    Typical defence of a bully = blame the victim..accuse those who see what you are of ‘not understanding the issue’.  The stark truth is that some of the victims families have been solicitors, doctors, pharmacologists, scientists, and the number who have got to know each other has now formed a critical mass….the scheme has been rumbled, I’m afraid.
    The appalling thing is that many of the ‘consultants’ at the top of the LCP are not actually  medically qualified….they are these new ‘consultant nurses’…the ones who have a paper certificate and job title that makes them feel important….that’ s one of the reasons its SO FLAWED-a bright 4th former could have done a better job !

  • Pogue222

    Jenny do you know the actual diagnosis. Maybe there was really nil to be done medically. So old people do not receive medical care. I beg to differ! Blood transfusions,endless investigations the list is endless! Age is no barrier?

  • watchman

    paul do you never read or can you not it sounds like your an implementer of the lcp at the moment there are talks of its abolishment because of the supposed to have been dying but when taken off the lcp they still are living i smell a rat.a money saving rat shares in morphine   have gone through the roof its the thing to invest your cash into the morphine industry.