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The break up of the NHS in England into 42 us style integrated care systems, adds to fears of funding driving clinical decisions, along with the financial penalties being placed upon the ICBs of those ICS' if they are unable to balance their books. This effectively follows the American system of denial of healthcare through cuts to budgets in favour of profit. A perfect example of such concerns is the arguments put during the Parliamentary debate on the Assisted Dieing Bill, when those opposed to the bill raised concerns about possible coercion from patients doctors, in order to reduce the number of elderly patients requiring hospital beds and costly treatment. Opposing pressure groups and MPs give this policy of denial of healthcare as an example of how this has already occurred in the NHS:
The Liverpool Care Pathway (LCP) was a controversial end-of-life care program implemented in the NHS in the late 1990s to manage terminally ill patients, particularly those with cancer, during their final days. It became widespread but was discontinued in 2014 after significant public and medical concerns arose, notably due to allegations of involuntary euthanasia and neglect. The LCP’s approach, which sometimes involved denying food and water to patients, sparked outrage as it was feared to hasten death, especially when improperly administered without clear consent from patients or their families. Despite its official end, some critics argue that elements of the LCP are still in practice today under new names or guidelines. A 2023 report raised alarms that some hospitals and care homes have not adequately implemented the revised end-of-life care guidelines and are continuing practices similar to those of the LCP. This has led to accusations of prematurely ending patients' lives through practices like over medication and the withdrawal of nutrition and hydration, often without proper consultation with families or clear documentation of patient consent. Grieving families and medical professionals still report troubling cases, suggesting that practices such as the use of sedatives like midazolam to induce comas or limit communication, as well as the withholding of hydration, continue. These practices have led some to believe that the LCP was not entirely abolished but rather rebranded under new protocols that are still susceptible to misinterpretation or misuse. The controversy surrounding the LCP, its legacy, and the ongoing challenges in end-of-life care remain deeply divisive. Advocates of palliative care stress the importance of compassionate and individualized treatment for terminally ill patients, while critics argue that systemic issues within the NHS, like underfunding and lack of staff, still hinder the quality of end-of-life care. Meanwhile, debates over assisted dying, such as those seen in recent legislation discussions, have further fueled concerns about vulnerable patients being pressured into death rather than being given proper care and support in their final days. You can read the full analysis of this pressure, the history of the Liverpool Pathway,and risks to terminally ill patients being denied healthcare in an article published in on-line newspaper The Post here Source: The Post / Unionsafey
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