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 England’.
Accusing: Oncologist Professor Mark Glaser says NHS managers use the Care Pathway to clear bed space and to achieve targets‘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 pathway.
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’.
Case and point: Rustie Lee refused permission to allow a Birmingham hospital to put her mother Euginee Edwards on the Liverpool Care Pathway and six days later she was discharged from hospital
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.
Reassuring: Health Secretary Jeremy Hunt is expected to announce new rules making it a legal requirement to inform families‘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 bullied”.’
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 care.
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 NHS.