Episode 6 The Big Questions

Thank you, good morning. Welcome to Big Questions, live from

Michaelston Community College in Cardiff. I'm Nicky Campbell, the UK

is now the fattest country in Europe. One quarter of British

adults are clinically obese, one third actually here in Wales. More

worryingly, one third of British children are overweight or obese by

the time they leave primary school. So, another flurry of and campaigns

has launched in the last fortnight to do something about T one idea is

to tax unhealthy foods. Our first big question, should we tax to

tackle obesity? This grass tro entologist said that

obesity is such a burden on the NHS we should tax all foods containing

shruger. This campaigner says tax is too blunt an instrument and the

food industry would find a way to avoid it.

Some people believe in ghosts, others think horoscopes are a guide

to life, and others trust hem homeopathic -- in homeopathic

medicines. These people trust. Our question is faith compatible with

reason. This author says human progression needs to unravel

mysteries not revel in it. Andrea Foulkes, past regression therapist,

says her heart tells her what to believe.

This week's report into Mid Staffordshire NHS Trust said

appalling care flourished because managers put cost control and self-

interesting ahead of care and safety. This is not confined to one

hospital, across the National Health Service doctors and nurses

have raised serious concerns about the Care Pathway, it is a protocol

designed to give a good death in hospital. I will ask the question,

is NHS cutting lives short. This doctor says Liverpool Care

Pathway has become a self-fulfiling prophesy. Many people die too soon

because they are put on it. And this doctor says people are only

put on it if there is a 97% likelihood the patient would die in

24 hours. It does not cause deaths, and it aims to ease dying.

Welcome everybody to Big Questions. Today the average ten-year-old boy,

living here in Wales, where we are this morning, is 10 kilograms, or

one stone eight pounds heavier than his counterpart ten years ago. This

is the first generation of children not expected to live as long as

their parents. Obesity already cost the NHS �6 billion, thought tole

balloon to �50 billion by 2050, 300 separate conditions in all are

attached to obesity. Should we tax to tackle obesity. Zoe Harcombe,

you have written this book, The Obesity Epidemic. You talk about

"insidious" sugar. That is the great Satan of food? I believe we

should tax and we have to get the right tax. We must not tax anything

that is real food or a component of real food. People often put three

things together, fat, sugar and salt, two of those are wrong. Fat

and salt are real foods, found in real foods, we need more of both of

them, ironically. Sugar is the demon. We had a sugar tax until

1874, we just need to bring it back in. It needs to be punitive, such

that it acts as a deterrent. Punitive and prohibitive? As you

said at the top of the programme, we have to do something. Foresight

report says that 90% of 200's children will be overweight by 2050

unless we do something. We have to do something serious. Sustain

called last week for a 20p per ly theer on sugary drinks, I would go

further, anything that contain as gram of sugar or sweetener, the

food industry will only do one or the other, double the price and tax

it t a bag of sweets should cost more than �20 rather than 20p. We

have to price this out of people's range!

�20 for bag of sweets? Behaves lived fat for so many years, I have

learned the hard way that to lose weight you shouldn't eat any of

these things. If you tax -- having lived as fat for so many years I

have learned the hard way you shouldn't eat those things. If you

tax these food it won't help fat people. Let's not take obesity as

an excuse, the more we talk about fat people, the more we demonise

fat people. The more obesity is on the rise. You think it is a self-

fulfiling prophesy because people's reasons for eating more are

exacerbated? There are so many reasons for people being fat. There

are health conditions like overgrowth, that gets people to

want to eat sugary food. Why blame fat people all the time. This is

not demonising fat people, it is not at all. I have every sympathy

but, this is demonising the food industry. I deal with thousands and

thousands of people who are fat, and the only thing they want is to

lose weight. Absolutely. I don't think any fat person alive,

especially women, with all the shame and humiliation, with all the

ostraciseing of them. What is wrong with making sure the food that is

killing people and cutting life short is more expensive than the

food that is good for you, what is wrong with that? There is nothing

wrong, ban it, ban it! If it's bad for the fat it's bad for the thin!

I go there, ban it! Even better. Don't tax it, ban it. Food writer,

Oliver? Agree with Zoe, sugar is far more dangerous than FA a good

wave doing things might be, by -- than fat, a good way of doing

things might be offsetting the tax on fizzy drinks is with suss

December for healthy food. stigma of fat people, we get the

worst jobs, we are worse off, you see insults everywhere, we can't be

superstars or film stars or anything. Fat is being humiliated

and insulted, I don't think anyone in their right mind wants to be fat.

How do we stop children from getting fat in the first place.

This will increase life chances of children, and include their health

and well being, we are what we eat, educational attainment. It will, if

we do something radical, lead to fairer society what do we need to

do? The danger here that we are focusing on food. Obesity is never

just simply excessive calorie eating on the own. I think the

whole society has become so sed dentry, it is for -- dsedintry, we

need to get up. He is saying it is laziness not sugar? The food

industry wants us to believe, that they want to tell us, eat all of

our product, eat more of our products, as much sugary and fizzy

drinks as you like, but exercise it off, you lazy so and sos.

National Obesity Forum says, what? You don't like them? I like

everybody! Some less than others? We have a big heart, as our

beautiful big bodies! You are a gentleman and your association and

your movement with the diet industry and everybody are trying

to eradicate fat completely. Anyone who is fat is diseased, which is

not true. Obesity is a disease, it is a progressive disease. It is not

a disease for everybody. All the diseases that you find, in fat

people, you find in thin people, diabetes, high blood pressure,

cholesterol, all sorts of this. Show me a disease that is only for

fat people, and thin people don't have? Where? Your risk is much

higher of those things. We need to come back to, we have a fine night

budget to spend on disease in this country. The NHS only has a certain

amount to spend, and the Government has a duty of care to ensure it has

the best resources available for us all. The emphasis needs to be on

prevention. I think I agree with a lot of what has been said already.

We don't know, most people don't nope what is healthy food any more.

So I think we need to do some radical things around banning the

word "healthy" on most product, because they are not healthy.

what for example? There are all sorts of things that call

themselves healthy because they have a few oats in, the fact that

they have 30 grams of sugar is ignored. We need intelligent food

labelling. The current traffic light system demonises really

important nutrition tral product, such as eggs, dairy, cheese --

nutritional products, such as eggs, dairy and cheese. The policy should

be, don't buy anything with a label. The fact that we don't know what is

in our food is patently clear this week with the whole horse business!

Where do we start with this? I was going to saying, I used to be 14

stone 10, obviously I'm tall, but it was a real problem and horrible,

because you are away everyone looks at you, everyone is thin, and

everyone is telling you shouldn't be that size. But I was perfectly

healthy, and, in fact, I was trying to lose weight, everything I did to

try it lose weight didn't work, I was doing Weightwatchers, the

cabbage diet, and I just got fatter. The way to be losing weight is to

be happy, active and do something you love doing. To eat less?

happens naturally. To eat less sugar, definitely. So much of the

scientific evidence is moving in favour of sugar as being the really

dangerous thing. HFC as well, but for a long time it was fat being

demoniesed, buying low-fat foods full of sugar, all the evidence is

shifting away from that Barry Tubbs has writ an great book called How

Do We Get Fat about this. We are all liable to get the 300 related

diseases, related today obesity? You are more likely if you are

obese. That is what we are hearing, in your opinion, doctor, do you

think I'm thin? Hear out the doctor. In the coming decade there will be

an increase by 50% of type II diabetes, simply because there is a

trend increasing in obesity. There is a very close relationship

between the two. There is no co- relation, there is a co-relation,

not causality. There is causality. It has not been proved. Are you in

denial here, of the scientific facts, that is our second debate!

The science improves and changes every day. I'm talking as a fat

person who is in contact with so many other fat people. If we want a

healthy nation, we have to stop this pressure on losing weight.

Forget the weight, change the pardigm from weight to health. Get

people to eat healthy to exercise. We are not talking about yourself,

we are talking prevention, and we are talking about management for

those who are already obese. If you don't want to be treated fine, if

you are happy with what you are. You see you are accusing me already

of being diseased because you don't like my size. You would rather I

melt. Is it a disease? Of course it is. It isn't. It is a body shape.

You don't say there is a pandemic about something that isn't a

disease. It is a body shape that is so manipulated that is in danger

because of Yeoh dieting, we lose weight -- yo-yo dieting and losing

weight and putting it back down. Ten years ago the weight of an

average child in Cardiff, the average boy weighed a stone flaf

less ten years ago than no -- stone-and-a-half less than ten

years ago, why? Cheap sugar. Coca- Cola and all that? Studies have

been done on this, children are no more less active than they were in

the 1960s, what has happened is a plummeting of the price of sugar,

largely through subsidies in American corn, ands and as a result

people are taking on 300-400 more calories more than they used to be,

that is why the weight has ballooned, especially in young

people. When we had Coca-Cola it was a treat in our house? On the

Government's website, it has this healthy food plate, on it has 8% of

that in things like cake, and coal la can. That should not be part of

a -- coal la can, that should not be -- cola can, that should not be

on there. Did you have a healthy breakfast? I didn't have breakfast.

A lot of factors are contributing to this, we are giving people

negative images of themselves, and that doesn't help their mental

health and that needs to be addressed. People don't just eat or

eating's sake there is something behind T we are consumerist, we

want everything yesterday, why cook a healthy meal within I want

something easily accessible. If you tax it, alcohol is taxed,

cigarettes are taxed, if you ban it, you create a black market. You need

to look at the reasons why people are doing these things.

I was think to go myself, the British public are pretty fed up of

being taxed all the time. APPLAUSE

Why don't we spend some of this money on an awareness campaign. Add

some bicycle lanes in some of these areas, push this idea of the

healthy lifestyle. I'm just wondering how much of a difference

it will make things like smoking bans came into public places,

obviously with taking it off the shelves in supermarkets and then

having the "smoking kills" sign, how much difference will it make.

We have half the smokers we had in the 1960s, smoking it one of the

arguments against the point you just made. You have to look at who

owns the food industry, the pharmaceutical industry owns the

food industry, the food industry want to make you sick and ill by

putting chemicals in that rot your bod and make you ill, they then

give you tablet that is make you better. It is all about iluminati

families making money in the world. You perked up there Rob, Iluminati

families making money? It doesn't make a lot of sense to me, to be

honest. He gave our power away, we started not growing our own

vegtables and gives power to people saying we will make the food, you

don't want to cook, we will make it for you, we didn't question what

was in this stuff, they started putting all kinds of crap in it.

Language for saund morning! I'm a raw food -- A Sunday morning.

a Big Food eater, why would you want to eat corto isol in your food,

that gives you fear. Is there anything in what she's saying about

chemicals in your food, we are what we eat, they are having a bad

effect? I think smoking is difficult, obviously. We have moved

on from smoking. We are talking about the chemicals the stuff

pumped into our meat? You are a doctor you know what cortisol does

to the body? Processed food is not as healthy as genuine food. We know

that, that is a fact. The question is, I come back to this, though a

lot less people smoke nowadays, mortality among the population has

not been reduced. Monosantumare genetically modified seeds that are

patented, you can't use the same seed nexty, our bodies can't break

down genetically modified vegtable, they aren't vegtables. I don't want

to get distracted into a GM argument, that is not true that our

bodies can't digest GM food. What about the danger that this would

ultimately, in the short-term and mid--term, before we have this

cullinary and Cultural Revolution, this would be a tax on the poor?

The difficult is the very groups that we are seeing obesity tend to

be those with very low incomes. There is a huge cultural problem in

the way we are bringing up children, particularly rewarding children for

good behaviour with sweets, they get a sugar rush, they then get a

bit hyperactive, they get hungry afterwards. I remember going to the

doctor and getting a jelly babey at the doctor, that was OK? We are

conditioning children to go for the treat foods and we need to change

the pattern. Our respect for local farmer, look in Wales we grow

fantastic vegtables, but people don't know how to cook vegtables

any more. That needs to go into primary schools and reward good

behaviours. I think we are failing to address

the fact that eating more healthily is more expensive, if you are

trying to feed a large family of small children, where there is

hidden sugar in fast-food, that's where we are going wrong. Should we

tax it? No, we shouldn't tax it, we need to make healthier food more

available to those that are economically disadvantaged.

Good morning, I agree with what was just said, also I think the

Government, rather than taxing the food, they need to further regulate

the food manufacturers, because you go to the supermarket, there is

hundreds of item on sale, full of sugar, full of ingredients we can't

even pronounce, that are highly addictive. The problem with the tax

is if you tax the foods, the people addicted to them will still buy

them regardless. Ing Back to what do we do? I --

coming back to what do we do, the focus needs to be on prevention, we

need it start young, cooking should be compulsory in schools, nutrition

should be compulsory in schools. As soon as a child starts to become

overweight, they and their family should be given compulsory

education on how to eat healthily, unless you intervene young, that

person will go on to become more and more overweight, and have all

the risks that are associated, the bottom line is, you are beautiful,

you are lovely, but we can't afford a world full of people who are

overweight. We have to accept that God has created people in different

shapes and sizes, why are we trying to elimb nai. People get to my --

eliminate. People get to my size because they are trying to get to

your size. They are against their size, if I was supposed to be 10

stone, and they tell me to lose, lose, lose, I become 35 stone.

I think the argument that people should lose weight because the

health service can't afford to fund overweight people is a very

dangerous argument. I don't think it is up to the health service to

decide what people should be like. It is up to the health service to

provide healthcare for people who be, they choose to be. It may well

be right for us to encourage healthy eating, that is very

important. We don't choose to be obese. Otherwise we end up saying

therefore we shouldn't offer orthopaedic for people who choose

to go skiing and break their legs. The health service is there to

serve people, not the other way round.

Thank you very much indeed everyone for your contribution. I'm sure you

would like to say something about that, log on to the website, follow

the link to where you can join in on-line. You can join the

discussion on Twitter too. We are also debating live this morning

from Cardiff, is faith compatible with reason? Is the NHS cutting

lives short. Tell us what you think about those topics, send your ideas

for future debates if you will, or any comments you would like to make

about the programme. Britain's most famous atheist,

Professor Richard Dawkins, said, "faith is the great cop out, the

great escape from the need to evaluate evidence", a founding

father of Christian theology, St Augustine said the understanding is

the reward of faith, seek to not understand what you believe, but

believe that you may understand. Is faith compatible with reason?

You have written this very interesting book, The Her

particulars Adventures With The Enemies of Science. The psychology

of this is very interesting, there are creationists and people are

into horoscopes, past life regression people, we have

something of that ilk to talk to, I'm delighted to say is in the

studio. David Irving, the Hitler apologyist, the psychology is

interesting, in the face of evidence overwhelming to the

contrary people will stick to their belief and have this filtering

system in their mind. It is fascinating. What I discovered is

people decide what to believe with their emotions. We are confronted

by a fact, and we decide emotional low and instantaneously whether or

not we believe T through lots of filters, like emotional bias, we

seek to justify the emotional response, anything we come across

to dismiss the emotional response we put it aside and say the person

coming up with is an idiot. This is how our beliefs come about and we

become more and more convinced they are right. It all begins with

feelings. The quest for certainty? Yes, people are intolerant of doubt.

People will have this drive to find more and more evidence to back up

their beliefs. Although doubt arguably is driven discovery in the

past and science and progress? Absolutely, I think people are

naturally intolerant of doubt, we need to have a bit of humility

about we believe, and understand we should always encourage that

feeling of doubt. Past life regression therapy? Most people

think they know about past lives and what I do don't unless they

experience it. You have said you can't scientific prove things, I

just know they are true? You can't scientificly prove it, but quantum

physics improving that the heart has a cohesive wave form, a pat orn,

that creates emotion. Everyone's thoughts and beliefs are coming

from an origin, where do they come from? Three strains, ancestoral

pattern, passed down through ancestors, which we call genetic, I

work with when I regress people to change something in the

subconscious, then you have past life patterns and compounded stuff

from being in the womb to present day. You have consciousness in the

womb. This creates your current reality. Even weight is an issue of

a slowed metabolism, coming from programming from past lives or

ancestor, that is why it is genetic, and a lot of people might be

overweight. The conscious self is going I have no issues but the

subconscious is going another story. What is external proof? Clients and

people who have experienced and they change their reality. I don't

deny your reality exist, that person's exist, all realities exist,

but within different dimensions, we live in a multidimensional reality,

a holographic universe. A what? holographic universe. Babble!

have free will to believe it is babble, it is free will. That is

why a lot of people haven't heard of past life regressionism is there

is no scientific basis, the burden of proof rests with you, you need

to prove what you have just said. did my own show on ITV I have

proved it with clients. The point you are making is a theory attain

as status of scientific they arey, if anything disproves it or

successfully proves it, it is or isn't a theory? Your heart tells

you this is true. It is. That isn't the organ that allows you to tell

you reason. The heart has an intelligence. Science is proving

that now. Reason is based on empier ral evidence that is testable, and

falsifyable, and verifiable, and you are not able to do that.

you interrupt in a previous life as well! That is all I have to say.

The burden of proof rests with you, you can't provide the evidence.

can provide the evidence. It is such a dangerous way to look at

life, you can justify anything, a belief in anything with faith.

Everybody experiences their Israel tee, everybody experiences their

reality. If -- reality. Everybody experiences their reality, if

somebody has an experience and you can't prove, they heal disease and

illness. You are a physicist but also a Christian, but you see great

proof of God in physics, don't you, and in the world around you.

Although some would say, as those mysteries are unravelled, as we

progress scientifically and we discover more and more, some argue

there is less of a space for God, but the rainbow is a good example,

God did it, we know how rainbow through the refraction of light

work. It is the idea of the God of the gaps, those gaps get smaller

and smaller? Can I answer? If I can just set up the background, let's

think about faith generally, faith in human life. Hopefully husbands

have faith in their wives, visa versa, that is based on past

experience. But you don't know that your spouse is going to be faithful

in the future. So you are taking something from the past, which is

rational, reasonable, based on observation of this person as you

are courting, and then at some point one of you decides, both

decide at the same time you want to get married. Once you are married,

then have told each other you will try to stay together. You have

faith this person will be steady, kind, faithful, and you have to

keep going. At some point you might start thinking is he seeing someone

else, for example, and then, you can either say I will trust in him

a bit longer until it is absolutely obvious that he's being unfaithful,

or you can start setting ...It falsifyable, you can get a private

detective to find out? But there is still an element of taking what you

know to be true, and applying that to the future which you don't

actually know. So other examples are, orchestras and the conductor,

the conductor takes the orchestra through a series of rehearsals, you

have to have faith he will rehearse you enough in the different places.

So far? I think it is interesting we are talking about past life

regression, which I have experienced, and you say you know

it in your heart that is real. I think it is the same with

Christians, Christians begin with extremely powerful emotional

conviction that God is real. But, of course, we don't know that God

is real until you have been in a room with God and shaken his hand,

you don't know it is real. It begins with the feeling. The source

of your feelings is your brain or mind or not anything out there. We

are all the same. I'm not more rational in lots of ways than you.

I'm not saying I'm Mr Perfect, we all begin with these feelings, but

these feelings aren't to be trusted? Why aren't these feelings

to be trusted? Because, emotionally, we all tell ourselves stories about

the world, these stories are very emotional, full of people who hate

us and love us, good guys and bad, the brain is like a story-

generating organism, it is not fact-begin the and rating organism,

we become vulnerable to the narratives we tell of the world. As

I say, they lead us down very distorted passages in terms of what

we should and shouldn't believe? is not about should and shouldn't.

Clearly God is invisible, we don't wake up and the huge face of God

smiling down at us from the sky. Is that deliberate? Is God perhaps

setting us, if you think about the story of Beauty and the Beast,

beauty wakes up, I can't remember it, there is this bit, and

everything is provided for her, a sumptious mansion, she can't see

who is in charge, it is the beast, obviously, and she gets to know his

character through what he is providing for her. So that, when

they meet, she understands his actual kindness, rather than

judging him from appearance. With respect, what we are seeing here is

confirmation bias in action. You are intelligent person, you have

this belief in God, but there is a problem, where is God, I can't see

him. Now we are watching you doing it, how can we explain this, how

can we think our way around this? Your book sounds interesting, I'm

looking forward to reading it, you are right about confirmation bias,

but the point about reason is a belief in reason or the value of

reason encourages you to advance high poties, to test them, reach

conclusions and test those conclusions. And when does the

hypothesis become theory? Faith rejects all of that.

That is not true. Many people come to faith through an intellectual

study, they look at the evidence, archaeological, the writers at the

time, the verification, that is what brings them to faith. It is

the intellectual evidence base for faith that then is confirmed by

existential experience. It does not come from a feeling. Intellectual

evidence base confirmed by existential experience? It sounds

like a spurious term, every discovery made by science has

excluded a supernatural constituent in that experiment. It is the God

of the gaps. Up been more than optimistic if you think any

scientific discould have r cover rees in the future will contain

that supernatural. What about the human mind that we do not have an

understanding of the human mind and consciousness, you are not there

yet. There is a big gap? I would say even if we could never

understand human consciousness, I still think the most implausible

explanation for consciousness is an invisible man in the sky put it

there. There is going to be a scientific explanation. One second.

I don't think it is an invisible man. Why do we think it is man, why

can source, which is life force energy be male or female, why can

it not be both. I don't want you two to fall out with each other. We

have the conscious and subconscious self-, and that is running your

fight or flight actions. By your past life programming. It is not by

an external force. It is an inner force. It comes from within us.

There is nothing out there, it is inside you. John Paul II said faith

and reason, I will put it to you ol version he said that faith and

reason are like two things are like two wings on which the human reason

rises to the contemplation of truth. Discuss? It is complete babble.

Martin Luthur was much closer to the mark, when he said reason was

the greatest enemy that Christians face, and Christians should pluck

out the eye of reason. The tragedy of that quotation is he recognised

that reason was a way of seeing things. Do you think anyone there

in this studio and watching at home who has faith is being illogical?

think it's difficult to, I think people who have faith can begin

from a position that face faith is the primal thing, the most

important thing, and then they can reason within that. I have argued

before, I just argued that faith and reason are diametrically

opposed, one starts with conclusion and one parts with a premises.

greatest mathematician that lived, Sir eyes sack Newton, said that a

thumb print, and no two are identical, is enough for him to be

persuaded that there is a creator God. The probability for that one

fact is so huge, that led him on that one fact. Some of the world's

leading evolutionists biologists are Christians, Ken Miller and

Watson. They see wonderful things in, for example, the natural

processes of evolution, it is not exclusive, it was Steven J Gould

who spoke of the non-overlapping imagination teary of science and

faith, you -- majesty of science and faith, you don't buy that?

is hard to reconcile evolution and faith. We have to believe that God

twidled his thumbs for billions of years, waiting for evolution to

deliver the human masterpiece. The reason why evolution has been

accepted by faith is because of the twinedling intellectual integrity

of religion -- dwindling intellectual integrity of religion.

Most churches accept it, we did a debate, it is not just evolution,

there are other aspects of science as well? It is clutching at straws,

it is having your cake and eating it, to be honest. It doesn't stack

up to tally the two. But it is just a means, as all of us said, it is a

start with that truth, there must be a God, we must find a way to

link that evidence back to God. It doesn't stack up. It is not just

the natural world, for a start we have got people claim, Jesus came

2,000 years ago, and the idea is that he was actually God in human

form, showing us what God was like. Do you think if he had a DNA test,

half of it would be untraceable? Half came from his mother?

Scientifically? I don't know. was all divine. All his DNA is

divine? Half is from your mother or father? It was imMaastricht late

conception, it was all de divine, she carried the baby.

-- it was all divine, and she carried the baby. What if we're all

God, and I love all the prophets and they are all right, Mohammed,

Jesus, but we man have distorted it to be seech this external deity, --

be seech this external deity which is not true the In terms of hope

and faith, faith as defined is based on conjecture, this is

general definition, from an Islamic perspective, faith convinces the

mind, settles in the hat and follows the option. Faith is an

intellectual journey, when you are talking about reason and rational,

using reality, you will find that actually this is very compatible

with religion, in fact, it actually leads to you belief of the creator.

Another point that has been made, we keep talking about God, almost

in a sort of human form, where as for us we should be looking at the

creator and starting from that premise, coming to the point of a

creator, that is eternal. That everything is limited and dependant

on the creator. Rather than an anthropecenric God? This man has

described bias, it starts with a belief and goes on a journey.

Koran has very strong edicts in it to seek knowledge? But problem is

with that, we feel as if we are seeking knowledge, as has been

demonstrated, this is confirmation, we feel as if we are having a

rational, reasonable exmoreation of the facts, we are not, we are just

-- exploration of the facts, we are not, we are confirming what the

thought in the first place. science the same things thing

happens, I'm sorry. Scientists have a hypothesis, it might be a PhD

student given an idea by a superviser, and he says, go away

and see if this is true. So you start with a premises, and I think

with God it is a bit impossible to extrapolate and find out what God

is just from reason alone. God has to come as Jesus as a Holy Spirit

in our lives and so on, but does that mean it is not threw? I agree

to an extent that of course scientists aren't free of these

problems as well, but the scientific method is the method by

which we have come across to destroy the processes of

confirmation, destroying emotion, it is not a perfect system, you

will get eminent scientists completely disagreeing on the data.

But it is a brilliant and largely successful attempt. When Einstein's

relativity theory came along everything had to ING cha.

D change. We are all God, that is the message to take from it? If you

have any questions or thoughts, go to the website and follow the on-

line discussion. Send us views about the last on-line discussion,

is the NHS cutting lives short? If you would like to be in an audience

and come here for a future show, you can e-mail the address on the

below. We are in Northolt next week, we are in south ham on --

Southampton on February 24th. Most of us prefer not to think too

much about dying, it is not something to plan forks but we hop

for a good death, pain-free, surrounded by loved ones at home

and in peace. But more than half of us will die on busy hospital ward.

That is why the Liverpool Care Pathway was developed, to try to

make each of those deaths as pain- free and peaceful as possible. As

some families and doctors now fear that putting a patient on the

Liverpool Care Pathway has itself become a death sentence. Ruling out

the chance of recovery. Is the NHS cutting lives short.

There has been quite a media furore about this, some thing a media

hysteria about it. The Mail has been talking about it a lot. It is

not about not prolonging a life, it is about not prolonging a life

unnecessary, -- necessarily, isn't it, do you approve in principle

with the Liverpool Care Pathway? One of the problems is it is

predicated on a false premises, namely that you can accurately

diagnose death, can you make an accurate prognosis of when a person

is going to die, within the next few hours or days. There is no

scientific evidence that we can do that. I know of no calibration

tools to use to say how accurately we can make that prognosis. That is

the danger. If you then sedate the patient, stop observations, stop

interventions, and stop food and fluids, the patient must die.

Whether or not they would have died any way, they must die, if you

adopt that regime in full. Baroness Finlay, can we have full confidence

that given the perceived crisis in care, it has been a very difficult

week for the NHS, that this has been ethically and appropriately

applied? Can I pick up the point, first of all, about prognosis, The

Royal College of GPs in evidence to Select Committee and I was on, I

quote, "it is possible to make reason reasonably accurate

prognosis of death within minutes, hours and days, when it stretches

for months, the scope for error increases". There is no accurate

way of predicts what will happen anywhere, it is on probabilities.

When somebody looks as if they are dying, and you have done all you

can to exclude all reverse pbl causes, then whatever you -- pos --

reversible causes, then whatever you do good evidence is base --

care is based on evidence and analysing what you see before you.

What about junior doctors, a weekend, busy ward, it is in the

hands of people not under pressure and stressed, then fine, but is

that always the case? I CERNly think the evidence coming forward -

- I certainly think that evidence coming forward, let's look at

evidence, is there seems to be a problem in some cases, there is now

Anne inquiry set up. I think the inquiry has to access all the

evidence and look at all the cases and conduct the inquiry,

independently, impartially and look at where the problems lie, where

there are problems, and, much more importantly, what the solutions to

those problems are. For people hearing at home, if there is a

problem with the application? would argue, of course there is a

case for high-quality palliative care in hospices and in the home.

But when that's rolled out, indiscriminately, in the NHS, it

becomes very, very dangerous. My father was admitted to hospital on

a Friday evening, parked on a ward all weekend, we begged them to do a

CT scan, they kept saying we will have to see, we will have to see.

We got the consultant brought down to his bed, she still refused to do

a CT scan. On the Tuesday morning they called us in, too late now,

he's too poorly. We were given a "definitive" diagnosis of

perforation, we said how can you say that based on inconclusive X-

rays, they said they were sure. He was put on the Liverpool Care

Pathway, and died. At postmortem it was found that he actually had

pulmonary embolism. misdiagnosis? It was a total

misdiagnosis, but the reason we are here is because elderly care in the

NHS is appalling. Can I say, firstly, I'm not here to

defend the whole NHS, I don't know the ins and outs of the tragedy of

your father's case. Exactly. can't comment on that, there would

appear to have been a misdiagnosis, the difficulty in this discussion

is did the Liverpool Care Pathway itself prevent people reviewing

that diagnosis, or was the failure at a different point earlier? And

the failure of care? The problem it wasn't just a misdiagnosis, they

didn't do any investigation into what he had. Unfortunately a system

like this, with the best intention in the world, people fall through

the cracks, like our granddad. If one person fall through the cracks,

for me, that is wrong. I would certainly not condone anyone

falling through the cracks. The whole of the work that we do is to

drive up care. Given, you know, the current problems, current stresses

and pressures, future pressures, reorganisation, do you have the

utmost, as much as you can, confidence that this is being

appropriately and ethically and responsibly applied? Of course I

couldn't say that I have a 100% confidence. We have an inquiry, I

have been arguing for an inquiry, I have supported the setting up of an

inquiry, and we need to have it, it needs to go and look in detail. Is

the problem with the documentation itself, is the problem with the way

it has been rolled out, is the problem with what's happening

actually at the bedside. Financial incentives, hospitals have been

paid, we saw last week with the Francis inquiry, about the problem,

about target-driven NHS. Financial incentives have been paid to

hospitals, certain hospitals that are now being investigated for

their mortality rates. �30 million. One hospital was paid �308,000 for

reaching targets for putting people on what is basically a euthanasia

programme. Baroness, it is euthanasia. Euthanasia is about

intent. The Liverpool Care Pathway doesn't intend to kill people, it

intends to improve the care when people are inevitably dying. That

is quite different. It doesn't work in practice. In your interview with

the gazette, you finish your interview. What gazette for that?

It was your local one. Don't mention it. You made the point, you

said it is not that the Liverpool Care Pathway is bad in itself, it

is that it can be badly used. I'm paraphrasing. That's right, it is

abused in the NHS. The principle of it, it is a good principle?

principle is, there is a point in the life of a patient, when they

are going to die. We may not know it without absolute certainty, we

have already talked about how human beings find certainty desirable,

but can he can't always have it. If we wait until -- we can't always

have it. If we wait until we are certain, we have missed the chance

to care for them in that time. is not about prolonging life

haizening it. I'm a physician, and I look after acutely ill people. We

do occasionally put patients on the care pathy, we agonise on this

decision, we consult nurse d care path way, we agonise on this

decision, we consult, nurses, doctors, family. You can't put a

patient on it without consulting the family. Very often there is no

consent doing. Were you consulted? We were told that it was inoperable,

and that is what they were going to do. Beforehand we were fighting for

investigations to be taken. trusted their analysis and

diagnosis? We didn't know, dial 999 and call the police. I know a lot

of people who weren't consulted, their consent wasn't sought from

the relatives, consent wasn't sought from the patients. That is

absolutely wrong and not behind the development of the Liverpool Care

Pathway, developed at Liverpool with Marie Curie cancer, it was

about having the conversation around dying well. Just as an

expectant mother has a birth plan, we should all expect to have a

death plan. How we want to die, where we want to die, what kind of

interventions, to not have that conversation was absolutely

wrongment you were betrayed in that. I just want to come to another

point about the financial incentives, I think it is totally

wrong that hospitals are paid to put people on this path way. The

money should go -- puttway, the money should go into training

palliative care professionals. As we have heard with the Francis

Report, and one of the suggestions is we need many move professionals

trained in care for -- many more professionals trained in care for

elderly people. There is a real danger in trying to

put simplistic targets around healthcare which sin credibly

complex. The absolute critical thing -- which is incredibly

complex. The absolute critical thing is when you have a patient in

front of you must re-think and review. Is there something else

going on, is there something reversible. Richard, how often, I

know this is an interest area of your's, how often, once somebody is

on the Liverpool Care Pathway, has somebody within taken off it,

because signs of recovery have been perceived? I do paediatric

palliative care, we don't use the Liverpool Care Pathway in children.

But the principle you are asking, how often do we go back and review?

It is all the time, every minute and every day, we see a patient

every day, this issue of, it is not so much a question of consent to go

on the pathway, it is the fact that the conversation needs to take

place, it was designed to facilitate that find of

conversation, not get rid of it. It goes back to the individuality of

the patient we are dealing with, rather than the NHS trying to shape

theself through defining targets. Can I just saying, when you go back

and review, about 3% of times you find that actually you were wrong.

The person isn't dying, they are actually improving, because you

have stopped whatever treatments you were doing, that were making

them worse than they felt. Because that's the nature of medicine. You

have to look after them. Is it under constant review when somebody

is on the Liverpool Care Pathway? One of the problems with the

Liverpool Care Pathway is decisions are made, and very nursing

observations are stopped, simple blood tests are stopped, and nurt

interventions are usually stopped, with -- further interventions are

usually stopped, with the exception of oxygen, that is continued in 45%

of cases. Most other interventions are stopped and very rarely started.

How can the patient be properly reviewed if you don't have basic

nurse observations, basic blood tests and so on. After three days

three-quarters of the patients have died. But of those that are still

alive, according to the audit that was done of 7,000 patients two

years ago, only 20% were reassessed. You put your hand up a few minutes

ago. What's particularly worrying is the vulnerable are the ones who

are in most danger. How about the people who don't have families who

may not be in the right mental capacity to understand what is

happening around them. Yet again, we are seeing in this society that

the most vulnerable are being put at risk, from windswepter fuel

payments wanting to be cut down, taxes, yet again we are targeting

the vulnerable. This Liverpool Care Pathway shouldn't be allowed if you

can't 100% guarantee that there aren't risks like this happening.

The people I know, the people I know who have come off the

Liverpool Care Pathway have had families who have been strong

enough and confident enough to defy the doctors and nurses, an old

gentleman we know after three days he said that's it, I'm feeding my

dad, I'm giving him some porridge and a drink, that old man, at 91

years of age went home from hospital on Friday. But if his son

hadn't had the guts to stand up to the doctors and nurses he would be

dead by now. That's what's happening today in

the NHS. Not in hospices. Is there a danger then that it become as

matter of resources? There is a danger, but that's a misapplication

of a good pathway, rather than the pathway is wrong. Extol the virtues

of the pathway for those watching? It is more difficult for doctors to

do nothing than it is to do something. There are times when to

do nothing interventionist is the right thing to do for people. They

need some help in doing that nothing and doing it well. The

Liverpool Care Pathway provides the support for them to make those good

decisions. That doesn't mean it is always implemented properly what we

have heard is a number of example where is it has been implemented

poorly. The paperwork is sloppy, it just has to be signed by one doctor,

and a nurse. My father's paperwork is sloppy, the space for diagnosis

is tiny. The lady there. Can I just speak up for doctors and nurses,

any doctors and nurses that I have ever met in the NHS they are not

angels of death that I feel people are painting them out here today,

they care very much and they do have the patients' best interests

at heart, from my experiences. I think with death it is just that

people don't want to acknowledge it might be happening now. That they

might actually be on their way out. There is an aspect where we are so

afraid of death that we are fighting frontically, and then

there is the other side of it where we view this -- frontically and

then there is the other side where they are viewing this patient as

someone we want to get out of there. My father's friend had Alzheimer's,

I meant to go and see her for years, I went to see her in a comatose

state, in the bed all skrunched up. She was my father's cousin, I was

so glad to see her, she had Alzheimer's, but she recognised,

not my name or her husband's name, but she did know her sister and

cousin's name. We did have a conversation, about thank you for

everything you have done in the past. Doctors have just got to

remember that these people are grandparents, auoints, uncles,

there is this -- uncle, auoints, and there is this human thing, it

is not cutting it short as you say, but it is a really important event.

That, in the vast majority of cases is what happens? Yes, it is a bity

we have had palliative care in this country -- a pity we have had

palliative care in this country for 30 years, we pioneer good care for

the dying through the hospice movement, that was a qoit

revolution in medicine, we are very proud -- quiet revolution in

medicine, we are very proud of it, and it is applied widely. The

tragedy is we have a problem, we never had this sort of controversy

that we are seeing with the Liverpool Care Pathway over the

hospice movement. Walk down any high street and you will see

charity shops for hospices, there is a tremendous amount of support,

and rightly, in this country, for the hospice movement, for hospices,

for good care. And I entire agree with Baroness Finlay, that we must

have a proper review of this. It is quite clear that there is a genuine

concern about the way palliative care is happening in this country.

And it is going to have to be a proper and thorough investigation

as to what is going on. The sense that I get from relatives, and

Jackie has just illustrated this very nicely, is that relatives and

the public at large want good palliative care, everybody is

pushing from the same side, they want doctors and nurses and the

system to work well for those that are dying. That must happen.

You only have a few seconds, this has been in place for quite some

time hasn't it? If I may pick up on the comment that was made. Doctors

and nurses, by and large, desperately want to do what's right

by their patient. They don't get it right all the time. We have been