History > 2009 > UK > Health (I)

Debbie Purdy: 'We've got our lives back'

Campaigner triumphant
after Lords victory to clarify law on right to die

Friday, 31 July 2009
The Independent
By Jeremy Laurance,
Health Editor

Debbie Purdy, who has dedicated her living days to winning the right to plan her death, made legal history yesterday when five law lords backed her landmark appeal to have the law on assisted suicide clarified.

The 46-year-old campaigner, who has multiple sclerosis, was "ecstatic" after the peers unanimously supported her call for the Director of Public Prosecutions to spell out the circumstances in which her husband or someone in a similar position might face prosecution for helping a loved one end their life abroad.

Having lost twice in the High Court and Court of Appeal, yesterday's decision brought huge relief. Flanked by her husband, the Cuban violinist Omar Puente, and to cheers from her supporters, Mrs Purdy said after the ruling: "I'm ecstatic. I am eagerly awaiting the DPP's policy publication so that we can make sure what we do does not risk prosecution. I think people are beginning to realise now that this is not about a right to die; it is about a right to live.

"It feels like everything else doesn't matter and now I can just be a normal person. It's terrific. It gives me my life back. We can live our lives. We don't have to plan my death."

Responding to the ruling, the DPP Keir Starmer, QC, said prosecutors would start work immediately to produce an interim policy by September, followed by a public consultation before the final policy is published next spring. "This is a difficult and sensitive subject and a complex area of the law," he said. "However, I fully accept the judgment of the House of Lords. The Crown Prosecution Service has great sympathy for the personal circumstances of Mrs Purdy and her family."

The decision will bring relief to scores of people facing similar dilemmas. More than 100 UK citizens with terminal illness or facing intolerable suffering have travelled to the Dignitas clinic in Switzerland with friends or relatives to end their lives. No one has been prosecuted but the risk is always there. Under the present law, anyone who helps facilitate a suicide faces up to 14 years in jail.

Giving judgment in Mrs Purdy's case yesterday, the law lords said the DPP should be required to set out an "offence-specific policy", identifying the facts and circumstances that he would take into account in deciding whether it was in the public interest to prosecute under the Suicide Act.

Experts said the ruling meant it was no longer acceptable for the DPP to decide what was a crime on a case by case basis and that after he had set out the principles that would exclude prosecutions for compassionate assistance, the law would effectively have been changed. But the law lords said the ruling did not decriminalise assisted suicide, which was rejected after a highly charged debate this month by peers in the House of Lords sitting as the second chamber of Parliament and not as a court.

Mrs Purdy suffers from progressive multiple sclerosis which could mean she faces an undignified and distressing death. That might be avoided if she were able to travel to Dignitas to end her life peacefully.

Her dilemma was that unless the law was clarified she might be forced to end her life sooner than she planned, while she was still able to travel to Switzerland independently, to avoid the risk of her husband being prosecuted for assisting her. If the risk of prosecution was sufficiently low, she could wait until the very last minute before travelling with her husband's assistance.

The law lords said: "Everyone has the right to respect for their private life and the way that Mrs Purdy determines to spend the closing moments of her life is part of the act of living. Mrs Purdy wishes to avoid an undignified and distressing end to her life. She is entitled to ask that this too must be respected."

Campaigners hailed the victory as bringing an end to the "legal muddle" over assisted suicide. Pressure for a change in the law has grown. The Royal College of Nursing declared this month it was dropping its opposition to assisted suicide and adopting a neutral stance.

Sarah Wootton, chief executive of Dignity in Dying, said: "This historic judgment ensures the law keeps up with changes in society and, crucially, provides a more rational deterrent to abuse than a blanket ban which is never enforced."

    Debbie Purdy: 'We've got our lives back', I, 31.7.2009, http://www.independent.co.uk/news/uk/home-news/debbie-purdy-weve-got-our-lives-back-1765339.html

Swine flu cases

doubled to 100,000 last week

— 850 in hospital
 

July 23, 2009
From Times Online

David Rose The number of swine flu cases in Britain nearly doubled last week, as an estimated 100,000 people were infected, officials said today.

Outbreaks of illness have reached epidemic levels in several parts of the country, including London, the West Midlands and parts of the North East as the Government announced details of a new telephone line and website which will enable people in England to obtain antiviral drugs without seeing a doctor.

People with symptoms of flu were encouraged to call 0800 1 513 100 or check a dedicated website from 3pm today in order to obtain advice and treatment.

But within three minutes of its launch the website had ground to a halt. Visitors trying to get an online diagnosis of their symptoms were given the message: "The Service is currently very busy and cannot deal with your request at this time. Please try again in a little while."

Sir Liam Donaldson, the Chief Medical Officer for England, said that as of today, 840 people were being treated in hospital after contracting the H1N1 virus. Of these, 63 were in a critical condition. But the official number of deaths linked to swine flu stayed the same, as an inquiry led by Sir Liam reviewed whether the virus was an actual cause of death.

According to Sir Liam’s latest weekly update, the deaths of 26 people in England have been provisionally linked to the virus. Not all of these deaths have been fully investigated, but of the fatal cases where post-mortem examinations have been carried out, 67 per cent had severe health problems and 16 per cent were said to have been healthy previously.

Sir Liam declined to go into further details because of the risk of patients being identified.

The likely death toll across Britain is thought to be about 30, including four deaths in Scotland. The deaths of an unidentified patient in the West Midlands and a 15-year-old from Glasgow were announced earlier this week.

In the week to Sunday, an estimated 100,000 people were infected with swine flu, the Health Protection Agency said. Last week GPs advised more patients with symptoms than at the height of last winter’s flu season.

According to the latest data from a selection of GP practices, more than 155 in every 100,000 people contacted their doctor to report flu-like symptoms last week. This compares with 73.4 per 100,000 who did so the previous week.

The new National Flu Pandemic Service, for people with suspected swine flu in England, will be capable of answering more than a million calls a week.

It will be staffed by more than 1,500 call centre staff at centres around the country, taking calls for 15 hours a day initially but it could become a 24-hour service with the option of recruiting 500 more staff if required.

The Department of Health said that the service will be capable of answering more than 200,000 calls a day, far more than the peak of 10,200 swine flu calls that NHS Direct reported on Monday.

The new website will enable people to answer a questionnaire themselves and potentially receive Tamiflu, the antiviral medication.

Applicants will be asked to supply their name, address and date of birth either online or over the phone, before receiving a code, where appropriate, to exchange for medication.

This code can then be given to a “flu friend” who will collect the Tamiflu from a collection point on the patient’s behalf, using a form of identification from the patient. But some doctors and charities have warned that the new system could be open to abuse, or overlook cases of serious infections such as meningitis.

Steve Field, the chair of the Royal College of GPs, said that the system would rely on patients honestly reporting symptoms. “One problem could be that the public decide all to ring at the same time to get Tamiflu ‘just in case’ or if they are about to go off on holiday this weekend,” he said. “I imagine there will be a few people like that, but the public generally have so far reacted very stoically and shown common sense in this flu pandemic, and we need that to continue."

The new phone service is set to go live as a poll of health workers reveals that only around four out of 10 believe their organisation was managing to cope with the extra flow of patients experienced in recent weeks.

Earlier the Prime Minister had said that Britain was the first country in the world to start diagnosing cases remotely.

“It means that the load on GPs will be lessened, it means that people can phone up the call centre and go online and check what their condition is. It gives them advice about how to get access to antivirals."

He added: “We are trying to make it possible for people to be treated quickly, because we know that for people to be treated in the first 24 to 48 hours makes a real difference.”

But Andrew Lansley, the Shadow Secretary of State for Health, said: “With pressure on the NHS continuing to escalate, there is still far too much confusion about access to diagnosis and treatment for swine flu.

"Already, the Government’s new flu line service is unable to cope with demand. The website informs visitors they’re too busy to deal with their request, and reports that staff manning the service lack the medical expertise or training to offer a flexible response, it’s clear that this interim service is simply too little, too late.

"This could have been avoided if the Government had followed the advice in their own planning document, and set up a full National Flu Line as soon as a pandemic was declared a month ago.”

Sir Liam said that people at risk of complications or serious illness, such as pregnant women, people with chronic health conditions and very young children will still be referred to GPs.

His comments came after business leaders said they were working with the Cabinet Office to prepare advice for employers on how to plan for widespread sickness absence as rates of illness increase in the coming months.

John Wright, chairman of the Federation of Small Businesses, said: “Swine flu is expected to have a serious impact on the UK, with a more than a 5 per cent fall in UK GDP this year alone and up to half of the population infected.

“Although it is still difficult to estimate the full effect of the spread of the pandemic, we know that small firms — which contribute more than half of UK GDP and employ 60 per cent of the private sector workforce — will be very badly hit.”

The Federation called on the Government to ease the burden on small firms by simplifying the system under which they can reclaim statutory sick pay. “This will mean that small businesses with fewer than 20 employees are automatically entitled to repayment of sick pay during the epidemic,” Mr Wright said.

He added that all routine inspections in high-intensity infection areas should be stopped during the pandemic, “to reduce the burden of red tape on small firms”.

More than 700 people worldwide are known to have died after getting swine flu, which the World Health Organisation says is spreading faster than any previous flu pandemic, although most cases of illness are mild.

    Swine flu cases doubled to 100,000 last week — 850 in hospital, Ts, 23.7.2009, http://www.timesonline.co.uk/tol/news/uk/health/article6724925.ece

Britain prepares

for 65,000 deaths from swine flu

 July 17, 2009
From The Times

The NHS has been told to plan for a worst-case scenario of 65,000 swine flu deaths this year. The news came as the number of people to die after contracting the virus rose sharply.

Health officials said that 29 people had now died — up from 17 confirmed deaths on Monday. There were unconfirmed reports that the new cases included a young boy from Kent.

Sir Liam Donaldson, the Chief Medical Officer, said that it was not yet known whether the most recent victims had underlying health problems. In all, 26 people have died in England and 3 in Scotland, including an ill baby in London and a tourist with significant medical problems who died in hospital in Inverness. The results of a post-mortem on Chloe Buckley, 6, who died last week, are not yet known.

About 55,000 people reported flu symptoms last week. The number of patients in hospital with swine flu has doubled to 652, of whom 53 are in intensive care. Visits to GPs and calls to NHS Direct have risen sharply.

The surge prompted officials to announce the launch next week of the National Pandemic Flu Service, as disclosed yesterday in The Times.

The advice to prepare for 65,000 deaths is based on 30 per cent of the population falling ill. Children under 14 are being hit hardest and the NHS was told to plan for a worst-case scenario of up to half of all children being infected during a first pandemic wave.

President Obama has allocated $1.8 billion to fight the pandemic. The money will buy vaccine ingredients, allow vaccines to be approved quickly and help US health officials to plan for immunisation campaigns.

Sir Liam said there was now “exceptional influenza activity” across most of the country apart from Yorkshire and the Humber. Tower Hamlets in East London has the highest proportion of GP visits, with 759 consultations about flu-like illness per 100,000 of the population. Other boroughs badly affected include Hackney, Islington and Lewisham. “Some of these will have the worried well among them,” Sir Liam said.

Cherie Blair is among those with the virus. The wife of the former Prime Minister has had to pull out of a number of public engagements.

The planning model given to the NHS shows that deaths could range from 19,000 to 65,000 if 30 per cent of the population fell ill. In the pandemics of 1957-58 and 1968-70, between 25 and 30 per cent were infected. In the former, 33,000 people died; in the latter it was a few thousand fewer.

The model says that the NHS should prepare for up to 12 per cent of the workforce to be off sick. However, it emphasises that its figures are not a prediction but based on a “reasonable worst-case scenario for planning purposes”. It adds that the spread of the virus might slow during the summer holidays, peaking in October after children go back to school.

in London. Officials confirmed four of the cases yesterday, all with underlying health problems. They included a baby, a woman of 39 and a man of 70.

Some years there can be as many as 20,000 extra deaths in the winter that are linked with influenza.

Sir Liam said that the aim of the new flu service was to alleviate pressure on hospitals and GP services in England so that they could concentrate on those most seriously ill. The Government was trusting the public not to abuse the service, he added.

People will obtain a diagnosis over the telephone or by completing an internet questionnaire. They will then be given a reference number so that a “flu friend” can pick up the antiviral drug from a depot. Scotland, Northern Ireland and Wales have not yet set up such a service but may do so.

The Health Protection Agency estimates that there were 55,000 new cases in England and that up to 85,000 people could now be affected.

The Department of Health defended its preparations amid accusations that it was providing conflicting advice. A health trust memo passed to The Times had said that guidance was “muddled and contradictory”.

    Britain prepares for 65,000 deaths from swine flu, Ts, 17.7.2009, http://www.timesonline.co.uk/tol/life_and_style/health/article6716477.ece

London teenager

becomes Britain's fourth swine flu death

July 3, 2009
From The Times
David Rose

A 19-year-old man has become the fourth person in Britain to die after contracting swine flu and is the first fatal case in London, officials said today.

The unnamed teenager, from South London, had serious underlying health problems and it is not known if the flu infection contributed directly to his death.

The man died on Wednesday but was only later confirmed to be carrying the H1N1 virus.

Simon Tanner, director of public health for London, said: “It is with sadness that we have to announce the death of a patient in London who has subsequently tested positive for H1N1 swine flu.

“No further details will be released to protect patient confidentiality. Our thoughts are with [the family] as they come to terms with their loss.”

All the people who have so far died in Britain of swine flu and have tested positive for it were suffering from underlying health problems, which may have made them vulnerable to infection or complications.

There have been at least 7,500 confirmed cases of swine flu in Britain so far and Dr Tanner emphasised that in most cases infection was a mild illness from which people could recover in a few days without needing to see their GP or go to hospital.

“However, some people may be more susceptible to the virus,” he said. “If you have flu-like symptoms it is important that you talk to your doctor if you are pregnant, very young, over 65 or have long-term conditions, such as asthma or diabetes.”

Jacqui Fleming, 38, of Glasgow, was the first person in the UK to die after catching swine flu.

Ms Fleming died last month, two weeks after her son, Jack, was born 11 weeks prematurely. Jack died later but had not been infected.

The second victim was a 73-year-old man from the Inverclyde area of Scotland.

A week ago today, six-year-old Sameerah Ahmad became the youngest British victim to date.

Sameerah, who was born with a rare life-threatening disease, died at Birmingham’s Children’s Hospital. It is unclear if swine flu contributed to her death.

Sir Liam Donaldson, the Chief Medical Officer for England, said yesterday that more research was needed to understand the nature of the virus and why some people might be more susceptible to infection or serious illness than others.

He said that the deaths of young and previously healthy people have been reported in other countries after they contracted swine flu and that all people with symptoms in Britain would be offered treatment with anti-viral drugs.

He warned the public to avoid panic-buying “counterfeit” anti-viral drugs online.

Sir Liam confirmed that the United Kingdom had moved past the stage of containing the swine flu outbreak and into the “treatment phase” but added that there was no need for people to resort to the internet to self-medicate.

He said that Britain had a massive stockpile of Tamiflu and would be one of the first countries to have access to a vaccine, with the first supplies arriving at the end of next month.

Sir Liam said: “There’s generally a growth in people ordering drugs from the internet worldwide and there’s a lot of concern amongst health authorities that people might buy counterfeit drugs.

“I think this is a similar situation - people shouldn’t buy Tamiflu from the internet. “We have got a massive stockpile in this country and everybody can have access to it through the National Health Service.”

Sir Liam added that he was “surprised” health services controlled the virus for as long as they had. The first case in Britain was recorded in April.

He said: “We have been dealing with it very aggressively so far. We have investigated every case, we’ve treated their contacts, we’ve closed schools and all of that has helped slow the spread.

“We are surprised we have been able to run it as long as we have like this. Flu viruses spread extremely quickly so this is very much going as expected.”

The numbers

7,447 cases of H1N1 swine flu confirmed in Britain so far

100,000 new cases predicted each day by the end of August

35 per cent of the population may become ill at the peak of the pandemic

£800m cost of antiviral drugs stockpiled to treat 80 per cent of the population

£155m cost of contracts for vaccines for the pandemic flu strain over four years

12,000 deaths annually due to seasonal flu, likely to be far exceeded in a pandemic

Sources: Department of Health; Times database

    London teenager becomes Britain's fourth swine flu death, Ts, 3.7.2009, http://www.timesonline.co.uk/tol/tools_and_services/mobile_times/swine_flu/article6630493.ece

Britain suffers its first swine flu death

June 15, 2009
From The Times

The first death in Britain from swine flu was confirmed last night after a woman died in Scotland.

It is understood that the victim was a woman aged 38 in the Royal Alexandra Hospital in Paisley, who had been admitted to intensive care suffering from the H1N1 virus.

The death is the first in the world not in the Americas, where the outbreak was first identified in Mexico in March.

A statement issued last night by the Scottish government said: “With regret, we can confirm that one of the patients who had been in hospital, and had been confirmed as suffering from the H1N1 virus, has died today.”

The statement added that the patient had had “underlying health conditions”, suggesting that the swine flu virus might not have been the only contributing factor.

The patient was one of ten people who had been in hospital with the virus in Scotland. At least three people with underlying health problems were admitted to intensive care at the Royal Alexandra in recent days — among them was a man, 45, a woman, 23, and a woman, 38, who gave birth two months prematurely as a result of the virus.

It is believed tests have shown that the baby does not have the infection.

Yesterday 35 new cases of swine flu were identified in Scotland, bringing the total to 498, almost half of the total cases in Britain, which now amount to 1,226. Sixty-one more cases were confirmed in England, bringing the total number of cases to 752, with eight in Northern Ireland and three in Wales.

Across Scotland another 175 unconfirmed cases of swine flu, which has predominantly affected younger people, were being investigated yesterday.

Last night Nicola Sturgeon, the Scottish Health Secretary, said: “I’d like to express my condolences to the patient’s family and friends. They have my heartfelt sympathy.

“I would like to emphasise that the vast majority of those who have H1N1 are suffering from relatively mild symptoms.

“The risk to the general public remains low and we can all play our part in slowing the spread of the virus by following simple procedures like washing your hands and using tissues when coughing or sneezing.”

The first case was confirmed in Britain on April 27. Graeme Pacitti, from Falkirk, subsequently became the first man to contract the disease from within Britain, after contact with newlyweds who had recently returned from honeymoon in Mexico.

Andy Burnham, the new Health Secretary, said in a statement to the Commons on Friday that Britain had enough anti-viral drugs to treat half of the population and that plans had been made to raise that figure to 80 per cent. He added that agreements were in place to allow the Government to purchase 132 million doses of vaccine — enough for two doses for the entire population. Orders had been placed for 226 million face masks, 34 million respirators and 15.2 million courses of antibiotics.

He said: “We recognised from the outset that we would be unlikely to prevent a widespread outbreak indefinitely.”

A Department of Health spokesman said: “The localised cases of swine flu found in the UK have so far been generally mild in most people, but are proving to be severe in a small minority of cases. We are continuing to work to slow the spread of the disease and to put in place arrangements to ensure that the UK is well-placed to deal with this new infection.”

Experts are predicting that the number of cases will rise significantly during the autumn and winter months, though they emphasised that this was common with all strains of flu, which tend to be seasonal.

Professor Hugh Pennington, a bacteriologist at Aberdeen University, said that the death did not necessarily mark a worsening of the outbreak in Britain. “It does not point to the virus getting nastier. All the evidence to date suggests the virus is not changing at all,” he said.

“This is a flu virus, it is in no way different from an ordinary winter flu virus, so if there are enough cases some people will have to be admitted to hospital and some will die.”

Britain suffers its first swine flu death, Ts, 15.9.2009, http://www.timesonline.co.uk/tol/news/uk/scotland/article6499353.ece