THE most seriously ill NHS patients should be allowed to die so that the money spent on them can be better used elsewhere, the Health Department is expected to tell the Court of Appeal in a test case.

John Reid, the Health Secretary, is expected to refer to the cost of keeping coma patients alive with food and water, according to legal papers leaked to a national newspaper. The department could not be reached for comment last night.

The court will hear the case of Leslie Burke, 45, found in 1983 to have cerebellar ataxia, which eventually will render him powerless to communicate with his doctors.

The Secretary of State argues that if the decision of Mr Justice Mumby — that artificial nutrition and hydration (ANH) should not be withdrawn unless the patient’s life is intolerable — is not overturned, another patient could have a right “to demand and receive medical treatment of his choosing”. This, the document says, “will require substantial additional expenditure of scarce resources, regardless of whether those resources might be more effectively deployed elsewhere”. It continues: “The Secretary of State would wish to put before the court evidence of the cost of ANH.”

The department says that should Mr Justice Mumby’s ruling be upheld, doctors could face being undermined in the courts when decisions are sought on withdrawing treatment, which will be forced to “concentrate unduly on the subjective views of patients”.

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