Socialized medicine in the UK (and beyond) LCP... Death

[Deleted]

With due respect to your profession, the accusations aren't just from the Daily Mail.

It appears that there are several reports of individuals being placed on the LCP who are either uninformed of that decision or, in other cases, there was no documentation showing that the patient's condition was untreatable. That's not the Daily Mail saying that. That's the Telegraph.

I think the problem with "news" like the Daily Mail is that it only focuses on anecdotes of a story, rather than the problem that allowed such an event to happen.

Obviously I can't possibly know every case ever.

However of course most people who are placed on the LCP don't know, for an obvious reason, they are unconscious.

To clairfy as well, all patients on the LCP are put on it by a Senior Consultant in that speciality.

[Jeleh]

The issues that seem to have risen from this controversy are two fold

1) Patients being put on the pathway without the desire to do so (this probably does happen but is the minority of cases and a negative experience that needs to be addressed on an individual basis.)

2) Hospitals apparently being paid to hit targets for the LCP program.

Point 2 is the one that really concerns me, something like the LCP is there to help provide a better level of care once a patient has accepted their prognosis. Hospitals being paid targets for such a program means they are pressured into pushing patients at some stage towards the LCP even if they may not want it. This is an issue that needs looking into and is why ministers are calling for an inquiry into the matter.

As an advocate of euthanasia in terminally ill patients; where said patient can make an informed decision, I feel programs like the LCP are essential in helping those who are suffering pass in a less painful manner instead of prolonging life just because we struggle to accept the inevitable. I am however strongly against the abuse of such systems and paying hospitals for targets related to such programs is very questionable and needs looking into.

[Deleted]

The huge majority of people in the United States have insurance. 40 million people is an objectively big number but the fact is it's only 12.5% of the total population.

That's 12.5% too many.

I find it strange how the critics in this thread aren't responding to the two nurses who've posted, both of whom have direct experience which contradicts the Daily Fails sensationalist article.

[Laize]

Obviously I can't possibly know every case ever.

However of course most people who are placed on the LCP don't know, for an obvious reason, they are unconscious.

To clairfy as well, all patients on the LCP are put on it by a Senior Consultant in that speciality.

And what of the accusations that some are placed on the LCP without documentation that their condition is untreatable?

---------- Post added 2012-12-01 at 10:28 AM ----------

That's 12.5% too many.

I find it strange how the critics in this thread aren't responding to the two nurses who've posted, both of whom have direct experience which contradicts the Daily Fails sensationalist article.

Because I refuse to argue with nurses. I have too much respect for that profession to question them in almost anything they say. I'm pretty sure they know more than the doctors themselves when it comes to individual patients.

[Jackmoves]

Insurance refusing to pay out is an EXTREMELY rare scenario.

Just as denial of care is here Laize, I mean I think I could dig up a lot of rather nasty stories about the american health care system. Mistakes happen.

One of the biggest problems here is precurment of medicine, our system is flawed, what is supposed to lower costs, often makes it more expensive, they run quite a lot of stories on this lately. I noticed that Larson pdf mentioned a case when the med was too expensive, quite a lot of times, it's actually quite the opposit as has been revelead here as of late. We try to precure generic medicine(thats the term right), but quite often one perfectly viable medicine gets exchanged for something more expensive rofl.

Another interesting thing, is that our state owned pharmacy chain has been privatized quite recently and most people think it has lowered the standard of the shops, less knowledgable staff, less alternatives as far as medicine goes etc.

I'm not against privitzation, Sweden is and has almost always been a very privatized country, but it's still interesting to see what people think.

[Nigeldruid]

With due respect to your profession, the accusations aren't just from the Daily Mail.

It appears that there are several reports of individuals being placed on the LCP who are either uninformed of that decision or, in other cases, there was no documentation showing that the patient's condition was untreatable. That's not the Daily Mail saying that. That's the Telegraph.

I think the problem with "news" like the Daily Mail is that it only focuses on anecdotes of a story, rather than the problem that allowed such an event to happen.

I'm sorry, but did you check the references on that section? All of them were from the daily mail and the daily telegraph. They even directly quote the daily mail. Just because something is on Wikipedia doesn't mean that it's not bollocks or blown out of proportion. Wiki supports all points of view getting a chance, it's an encyclopedia of the people, which means that tabloid opinions are just as common there as they are anywhere else on the internet.

In short, always check Wiki references.

[Deleted]

The guy who wrote that article should be ashamed of himself. I'm an atheist, but there would be a special place in hell for people who attempt to increase the suffering of the dying to sell Newspapers.

The issues that seem to have risen from this controversy are two fold

1) Patients being put on the pathway without the desire to do so (this probably does happen but is the minority of cases and a negative experience that needs to be addressed on an individual basis.)

I don't think you and most people in this thread understand the specifics of this issue at all.

The overwhelming majority of LCP patients are NOT long term cancer sufferers, long term terminally ill patients and so on. They are a small minority of people who are placed on the Liverpool Care Pathway.

They are people who have had things like a Dissected Aorta, a Subarachnoid hemorrhage, patients who have suffered VF arrest and have regained extremely minimal cardiac output. These are the kinds of patients who make up most LCP patients. Typically they will come into hospital into A&E be assessed by a Consultant who diagnoses them as being untreatable (and despite what laypeople think there's a huge number of medical emergencies which are still almost completely untreatable).

The majority of people on LCP are unresponsive because they are so ill, that's why they are even candidates for the LCP to begin with. Treatment is then discussed with the family of those patients and in most cases they agree that the LCP is the preferable option. It's worth pointing out as well that is the person in question is quite young (under 50 lets say) then we will literally try everything now matter how small the chance. I've never seen someone under 50 on the LCP. If the family doesn't agree then we don't put someone on the LCP and if there is no family the decision is made by a Consultant specialist (with 20+ years experience) with input from Surgeons and any other specialists about the likelyhood of any intervention working and an informed decision is made on their behalf.

2) Hospitals apparently being paid to hit targets for the LCP program.

Point 2 is the one that really concerns me, something like the LCP is there to help provide a better level of care once a patient has accepted their prognosis. Hospitals being paid targets for such a program means they are pressured into pushing patients at some stage towards the LCP even if they may not want it. This is an issue that needs looking into and is why ministers are calling for an inquiry into the matter.

As an advocate of euthanasia in terminally ill patients; where said patient can make an informed decision, I feel programs like the LCP are essential in helping those who are suffering pass in a less painful manner instead of prolonging life just because we struggle to accept the inevitable. I am however strongly against the abuse of such systems and paying hospitals for targets related to such programs is very questionable and needs looking into.

This is a complete non sequitor and something I have never seen happen at all on any Ward I have worked on. The complete opposite is actually true, Doctors use the LCP as a last resort when every other avenue has been exhausted and most Doctors try their best not to put someone on the LCP (I guess they see it as themselves failing).

Another point is the issue of targets and once again Ministers, Posters on MMO Champion and Newspapers completely do not get it at all.

Targets in the NHS are placed on management, they are never placed on frontline staff like Doctors and Staff Nurses. I feel no pressure at all in my job to meet something so absurd as national targets and Doctors have even less pressure on them especially a Consultant.. When a Doctor/Nurse is making a decision on patient treatment the only thing we think about is the best interest of the patient, it would never even enter our head to consider what management/ministers think (seen as they are universally viewed with disdain for being undeducated laypeople chasing money/votes rather than qualified and registered professionals who actually know what they're doing).

Now obviously Doctors make the wrong decision sometimes because they are human and medicine is extremely complex and technology isn't nearly as good as laypeople often think, but they certainly aren't making the wrong decision to meet government quotas. There's not a person in the healthcare industry in the UK who wouldn't laugh at such an absurd suggestion.

And what of the accusations that some are placed on the LCP without documentation that their condition is untreatable?[COLOR="red"]

I say show me the specific cases with reputable sources and quotes from the parties involved on all sides.

Don't show me The Daily Mail writing absolute rubbish with no quotes or evidence from anyone involved.

And once you have that show 100 more cases so I know it's not a 1 off.

[Deleted]

Dailymail? Whoopee. Also a really biased post, not to mention hilarious considering what a shamble the US healthcare system is compared to any "socialized" system.

[FusedMass]

I can't believe this many people are STILL mad at Obama Care. People forget not everyone could afford insurance. It's not like some people aren't going to be paying. The only other option is to repealing the law that means leaving people without insurance. I for one am glad everyone will finally get insurance. Hospitals cost way too much into the hundreds even thousands of dollars for a few tests.

Then they send you to four different doctors. I'm looking at this as we're getting with the current themes. Most places outside the US have a system where everyone has Health Coverage. It's time we did too. You know comparing things to "socialism" is a state of mind. For example Mitt Romney thought the ER was a form of socialism because everyone get's treated there.

It's just a talking point re-reinforced by certain news casters (Fox News) Coughs.

[RüneRS]

Welcome to the wonderful world of socialized medicine.

http://www.dailymail.co.uk/news/arti...#ixzz2DcUKj73D

This is disgusting and wrong on every level. This isn't the work of a civilized society.
Hospitals were paid in the tens of millions of pounds to meet quotas of people killed using the LCP.

http://www.dailymail.co.uk/news/arti...al-system.html

The dailymail is such a good source, how come I don't see this on any other newssite?

Ah yes, I live in a social country, the government is controlling the press, luckely they don't do that in free capitalistic America ! xD

[ovm33]

I can't believe this many people are STILL mad at Obama Care. People forget not everyone could afford insurance. It's not like some people aren't going to be paying. The only other option is to repealing the law that means leaving people without insurance. I for one am glad everyone will finally get insurance. Hospitals cost way too much into the hundreds even thousands of dollars for a few tests.

The problem with Obama care is that IT DOES NOT GIVE PEOPLE INSURANCE. It only fines you if you do not have it. People who could not afford insurance before, still won't be able to, and now will be fined for it.

[Deleted]

The dailymail is such a good source, how come I don't see this on any other newssite?

Ah yes, I live in a social country, the government is controlling the press, luckely they don't do that in free capitalistic America ! xD

The Daily mail is British, hence the .co.uk
Even so, most Brits know they are a crock of shit, the only people that buy that rag is crazies and old people that are stuck in the 1950's.

[FusedMass]

The problem with Obama care is that IT DOES NOT GIVE PEOPLE INSURANCE. It only fines you if you do not have it. People who could not afford insurance before, still won't be able to, and now will be fined for it.

I disagree they are creating a public option with their insurance that will drive down the prices of other insurance company's driving their over priced down to where it should be. And it only fines the people who do not have insurance AND..wait for it can afford it. Meaning those people who have to go to the ER who don't have insurance driving up the price of everyone's bill.

Public Option

You have to buy Insurance if you can afford it

It also would stop company's from denying people based on pre existing conditions and let you stay on your family's health plan till age 26. It used to be 18. Do you see the massive difference and tons of pocket change that would save people. In fact this model was created by a Republican in his state and no one complained. Yet when a Liberal uses it even giving the states the option to "Opt Out" they can choose to do that.

[smelltheglove]

my, i didnt know daily mail could sink any lower, but they arent even trying any more. recycling fox news leftovers? death panels anyone?

[mvaliz]

The problem with Obama care is that IT DOES NOT GIVE PEOPLE INSURANCE. It only fines you if you do not have it. People who could not afford insurance before, still won't be able to, and now will be fined for it.

...did you just say the Affordable Health Care act doesn't offer people affordable health care? o_O

As the poster said above, there are new options for public healthcare... and as somebody who's been unemployed for over a year, I could NOT welcome it more! ^_^

[ovm33]

http://www.healthcare.gov/law/timeline/full.html

2010: A new Patient’s Bill of Rights goes into effect, protecting consumers from the worst abuses of the insurance industry. Cost-free preventive services begin for many Americans.
See More 2010 Changes.

2011: People with Medicare can get key preventive services for free, and also receive a 50% discount on brand-name drugs in the Medicare “donut hole.”
See More 2011 Changes.

2012: Accountable Care Organizations and other programs help doctors and health care providers work together to deliver better care.
See More 2012 Changes.

2014: All Americans will have access to affordable health insurance options. New Health Insurance Exchanges will allow individuals and small businesses to compare health plans on a level playing field. Middle and low-income families will get tax credits that cover a significant portion of the cost of coverage. And the Medicaid program will be expanded to cover more low-income Americans. All together, these reforms mean that millions of people who were previously uninsured will gain coverage, thanks to the Affordable Care Act.

http://www.cbsnews.com/2100-250_162-6231221.html

There is no Public Option. As in you can't now buy your insurance from the government. (Assuming you make more than 15k a year***.) There will be a million or two more people with Medicaid now. But they are not paying for it. It's being given to them by the government. But this can't be considered a public option. A public option is just like how insurance works now, but you buy it from the government. So... Anthem Blue Cross and Blue Shield would equal US Government.

The biggest plus to the law is that you can no longer be denied benefits based on per-existing conditions, such as cancer or diabetes.

***15k a year is basically minimum wage x 32 hours a week. If you make more than that, even by a penny you now have to buy insurance. (There will be some tax breaks. So less money weekly, bigger refund at end of year.)

[Thorim]

People from the US really shouldn't be basing their opinion of the NHS on articles written in the Telegraph and Daily mail, or ANY rag (newspaper) really.

If you live in the UK, and have first hand experience of the system and still have bad things to say about it, fine, have a debate (usually its badly allocated funds or misspending rather than it 'costing too much') Personally, having lived in the UK for 24 years and having treatment for things from Tonsillitis to minor surgery to broken bones....it is a great system and I wouldn't trade it for an Insurance based one ANY DAY.

[draykorinee]

my, i didnt know daily mail could sink any lower, but they arent even trying any more. recycling fox news leftovers? death panels anyone?

Tbh I'm suprised they haven't put the blame on the immigrants coming over and getting free healthcare. I once saw a comedian make a joke about the mail, at the time the daily mail proclaimed to have the first smudge free ink so you're hands didnt get dyed by it, so this comedian used it to say, Daily mail the only paper that wont turn you black, thought it was very fitting.

---------- Post added 2012-12-01 at 08:31 PM ----------

This is a complete non sequitor and something I have never seen happen at all on any Ward I have worked on. The complete opposite is actually true, Doctors use the LCP as a last resort when every other avenue has been exhausted and most Doctors try their best not to put someone on the LCP (I guess they see it as themselves failing).

What you wrote is what wished people actually got to read in the daily mail, unfortunately it wouldnt sell papers. As a nurse it makes me sick to my stomach to read these articles and replies.

[FusedMass]

http://www.healthcare.gov/law/timeline/full.html



http://www.cbsnews.com/2100-250_162-6231221.html

There is no Public Option. As in you can't now buy your insurance from the government. (Assuming you make more than 15k a year***.) There will be a million or two more people with Medicaid now. But they are not paying for it. It's being given to them by the government. But this can't be considered a public option. A public option is just like how insurance works now, but you buy it from the government. So... Anthem Blue Cross and Blue Shield would equal US Government.

The biggest plus to the law is that you can no longer be denied benefits based on per-existing conditions, such as cancer or diabetes.

***15k a year is basically minimum wage x 32 hours a week. If you make more than that, even by a penny you now have to buy insurance. (There will be some tax breaks. So less money weekly, bigger refund at end of year.)

That article is dated back to 2010.

This is something a bit more recent.

http://www.markpine.us/?p=3692

On Thursday, Vermont Governor Peter Shumlin will sign legislation to create a “universal and unified health system” in the state. The legislation establishes a system that might be thought of as the Affordable Care Act with a public option.

The law lays out the framework for a universal health care system. A five-member Green Mountain Board, appointed by the governor and confirmed by the state Senate, will come up with plans for the state program to provide health care benefits to enrollees and pay providers and reform the existing system. The plans would be submitted to the legislature for approval by 2013 .

In compliance with the federal Affordable Care Act, the law sets up the Vermont Health Benefit Exchange to begin operating in 2014. Private insurers (at least two are envisioned in the law) and a state-funded public option for coverage would be offered on the exchange.

[Catta]

The Daily mail is British, hence the .co.uk
Even so, most Brits know they are a crock of shit, the only people that buy that rag is crazies and old people that are stuck in the 1950's.

Your post reminded me of this bit from LATA
http://www.youtube.com/watch?feature...nv760Ig#t=452s