A serious conflict of interest and the death pathway review

Baroness Julia Neuberger was chair of the 2012-13 Review into the Liverpool Care Pathway. The Review was ordered after it emerged, thanks to some revealing Freedom of Information Act requests, that hundreds of thousands of people had died on the financially incentivized Pathway after 2008 when the strategy to increase numbers of patients dying on the Pathway was announced. The Death Pathway, as it is now known, is a sedation-dehydration programme long criticised by concerned medical and legal professionals as both dangerous and potentially homicidal given that death cannot always be diagnosed with any certainty.

Today, online author ‘Jemima Khant’ points out that Julia Neuberger is on the board of the private healthcare insurance company Vhi Healthcare “(registered offices in Ireland – where Bee Wee’s APM was originally registered …from 2008 onwards.” These facts emerge in this annual report.

Whether or not Baroness Neuberger declared her interest in Vhi Healthcare as a member of its Board of Directors, the Baroness was a singularly inappropriate choice for the conduct of the 2012 review into the Liverpool Care Pathway. With her interests in a private company whose shareholders demand profitability when patients are often far from commercially lucrative, it was always important that she be excluded from running the review. There is a manifest conflict of interest in her doing so.
An organisation representing families of people who died on the Pathway has indicated that they have no confidence in Dr Bee Wee, a long-time supporter of the Pathway, and have called for her resignation from the Leadership Alliance for the Care of Dying People or LACDP, the organisation tasked by government to supply an alternative to the LCP.

The rush to implement a new version of the Liverpool Care Pathway needs reconsideration forthwith. Not only is there a vital need for evidence based research into end-of-life care, rather than the insufficiently tested Ellershaw proposals, it is critical that those who have a financial interest in the introduction of Pathways that allow medics and others to control death, be seen to exclude themselves from the implementation process. The lives and well being of vulnerable people are at stake.