'Hospital or hospice' for Charlie Gard's last days - judge

A judge deciding where Charlie Gard will spend his final days has said he believes there are only two options - Great Ormond Street Hospital or a hospice

Charlie's parents want to take him home to die, but Great Ormond Street Hospital believes he cannot get the specialised care he needs there and is at risk of a "distressing" death.

On Wednesday, Mr Justice Francis will decide what will happen.

Speaking on the baby's behalf, lawyer Victoria Butler-Cole told the High Court he would be able go to a hospice "at the end of this week".

But a lawyer for Charlie's parents, Grant Armstrong, said moving the 11-month-old to a hospice for "just a period of hours" would be "brutal".

He said their last wish was to be able to take their son home.

Mr Grant accused GOSH of putting "obstacles" in the way, and said, "we struggle with the difficulties the hospital is placing in the way of the parents having a... short period of time before the final act in Charlie's short life".

Ms Yates and her partner Chris Gard withdrew their bid to take their terminally ill baby to the US for experimental therapy on Monday.

They said tests had shown the window of opportunity to help him had closed.

:: Why doctors are stopping Charlie going home

Charlie suffers from a rare genetic condition which causes progressive muscle weakness and he also has brain damage.

His parents do not expect him to live to his first birthday on 4 August.

Mr Justice Francis said part of the disagreement appeared to be over GOSH's views on the specialised ventilation he needs to help him breathe.

The "key obstacle" is the "reality of the invasive ventilation that Charlie requires" - with a nurse required "at all times and a doctor close "close at hand", said a submission by the hospital's lawyer, Katie Gollop QC.

Charlie's ventilator will not fit through the front door, according to GOSH.

Ms Gollop said the hospital would like to fulfil the parents' wishes but it was essential nothing should occur that could cause him suffering.

"His care cannot be simplified," said Ms Gollop "It must be provided in a specialist setting by specialists.

"It is in Charlie's best interests, and everybody's, that the risk of a precipitate, distressing or disordered death is removed so that he may be assured of a peaceful and dignified passing."

The judge said he would prefer if the hospital and Charlie's parents could work out an agreement via mediation.

However, the hospital's lawyer said the parents had so far refused "direct contact" with the hospital.

:: Timeline of parents' battle to save Charlie

Ms Gollop added: "The care plan must be safe, it must spare Charlie all pain, it must protect his dignity, at the same time it must honour his parents' wishes about the time and place of his passing, and it has to balance Charlies interests and his parents' needs."

But Charlie's parents' lawyer said hospital representatives had not visited the family home.

Meanwhile, the president of the Vatican's Bambino Gesu hospital - which had offered to help Charlie - said experimental therapy "could have been an opportunity", but it was now too late to start care.

Mariella Enoc said they did not know what might have happened six months ago and if Charlie would have responded to the therapy.

GOSH has consistently argued it would not have helped.

The High Court, Court of Appeal and Supreme Court all ruled against Charlie's parents in recent months, with judges at the European Court of Human Rights refusing to intervene.

The case has become a flashpoint for opposing views on health-care funding, medical intervention, the role of the state and the rights of the child after US-based pro-life activists flew to London to support Charlie's parents.

The hospital said it would give "careful thought" on how the case was handled and how it can "enrich the care it provides to its most vulnerable patients and families".

However, it said it hoped Professor Michio Hirano, the doctor who advised Ms Yates and Mr Gard on care in the US, would also "find much upon which to reflect".