Hospitals bribed to put patients on pathway to death: Cash incentive for NHS trusts that meet targets on Liverpool Care Pathway
- Some hospitals set target of two thirds of all deaths should be on LCP
- At least £30m in extra money handed to hospitals to achieve these goals
- Critics warn financial incentives could influence the work of doctors
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Hospital consultant Professor Patrick Pullicino warned financial incentives for hospitals to put patients on the Liverpool Care Pathway could influence the work of doctors
Hospitals are paid millions to hit targets for the number of patients who die on the Liverpool Care Pathway, the Mail can reveal.
The incentives have been paid to hospitals that ensure a set percentage of patients who die on their wards have been put on the controversial regime.
In some cases, hospitals have been set targets that between a third and two thirds of all the deaths should be on the LCP, which critics say is a way of hastening the deaths of terminally ill patients.
At least £30million in extra money from taxpayers is estimated to have been handed to hospitals over the past three years to achieve these goals.
Critics of the method warned last night that financial incentives for hospitals could influence the work of doctors.
The LCP involves withdrawal of life-saving treatment. Patients are sedated and most are denied nutrition and fluids by tube. On average a patient put on the Pathway dies within 29 hours.
One of the leading critics, hospital consultant Professor Patrick Pullicino, said: 'Given the fact that the diagnosis of impending death is such a subjective one, putting a financial incentive into the mix is really not a good idea and it could sway the decision-making process.'
LCP is thought to be used in more than 100,000 cases a year.
Yesterday the Association for Palliative Medicine, which represents doctors working in hospices and on specialist hospital wards, announced it is organising an inquiry into the method.
The LCP is intended to ease the final hours of patients who are close to death and to spare them the suffering associated with invasive treatment.
Payments to hospitals to introduce it are made through a system called Commissioning for Quality and Innovation, or CQUIN, which channels money to hospital trusts through NHS 'commissioners'.
The use of CQUIN payments to encourage the spread of the LCP through the wards and to persuade doctors to meet Pathway targets was revealed in answers to Freedom of Information requests.
Among trusts that confirmed the use of targets was Aintree University Hospitals NHS Foundation Trust, which said that in the financial year which ended in March the percentage of patients who died on the Pathway was '43 per cent against a target of 35 per cent'.
Over the year the Trust received £308,000 for achieving 'goals involving the Liverpool Care Pathway'. Salford Royal NHS Foundation Trust had CQUIN payments connected to the Liverpool Care Pathway almost halved after failing to reach targets.
Controversial: The LCP is intended to ease the final hours of patients who are close to death and to spare them the suffering associated with invasive treatment
Figures show Salford Royal NHS Foundation Trust had CQUIN payments connected to the Liverpool Care Pathway almost halved after failing to reach targets
The Trust was offered £73,385 for increasing numbers of patients who die at home rather than in hospital.
Part of the scheme was a target for the number of patients discharged from hospital to die at home after being put on the Liverpool Care Pathway.
This would have paid £36,392 if a 47.6 per cent target had been reached. Its FOI statement said: 'The Trust achieved 45.5 per cent so funding for the LCP element was reduced to £18,600.'
'Given the fact that the diagnosis of impending death is such a subjective one, putting a financial incentive into the mix is really not a good idea and it could sway the decision-making process.'
Professor Patrick Pullicino
FOI replies so far received by the Mail suggest that if the money paid by NHS commissioners were spread equally around all NHS acute hospitals, it would mean £30million has been sunk into the campaign to put the Pathway into universal use since 2009.
The Department of Health defended LCP payments by target last night. A spokesman said: 'It is right local areas try to improve the care and support offered to dying people as it means patients are more comfortable and treated with dignity in their final days and hours.
'We are clear the Liverpool Care Pathway can only work if each patient is fully consulted, where this is feasible, and their family involved in all aspects of decision-making. Staff must properly communicate with the patient and their family – any failure to do so is unacceptable.'
But Dr Tony Cole, chairman of the Medical Ethics Alliance pressure group said: 'If death is accelerated by a single day that will save the NHS nearly £200 – that is the estimated cost of a patient per day in hospital.
'My position on the LCP is that it is inherently dangerous and unnecessary.'
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NEXT UP - Compulsory role as lab rats. Medical experimentation no longer an option.
The American Medical Association Will Soon Be Able To Force People To Enter Experimental Vaccine Trials
Oct 22nd, 2012 | By Christina England | Category: Christina England, Top Stories
The American Medical Association (AMA) recently published a paper proposing the introduction of a new law to force you and your children into experimental vaccine trials against your wishes. Your only way out of this directive would be to sign an ‘opt out form.’
In January, the AMA published a paper by Susanne Sheehy, BM BCh, MRCP, DTM&H, and Joel Meyer, BM BCh, MRCP on the ‘Virtual Mentor’ website, stating that there has been a steady decline in the numbers of healthy volunteers willing to participate in clinical trials. [1]
The AMA believes that more people should want to help in the development of new vaccinations. They stated:
“Reasons for this decline are unclear but are likely to be multifaceted. One familiar problem is the payment of volunteers. To date, the relatively meager compensation that participants often receive could be seen to belittle and undervalue the contribution of these individuals to global health.”
VOLUNTEER PARTICIPATION TO BECOME A THING OF THE PAST
Because of the decline in willing volunteers, the AMA has decided that volunteer participation in vaccination trials should become a thing of the past. They said:
“If progression of promising vaccines from the lab to the clinic is to remain unaffected and financial inducement is an ethically unacceptable solution to the recruitment shortage, other strategies need to be considered. Compulsory involvement in vaccine studies is one alternative solution that is not as outlandish as it might seem on first consideration. Many societies already mandate that citizens undertake activities for the good of society; in several European countries registration for organ-donation has switched from “opt-in” (the current U.S. system) to “opt out” systems (in which those who do not specifically register as non-donors are presumed to consent to donation, and most societies expect citizens to undertake jury service when called upon.”
That’s right; according to the AMA we should all sign ‘opt out’ forms if we do not want to participate in vaccination trials. If, for some reason, we should forget to do this, then we should automatically be classified as giving passive consent!
In my opinion, agreeing to be a guinea pig for a vaccination trial is a little different from undertaking jury service, whether it is for the good of society or not. As for organ donation, there is one small fact the AMA appears to have forgotten; when our organs are taken, we are already dead!
I say this because a paper released fresh off the press makes abundantly clear just how catastrophic mistakes can be when vaccinations are fast-tracked onto the market.
PROOF OF WHAT WE ALREADY KNEW
The paper, written by Dr. Lucija Tomljenovic and Dr. Chistopher Shaw from the Department of Ophthalmology and Visual Sciences, University of British Columbia, states:
“In the past several decades, there have been numerous studies and case reports documenting neurological and autoimmune adverse reactions (ADRs) following the use of various vaccines. Arthritis, vasculitis, systemic lupus erythematosus (SLE), encephalopathy, neuropathy, seizure disorders and autoimmune demyelinating disease syndromes are the most frequently reported serious adverse events.” [2]
The paper goes on to describe serious errors in the HPV vaccine Gardasil’s safety trials, which they say shows evidence of significant flaws in study design, data reporting and interpretation. They believe this has led to the death and injury of many young women.
Dr. Tomljenovic and Dr. Shaw have found the following alarming results after studying the brain samples of two young women who died shortly after they were administered with the Gardasil vaccination:
“In both cases, the autopsy revealed no anatomical, microbiological nor toxicological findings that might have explained the death of the individuals. In contrast, our IHC analysis showed evidence of an autoimmune vasculitis potentially triggered by the cross-reactive HPV-16L1 antibodies binding to the wall of cerebral blood vessels in all examined brain samples. We also detected the presence of HPV-16L1 particles within the cerebral vasculature with some HPV-16L1 particles adhering to the blood vessel walls. HPV-18L1 antibodies did not bind to cerebral blood vessels nor any other neural tissues. IHC also showed increased T-cell signalling and marked activation of the classical antibody-dependent complement pathway in cerebral vascular tissues from both cases. This pattern of complement activation in the absence of an active brain infection indicates an abnormal triggering of the immune response in which the immune attack is directed towards self-tissue.”
Bearing this knowledge in mind makes a mockery of the AMA’s belief that we should offer ourselves willingly as guinea pigs for vaccination experiments.
THE AMA WANTS YOU … FOR DEADLY DISEASES!
If all this is a little hard to believe, the AMA goes on to state:
“Society is unlikely to accept compulsory recruitment to a trial for a vaccine against the common cold if the vaccine causes severe complications in vaccinees. Increase the severity of the disease in question, however, and compulsory recruitment becomes a more palatable option.”
Unbelievable! The AMA is actually naïve enough to believe that society will be more willing to be used as guinea pigs in their vaccination trials, if the trials are for deadly diseases!