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Charlie Gard: High Court to decide where baby should die if parents and hospital cannot come to agreement

The baby's parents want their 11-month-old son to spend his last days with them at home

Charlie Gard 's parents are set to face another High Court hearing - this time to decide where there terminally-ill baby will end his life.

Connie Yates and Chris Gard became embroiled in a new legal fight with Great Ormond Street hospital bosses and have until Wednesday (July 26) to come to an agreement.

The pair want their 11-month-old son to spend his last days with them at home, in Bedfont , before dying.

11-month-old Charlie's fate will be decided by Mr Justice Francis(Image: PA)

But doctors caring for Charlie at Great Ormond Street Hospital in London said it is not practical to provide the level of life-support treatment to Charlie at the couple's home for days.

The issues include that his ventilator would not fit through their front door and so they said a better plan would be for Charlie to move to a hospice.

Connie Yates (centre), the mother of terminally ill baby Charlie Gard, arrives at the High Court on July 25(Image: Getty Images Europe)

Mr Justice Francis analysed the dispute and said he will make a decision on Wednesday (July 26) if agreement cannot be reached.

We'll be bringing you all the latest updates as the decision unfolds.

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A summary of today's hearing

Our reporter Qasim has now left court after this afternoon’s hearing and has sent this report.

Today's hearing confirmed as the last

Press has now moved to the outside of the courtroom.

Charlie's place of death to be confidential

Judge has said there will be a public order. The only information that will remain confidential (until after Charlie’s death) will be the time and place.

Judge orders Charlie to be moved to hospice to withdraw life support unless other plan made by 12pm

Judge has ordered that it’s Charlie’s best interests to be moved to hospice and extubated unless other plans can be made before 12pm tomorrow.

Judge tells court if no arrangement is made by 12pm tomorrow - an order for Charlie Gard to go to hospice where life support will be withdrawn within a few hours

Parents accept that GOSH and hospice are the only options

Distressed mum cries 'What if it was your child' at judge

Connie is reported to have said she ‘can’t be in the same room as the judge’ and leaves saying “I hope you’re happy with yourself”.

Media, public and wider family locked out of court

Connie will be speaking to the judge in private.

Mum Connie snapped wearing 'Charlie' necklace

Charlie’s mother Connie, who has attended without partner Chris today, was earlier snapped wearing a heart necklace in support of her son.

Connie Yates, mother of critically ill baby Charlie Gard, wears pendant in honour of her son(Image: AP)

Reports of mum Connie 'breaking down' and 'screaming at judge'

Public and media asked to leave the courtroom

Private discussion which will now take place as to how long Charlie Gard will have between leaving GOSH and the withdrawal of life support at a hospice.

The judge said:

“It’s not that I don’t trust people but members of the public might report information. I would call media back in afterwards.”

Judge considering giving extra time for parties to reach decision

The judge has said he “might give parents until 12pm” on Thursday (July 27) to try to reach agreement on alternative arrangements.

Doctor called for evidence has no experience of intensive care

The doctor that Connie Yates and Chris Gard found was a private GP with no experience of intensive care, he had not found a team or a hospice.

Delays will 'compound misery' says GOSH

Fiona Paterson, speaking on behalf of GOSH, said: “Any delay compounds the misery. We don’t wish to rush this but this can’t drag on into another day.”

Judge was hoping for a consensus today

Connie Yates’ lawyer asked for another 48 hours, but the judge responded:

“I’ve gone out of my way to accommodate the parents’ wishes.

“I must consider Charlie’s best interests.”

The LBC reporter tweeted that Barrister Grant Armstrong says Connie Yates still wants to work to sort arrangements and is asking for more time for this.

Great Ormond Street 'not satisfied' with suggestions

Discussions have taken place between the doctor found by Charlie’s parents and GOSH team - GOSH is not satisfied with the arrangements as they say intensivist needed.

Court is resuming after nearly a two-hour wait

Court still not back in motion after one hour's break

Our reporter, Qasim, is still waiting for the case to start again.

He said:

“We were expecting to reconvene at 3pm.

“Clearly that’s not happened and we’re ready and waiting to see what had happened in the break.”

Charlie Gard 'activist' told to leave court

An activist has been asked to leave the court. This is the same man who harassed the media, witnessed by our reporter Qasim, outside the courtroom.

Video shows Connie's arrival at court earlier

Court takes short break whilst awaiting evidence

The court will hear from Doctor found by Charlie’s parents

Judge 'doing everything possible' for Charlie's parents

Judge hits out at claims he is decider due to NHS system

The judge told the court:

“I want to deal with nonsensical notion that this is being decided by me because of a system of socialised medicine in this country.

“It’s pure nonsense to say that this is being decided by a judge because we have a national health service in this country.”

Parents continue to dispute that transportation is an issue

Lawyer for Charlie's parents say enquiries have been made about care at home

Grant Armstrong QC told the court:

“A former intensive care surgeon is on his way here to give evidence.

“We think we can provide private nursing staff. Some GOSH nurses have volunteered to assist.”

Proceedings are underway at the High Court

Connie Yates arrives at court alone

Charlie Gard's mother Connie Yates arrives at the Royal Courts of Justice on Wednesday (July 26)(Image: PA)

Charlie Gard's mother Connie Yates arrives at the Royal Courts of Justice on Wednesday (July 26)(Image: PA)

Connie Yates has arrived alone, without Charlie's dad, Chris

Today could be the day this landmark case comes to an end

Hearing due to start at 2pm

Our reporter, Qasim, is currently waiting outside Court 47 at the High Court, ahead of today’s hearing.

You can follow him for updates @qasimperacha

US expert who gave evidence denies financial interest in 'experimental' treatment

Dr Michio Hirano, professor of neurology at Columbia University Medical Centre in New York, travelled to London last week to examine Charlie.

He also discussed the case with Great Ormond Street Hospital (GOSH) doctors.

Dr Michio Hirano specialises in treating rare genetic conditions(Image: Columbia University Medical Cent)

In his first public statement since their decision, Dr Hirano said on Tuesday (July 25):

“I became involved in Charlie’s case when I was contacted by his parents, and I subsequently agreed to speak with his doctors to discuss whether an experimental therapy being developed in my lab could provide meaningful clinical improvement in Charlie’s condition.

“As I disclosed in court on July 13, I have relinquished and have no financial interest in the treatment being developed for Charlie’s condition. “Unfortunately, a MRI scan of Charlie’s muscle tissue conducted in the past week has revealed that it is very unlikely that he would benefit from this treatment.”

His comment comes one day after GOSH told a court hearing it was disappointed to find the professor had some financial interest in the treatment suggested for Charlie.

In its positioning statement, the hospital submitted that Dr Hirano contacted it in December last year about NBT (nucleoside treatment) and at the beginning of this month said he had new information.

It expressed concerns over his July 13 evidence to court that at this time he had not examined Charlie, read his latest medical records, or the opinions of experts who had seen him.

The statement added:

“Further, GOSH was concerned to hear the professor state, for the first time, whilst in the witness box, that he retains a financial interest in some of the NBT compounds he proposed prescribing for Charlie.

“Devastatingly, the information obtained since 13 July gives no cause for optimism.

“Rather, it confirms that whilst NBT may well assist others in the future, it cannot and could not have assisted Charlie.”

Great Ormond Street Hospital says suggestions are not forthcoming from Charlie's parents

Great Ormond Street Hospital says Charlie’s care cannot be simplified and want to ensure he has a ‘peaceful and dignified passing’.

The children’s hospital released a full statement on their position on Tuesday (July 25). It read:

Charlie Gard suffers from a rare condition of mitochondrial disease - a condition that causes progressive muscle weakness.(Image: Featureworld)

“So far as GOSH is aware, invasive ventilation is only provided in a hospital setting. It requires air to be forced into the lungs.

“For reasons that are obvious, that process and the correct, safe positioning of the tube have to be monitored by an ITU trained nurse at all times, with an ITU doctor on call and close at hand.

“Those resources cannot be provided by GOSH to Charlie at his parents’ home.

GOSH is aware that there are other practical problems one being that the ventilator does not fit through the front door. There are then stairs to negotiate and corners to turn.

“The physical lay-out of the route between the ambulance on the pavement and their home would require Charlie to be taken off the ventilator and provided with only “hand-bagging” until he was inside.

“Charlie is a child who requires highly specialised treatment. His care cannot be simplified. 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 reason Charlie's parents want him to come home

The latest fight with doctors came a day after abandoning attempts to persuade the judge to let their son travel to America for experimental treatment.

Parents of Charlie Gard, Connie Yates and Chris Gard, speak to the media in Queen Square, London(Image: PA)

Barrister Grant Armstrong, who leads the couple’s legal team, suggested to Mr Justice Francis that hospital bosses were placing obstacles in Charlie’s parents’ way.

On Tuesday (July 25) he told the court:

“The parents wish for a few days of tranquillity outside of a hospital setting.

“The parents had hoped that Great Ormond Street would work with them.”

He added that the couple felt there was a “brutality” in taking Charlie to a hospice.

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