Uh, oh – the Brits are moving towards reducing their health bill by hastening the ends of older patients

Alf is more likely to want to cling to life if a spunky nurse gives the mouth-to-mouth.

Actually, Alf is more likely to want to cling to life if a spunky female medic gives the mouth-to-mouth.

It won’t be too long before the Grumbles will have to give England a miss in their travel plans.

This will be highly disappointing for them, because while they don’t much admire your basic Pom they do admire the Royals. And England is where the Royals (the ones who matter) happen to live.

But age is catching up on the Grumbles and soon it looks like they might find themselves on a one-way ticket if they visited the land of Buckingham Palace, Windsor Castle and what-have-you and went down with a tummy bug or some-such.

Especially if their ailments led them to a stay in hospital.

The concern has been raised by news that British doctors are being told to ask all patients over 75 if they will agree to a ‘do not resuscitate’ order.

New National Health Service guidelines urge GPs to draw up end-of-life plans for over-75s – and for younger patients, too, if they are suffering from cancer, dementia, heart disease or serious lung conditions.

They are also being told to ask whether the patient wants doctors to try to resuscitate them if their health suddenly deteriorates.

This grim story is told today by The Daily Mail:

The NHS says the guidance will improve patients’ end-of-life care, but medical professionals say it is ‘blatantly wrong’ and will frighten the elderly into thinking they are being ‘written off’.

In some surgeries, nurses are cold-calling patients over 75 or with long-term conditions and asking them over the phone if they have ‘thought about resuscitation’.

Other patients have spoken of the shock of going in for a routine check-up and being asked about resuscitation.

These extraordinary new guidelines have been brought in despite the public outcry triggered by the use of ‘do not resuscitate’ orders under the Liverpool Care Pathway.

The Mail played an admirable role in bringing the DNR notice to public notice:

The discredited pathway was scrapped last year after the Mail revealed that doctors were placing ‘DNR’ notices on patients without their knowledge and depriving them of food and fluids.

The guidelines – which also recommend patients should be asked if they want to die at home – have been drawn up by experts advising NHS England, the organisation which runs the health service.

In a deeply chilling development, doctors and nurses are instructed to ask all patients over 75 if they wish to be left to die should they become terminally ill

Inevitably this has raised concerns that the new guidance is the thin end of the wedge of assisted suicide.

Professor Patrick Pullicino, who spearheaded the campaign against the LCP, said: ‘What is most blatantly wrong is trying to get someone to agree to a ‘do not resuscitate’ order before they are even sick. For somebody who is perfectly well, or has got a mild or not a serious illness, that would be totally out of place.’

Roy Lilley, a health policy analyst and former NHS trust chairman, said: ‘It will give some older people the impression that no-one wants to bother with them. It looks as though they’re being told: ‘You’re old, how do you want to die because you’re in the way’.

‘It’s a very clunky thing to do – it’s completely unnecessary.’

Roger Goss, of Patient Concern, said: ‘There will be some people who will be put out, disconcerted and think they are not going to get the best available care. They might think this is a way of saving money for the NHS. Other patients will be prepared to talk about it and think it sensible.’

The Mail explains that a ‘do not resuscitate’ order is meant to stop a patient suffering unnecessarily where their lives are likely to be extended for only a short period of time.

Resuscitation can be traumatic and cause broken ribs or damage to organs, including the spleen.

Doctors estimate that only 10 to 15 per cent of patients are brought back to life and some suffer permanent brain damage.

But asking patients to make such a decision when they may have many years to live will prompt concerns that the NHS is writing them off.

It gets worse, dear reader.

In some parts of England, practice nurses have been instructed to cold-call patients and fill out an advance care plan for them over the phone.

Ruth Nicholls, a palliative care nurse in the South East, told how her brother-in-law, who has a heart condition, was contacted immediately after he had a hospital appointment.

In an interview with Nursing Times, she said: ‘He came back from an outpatient appointment having not had very good news and later that afternoon got a phone call from one of the practice nurses at his GP surgery.

‘She said: ‘Hello, we’re ringing all our patients with chronic conditions to see how you are and whether you have thought about resuscitation.’

‘This conversation was absolutely out of nowhere. My brother-in-law was shocked and my sister was distraught.’

This nurse also said an elderly patient was asked about resuscitation by a district nurse he had never met during a routine visit.

‘One of the first questions he was asked was whether he wanted to be resuscitated,’ she said. ‘People are being left in great distress.’

The Mail gives people like the Grumbles an understanding of what was entailed under the controversial Liverpool Care Pathway before it was phased out last year.

Some patients were left so dehydrated they were left to suck on wet sponges given by relatives because nurses had banned water.

Mind you, Alf is bound to say he sees a need to inquire more deeply into this.

There may well be a good reason for banning water.

The late W.C.Field avoided it and explained:

“I don’t drink water. Fish fuck in it.”

Certainly Alf never heard of anyone getting nasty diseases from drinking whisky,  but drinking water notoriously is the reason why many people over the centuries have got very ill or carked.

Maybe the Mail has failed to mention that while water indeed was banned, nurses would supply their patients with ample supplies of good scotch.

We had best check that out before giving England a miss.

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