Patients killed to meet targets by GlynnePowell


Patients killed to meet targets

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A senior cancer specialist today condemned the controversial Liverpool
Care Pathway as a corrupt and scandalous system used to free hospital
beds of the old and sick.
Professor Mark Glaser said the Pathway – in use across the NHS as a
way to ease the suffering of the dying – is employed by Health Service
managers to clear bed space and to achieve targets that bring more
money to their hospitals.
The professor, who treated former Labour Cabinet minister Mo Mowlam
during her last illness, said practices in British hospitals are „morally bad
medicine‟ and that he would personally „never be treated in a hospital in
                                    „I would go to America because I don‟t trust
                                    anybody,‟ he said.
                                    He added that he has removed „dozens‟ of his
                                    own patients from the Liverpool Care Pathway.
                                    The intervention by Professor Glaser, consultant
                                    oncologist at Imperial College Healthcare NHS
                                    Trust, comes at a time of growing concern over
                                    the Liverpool Care Pathway.
A centrepiece of the NHS programme for „end-of-life care‟, it involves
removing life-saving treatment from patients considered to be dying.
Commonly, patients are heavily sedated and tubes providing nutrition and
fluid are removed. Typically a patient dies 29 hours after being put on the
But families have complained that loved ones have been put on the
Pathway when they were not dying and senior medical figures have
said it is impossible to predict when a patient will die.
Leading doctors opposed to the Pathway have said it hastens death and
that putting a patient on it is a „self-fulfilling prophecy‟.

Hospitals receive millions in bonus payments in return for hitting
targets for numbers of patients put on the Liverpool Care Pathway.
At the weekend Health Secretary Jeremy Hunt promised to reassure patients by
making it a legal requirement for doctors to inform families when a patient goes on
the Pathway, and to obtain their consent. He is expected to announce changes to
the rules today.
But Professor Glaser said it was not enough. The 67-year-old consultant, who is in
charge of radiotherapy at Charing Cross Hospital, in West London, said: „I would like
to see a whole inquiry set up to look at patients with incurable diseases, and how
patients can be managed within a time limit from the beginning of their pathway to
really good pain control and symptom control at the end of the pathway.
„You can‟t be just guided by admission rates
and targets.‟ He added: „There is nothing
more intransigent and corrupt at the moment
in medical practices as the hospice Liverpool
Pathway movement.
„It‟s not really active or passive euthanasia,
it‟s negligence. But it is right that all the
managers want the bed space and they will
take down drips weeks earlier to get people
out. That is a scandal.‟
Describing the way he believes staff operate
to put patients on the Pathway, he said: „The
average example is some poor person whose
family is absolutely miserable and a nurse
comes in, or a very abrupt palliative care
doctor, and says they‟re going on the
Liverpool Pathway.
„And then you get the treating doctor, such as
myself, rung up by the wife or the daughter in
tears, saying, “Oh no, we didn‟t want this, we
were baffled, we didn‟t want to do it, we were
He said he has protested on behalf of such
families and has removed dozens of patients
from the LCP and put them back on normal
He added: „Symptom control is right but taking drips from people, actually putting
them on the care pathway, is morally bad medicine.‟
Another leading critic is Professor Patrick Pullicino, a consultant at hospitals in Kent,
who has warned of hospitals using the Pathway to free beds and get rid of difficult
patients. He has also expressed concern at the use of targets and financial
incentives for hospitals.
An inquiry into the LCP was started last week by the Department of Health‟s End of
Life Care Programme, which has been funded with nearly £300million since it was
launched in 2008, and which recommends use of the Pathway.
A number of medical associations involved in end-of-life care, including the
Association of Palliative Medicine, which represents hospice and specialist hospital
doctors, will also take part.
However critics have called for an independent inquiry because the organisations
running the inquiry are the same bodies which have been promoting its use in the

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