More on Liverpool Care Pathway.

A few weeks ago I instigated a debate in the House of Commons on the Liverpool Care Pathway. The gist of the speech with which I opened the debate was that in general, I support the principle of transferring the commitment to palliative care typical of hospices to hospitals and other forms of care - but that the Pathway must be implemented strictly in accordance with the principles on which is has been established. There seems to be much evidence that this has not always been the case. I asked that the Gov't thoroughly investigate recent publicity about patients being placed on the Pathway without consultation with them or their next of kin. This is not acceptable. There are also reports of other departures from proper procedures. A line which grabbed public attention and summed up my approach was that "we shouldn't scrap the LCP - we wouldn't scrap the Highway Code because there are some bad drivers on our roads".

Since the debate, the Gov't has appointed former Lib Dem peer, Baroness Neuberger to chair an independent inquiry. She is on record of being supportive of the Liverpool Care Pathway, but there is no reason to think she will not be thorough and objective. She will have read comments in yesterday's Telegraph by her former Lib Dem colleague, Lord Carlile of Berriew, which offer her some strongly worded advice. On this sort of issue, I usually agree with Lord Carlile.

While I do not disagree at a fundamental level with anything Alex Carlile is reported to have said, there is no doubt that the tone of his comments take him further than I went. He calls for the Liverpool Care Pathway to be replaced, and to be given a different name. I would support that if Baroness Neuberger recommended it, though my view is that the problems arise from the Pathway not being followed as it should be, rather than the Pathway itself. I do agree that 'Pathway' seem to me to be a particularly unfortunate name though. Alex is also reported to be calling for doctors who put patients on the LCP without telling next of kin to be reprimanded by the General Medical Council, even 'struck off'. Personally, I feel that continuing with regular checks every few hours to make certain that patients have not rallied enough to be taken off the Pathway is another crucial part of proper palliative care. Whatever, Its clear there's much uneasiness about how the Liverpool Care Pathway is being implemented, and we need the independent report delivered to Secretary of State for Health as soon as possible.