The Far-Right Conspiracy against the NHS

[Craig Lamson]

What a strange disagreable chap you are Craig. You may be interested in the following (but I doubt it):

http://www.carenotkilling.org.uk/?show=842

Liverpool Care Pathway

TERMINALLY ILL PATIENTS ARE RECEIVING GOOD CARE, SAYS NATIONAL AUDIT

An audit of Care of the Dying covering nearly 4,000 terminally ill patients in over 150 hospitals in England has concluded that use of the Liverpool Care Pathway (LCP) is resulting in high quality care for those who are in the very last hours and days of life. The audit, which was conducted by the Marie Curie Palliative Care Institute Liverpool in collaboration with the Clinical Standards Department of the Royal College of Physicians and the results of which were made public yesterday, underlines the value of the LCP in providing a framework for decision-making by doctors treating imminently dying patients.

The audit does not support criticisms of the LCP that have appeared recently in the media – namely, that patients who are managed in accordance with the Pathway's guidelines are being heavily sedated until they die or that the LCP is promoting a 'tick box' approach in which doctors sometimes fail to spot where patients show signs of recovery. The audit reveals that two thirds of the 3,893 patients whose deaths were assessed needed no continuous infusion of medication in the last 24 hours of life to control distress caused by restless or agitation and that, of those who did require such infusions, all but 4% needed only low doses. Unlike practices in other countries, such as the Netherlands where deep continuous sedation until death is administered according to a protocol, palliative care physicians in Britain have the skills to ensure that the overwhelming majority of terminally ill patients are able to die peacefully and without any significant sedation.

Commenting on the Audit, Dr Peter Saunders, Director of Care Not Killing, said: “This audit of LCP practice in some three quarters of hospitals in England is reassuring. It confirms that deep sedation of terminally ill patients is rare in Britain and that recent suggestions of its widespread use under the LCP are unfounded. It also underlines that any trusts prescribing relatively high doses of sedatives regularly to dying patients 'need to review their practice'”. Professor John Ellershaw, Director of the Marie Curie Palliative Care Institute, confirmed this. “The Liverpool Care Pathway”, he said, “does not endorse continuous deep sedation nor, as has been misreported in some places, the removal from dying patients of beneficial medication”.

Commenting on suggestions that doctors following the LCP's guidelines who do not have specialist knowledge of end of life medicine may sometimes fail to recognise signs of a recovery, Dr Saunders said: “Any tool is only as good as the workman who uses it. It is important to remember, however, that clinical decisions in end of life care are not made in isolation and that palliative care hospital support teams are available throughout the country to support other specialities in this work. These teams include physicians who also practice in the local hospice or palliative care unit”. He added: “There is nonetheless a need for continuing education of health care professionals at all levels in all aspects of modern palliative care, including diagnosing correctly that patients are imminently dying and detecting reversible causes of deterioration in patients in advanced illness. The new version of the pathway has addressed past ambiguities in interpretation and has been warmly welcomed by the Patients' Association but we do need to continue close monitoring to ensure that it is being used appropriately.”

Dr Bill Noble, President of the Association for Palliative Medicine, has also commented on recent press reports on the LCP:

“The Liverpool Care Pathway is not a one-way street and, when further deterioration does not occur, it is common practice to take the patient off the Pathway and re-institute previous treatment. The care pathway approach is now commonly used to aid the work of many specialities throughout the health service. It does not replace clinical judgement, but acts as a prompt to assist clinical teams to ensure that every patient gets adequate attention to every aspect of their care. Clinical pathways are useful in auditing practice and developing services. It is possible to misuse any clinical tool, but our experience of working with colleagues in hospitals and the community is that, with adequate training and support, it is used appropriately”.

Wow, imagine that, the group that came up with the program in the first place says it took a look and everything is fine and dandy...imagine that.

Well never mind then, old Andy says, nothing to worry about....

I guess that settles the matter then [/sacrasm}

[Guest]

Wow, imagine that, the group that came up with the program in the first place says it took a look and everything is fine and dandy...imagine that.

I guess that settles the matter then [/sacrasm}

The Royal College of Physicians?? http://www.rcplondon.ac.uk/About-the-colle...ages/about.aspx - or are they the murdering agents of the British State you identified earlier?? (HEAVY sarcasm)

[Craig Lamson]

Now, if you want to talk about causing unneccessary deaths, have a read of the attached.

Hey, I've already stiplated there is a need for some reform in our system, did you miss that? Regarding the study, I've seen the down and dirty of this work and what they don't really tell you is if these 45,000 were served by the free clinics, declined to purchase their own insurance, were elgigable for Medicare or Schip or simply had zero accress to heathcare (* which is impossible becaise no one can be denied care t hospital emergency rooms)

Edited September 28, 2009 by Craig Lamson

[Craig Lamson]

Now, if you want to talk about causing unneccessary deaths, have a read of the attached.

Yes they seem to like to cull a proportion of the poor every year in the US. Perhaps it's more manly and ruggedly individualistic that way?? - I chose the 'weak and offensive' Welfare State any day.

Sheesh Andy, are you really this stupid? The POOR get free care in the US.

[Guest]

Now, if you want to talk about causing unneccessary deaths, have a read of the attached.

Yes they seem to like to cull a proportion of the poor every year in the US. Perhaps it's more manly and ruggedly individualistic that way?? - I chose the 'weak and offensive' Welfare State any day.

Sheesh Andy, are you really this stupid? The POOR get free care in the US.

http://news.bbc.co.uk/1/hi/world/americas/8199401.stm

[Craig Lamson]

Wow, imagine that, the group that came up with the program in the first place says it took a look and everything is fine and dandy...imagine that.

I guess that settles the matter then [/sacrasm}

The Royal College of Physicians?? http://www.rcplondon.ac.uk/About-the-colle...ages/about.aspx - or are they the murdering agents of the British State you identified earlier?? (HEAVY sarcasm)

I guess you really ARE that stupid....

"The audit, which was conducted by the Marie Curie Palliative Care Institute Liverpool...."

Who came up with this scheme? Oh yea....the Marie Curie Palliative Care Institute. Sheesh.

[Guest]

Wow, imagine that, the group that came up with the program in the first place says it took a look and everything is fine and dandy...imagine that.

I guess that settles the matter then [/sacrasm}

The Royal College of Physicians?? http://www.rcplondon.ac.uk/About-the-colle...ages/about.aspx - or are they the murdering agents of the British State you identified earlier?? (HEAVY sarcasm)

I guess you really ARE that stupid....

"The audit, which was conducted by the Marie Curie Palliative Care Institute Liverpool...."

Who came up with this scheme? Oh yea....the Marie Curie Palliative Care Institute. Sheesh.

Read it Craig then reply - you'll look less dumb that way

[Guest]

Now, if you want to talk about causing unneccessary deaths, have a read of the attached.

Yes they seem to like to cull a proportion of the poor every year in the US. Perhaps it's more manly and ruggedly individualistic that way?? - I chose the 'weak and offensive' Welfare State any day.

Sheesh Andy, are you really this stupid? The POOR get free care in the US.

According to the Institute of Medicine of the National Academy of Sciences, the United States is the "only wealthy, industrialized nation that does not ensure that all citizens have basic health care provision" (i.e. some kind of insurance). The same Institute of Medicine report notes that "Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States." while a 2009 Harvard study published in the American Journal of Public Health found a much higher figure of more than 44,800 excess deaths annually in the United States due to Americans lacking health insurance. More broadly, the total number of people in the United States, whether insured or uninsured, who die because of lack of medical care were estimated in a 1997 analysis to be nearly 100,000 per year.

'a cull' of the poor??

[Terry Mauro]

Now, if you want to talk about causing unneccessary deaths, have a read of the attached.

You've identified a news article you fool!

[Craig Lamson]

Wow, imagine that, the group that came up with the program in the first place says it took a look and everything is fine and dandy...imagine that.

I guess that settles the matter then [/sacrasm}

The Royal College of Physicians?? http://www.rcplondon.ac.uk/About-the-colle...ages/about.aspx - or are they the murdering agents of the British State you identified earlier?? (HEAVY sarcasm)

I guess you really ARE that stupid....

"The audit, which was conducted by the Marie Curie Palliative Care Institute Liverpool...."

Who came up with this scheme? Oh yea....the Marie Curie Palliative Care Institute. Sheesh.

Read it Craig then reply - you'll look less dumb that way

I read it Andy, it appears it was YOU who did not.

The fox is guarding the henhouse, but hey if that works for you, so be it, it seems to be what makes you happy.

[Craig Lamson]

Now, if you want to talk about causing unneccessary deaths, have a read of the attached.

Yes they seem to like to cull a proportion of the poor every year in the US. Perhaps it's more manly and ruggedly individualistic that way?? - I chose the 'weak and offensive' Welfare State any day.

Sheesh Andy, are you really this stupid? The POOR get free care in the US.

According to the Institute of Medicine of the National Academy of Sciences, the United States is the "only wealthy, industrialized nation that does not ensure that all citizens have basic health care provision" (i.e. some kind of insurance). The same Institute of Medicine report notes that "Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States." while a 2009 Harvard study published in the American Journal of Public Health found a much higher figure of more than 44,800 excess deaths annually in the United States due to Americans lacking health insurance. More broadly, the total number of people in the United States, whether insured or uninsured, who die because of lack of medical care were estimated in a 1997 analysis to be nearly 100,000 per year.

'a cull' of the poor??

I know you can't read Andy you prove that everytime you post.

No we don't "assure that all citizens have basic health care". Your false assumption is that those who don't have healthcare insurance are poor.

We provide FREE healthcare to the poor via Medicade, poor children via the SCHIP program, and via emergency room visits whcih cannot be denied to anyone regardless of lack of money or insurance. We provide free medical care to pregnant women if they lack insurance. WE also have a large network of free or low cost medicalk clinics. Big Pharma offers free or low cost medication to the poor.

It might suprise you that many of those without health insurace can afford it, they just CHOOSE not to purchase.

Now I understand FREEDOM is beyond your ken, being a ward of the state and all.

Choice is a byproduct of freedom. I'll take choice anyday.

[Guest]

Wow, imagine that, the group that came up with the program in the first place says it took a look and everything is fine and dandy...imagine that.

I guess that settles the matter then [/sacrasm}

The Royal College of Physicians?? http://www.rcplondon.ac.uk/About-the-colle...ages/about.aspx - or are they the murdering agents of the British State you identified earlier?? (HEAVY sarcasm)

I guess you really ARE that stupid....

"The audit, which was conducted by the Marie Curie Palliative Care Institute Liverpool...."

Who came up with this scheme? Oh yea....the Marie Curie Palliative Care Institute. Sheesh.

Read it Craig then reply - you'll look less dumb that way

I read it Andy, it appears it was YOU who did not.

The fox is guarding the henhouse, but hey if that works for you, so be it, it seems to be what makes you happy.

'by the Marie Curie Palliative Care Institute Liverpool in collaboration with the Clinical Standards Department of the Royal College of Physicians ' durr .... I wonder why the latter were involved?

[Craig Lamson]

Wow, imagine that, the group that came up with the program in the first place says it took a look and everything is fine and dandy...imagine that.

I guess that settles the matter then [/sacrasm}

The Royal College of Physicians?? http://www.rcplondon.ac.uk/About-the-colle...ages/about.aspx - or are they the murdering agents of the British State you identified earlier?? (HEAVY sarcasm)

I guess you really ARE that stupid....

"The audit, which was conducted by the Marie Curie Palliative Care Institute Liverpool...."

Who came up with this scheme? Oh yea....the Marie Curie Palliative Care Institute. Sheesh.

Read it Craig then reply - you'll look less dumb that way

I read it Andy, it appears it was YOU who did not.

The fox is guarding the henhouse, but hey if that works for you, so be it, it seems to be what makes you happy.

'by the Marie Curie Palliative Care Institute Liverpool in collaboration with the Clinical Standards Department of the Royal College of Physicians ' durr .... I wonder why the latter were involved?

Why? The apperance of "quality" perhaps? Durr....

Clearly this disscussion has reached a point of no return.

I'm gone. I hope you live happily ever after in the bosom of hte state.

[Guest]

Now, if you want to talk about causing unneccessary deaths, have a read of the attached.

Yes they seem to like to cull a proportion of the poor every year in the US. Perhaps it's more manly and ruggedly individualistic that way?? - I chose the 'weak and offensive' Welfare State any day.

Sheesh Andy, are you really this stupid? The POOR get free care in the US.

According to the Institute of Medicine of the National Academy of Sciences, the United States is the "only wealthy, industrialized nation that does not ensure that all citizens have basic health care provision" (i.e. some kind of insurance). The same Institute of Medicine report notes that "Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States." while a 2009 Harvard study published in the American Journal of Public Health found a much higher figure of more than 44,800 excess deaths annually in the United States due to Americans lacking health insurance. More broadly, the total number of people in the United States, whether insured or uninsured, who die because of lack of medical care were estimated in a 1997 analysis to be nearly 100,000 per year.

'a cull' of the poor??

I know you can't read Andy you prove that everytime you post.

No we don't "assure that all citizens have basic health care". Your false assumption is that those who don't have healthcare insurance are poor.

We provide FREE healthcare to the poor via Medicade, poor children via the SCHIP program, and via emergency room visits whcih cannot be denied to anyone regardless of lack of money or insurance. We provide free medical care to pregnant women if they lack insurance. WE also have a large network of free or low cost medicalk clinics. Big Pharma offers free or low cost medication to the poor.

It might suprise you that many of those without health insurace can afford it, they just CHOOSE not to purchase.

Now I understand FREEDOM is beyond your ken, being a ward of the state and all.

Choice is a byproduct of freedom. I'll take choice anyday.

You are now apparently arguing that your fellow citizens are exercising their all american right to choose to die young rather than being unable to afford health insurance. Your commitment to Big Pharma and their massive profits is touching and consistent. I assume you have shares?

I assume you meant 'Medicaid' the serious shortcomings of which are well documented??

With further and wider reading I am sure that your spelling will gradually improve.

[Craig Lamson]

Now, if you want to talk about causing unneccessary deaths, have a read of the attached.

Yes they seem to like to cull a proportion of the poor every year in the US. Perhaps it's more manly and ruggedly individualistic that way?? - I chose the 'weak and offensive' Welfare State any day.

Sheesh Andy, are you really this stupid? The POOR get free care in the US.

According to the Institute of Medicine of the National Academy of Sciences, the United States is the "only wealthy, industrialized nation that does not ensure that all citizens have basic health care provision" (i.e. some kind of insurance). The same Institute of Medicine report notes that "Lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States." while a 2009 Harvard study published in the American Journal of Public Health found a much higher figure of more than 44,800 excess deaths annually in the United States due to Americans lacking health insurance. More broadly, the total number of people in the United States, whether insured or uninsured, who die because of lack of medical care were estimated in a 1997 analysis to be nearly 100,000 per year.

'a cull' of the poor??

I know you can't read Andy you prove that everytime you post.

No we don't "assure that all citizens have basic health care". Your false assumption is that those who don't have healthcare insurance are poor.

We provide FREE healthcare to the poor via Medicade, poor children via the SCHIP program, and via emergency room visits whcih cannot be denied to anyone regardless of lack of money or insurance. We provide free medical care to pregnant women if they lack insurance. WE also have a large network of free or low cost medicalk clinics. Big Pharma offers free or low cost medication to the poor.

It might suprise you that many of those without health insurace can afford it, they just CHOOSE not to purchase.

Now I understand FREEDOM is beyond your ken, being a ward of the state and all.

Choice is a byproduct of freedom. I'll take choice anyday.

You are now apparently arguing that your fellow citizens are exercising their all american right to choose to die young rather than being unable to afford health insurance. Your commitment to Big Pharma and their massive profits is touching and consistent. I assume you have shares?

I assume you meant 'Medicaid' the serious shortcomings of which are well documented??

With further and wider reading I am sure that your spelling will gradually improve.

Actually many are using their freedom to CHOOSE to opt out. You now have a problem with personal freedom? I guess living under the thumb of big government all your life makes freedoom seem a silly option. I can assure you its not. IY should try it sometime.

Currently there are approx 8 million American citizens without health insurance. That number excludes those who can afford insurance but opt out, or qualify for a government program of some sort, along with illegals.. I've no problem finding a way for these people to get help affording coverage until such time they can afford to pay.

Profits drive innovation, and help support the retirement funds of many people as well as just plain shareholders. In other words profits are good, even if you think otherwise. I'm sure that without profits, the taxes that support your vaunted NHS would vanish into thin air....

Medicaid is a wonderful government healthcare program which is a template for why Americans reject government taking over the rest of the healthcare systems in the USA. Thanks so much for making my point.

And thanks so much for pointing out my spelling error, I suck at spelling and being a bit dyslexic does not help. It's a good thing I'm a visual artist as I'm quite sure it will not improve in my lifetime. But thanks so much for your concern [/sarcasm]