Why we need a women’s hospital

 

Why a Women’s Hospital?

Why do we want a women’s hospital?

We need a Women’s Hospital. Ours is one of only two in the country; it is not perfect but it is much needed. There are important medical and surgical differences between men and women. We have different life events, different illnesses, some different cancers, different symptoms for heart attacks, and we respond differently to some medicines. Women live longer than men, but have more illness in later life. Women’s role in reproduction means that we are subject to different physical and mental illnesses than men.

Women and children bear the brunt of poverty and ‘austerity’.

Every other field of medicine has specialist hospitals – in fact, the current ‘fashion’ is for specialist hospitals. Each of the Liverpool Hospitals is specialising, so why can we not keep our Women’s Hospital? Just as the other hospitals send women to LWH, LWH will need to liaise with other hospitals. We need integrated care. We need the focus and research a specialist hospital produces; research which is then fed back into all hospitals. The care of women is a valid sphere of medicine and surgery.

For matters that are specific and personal to women, we need to feel safe and respected. The over sexualisation of bodies, especially breasts, and the evident disrespect for breast feeding women, makes women uncomfortable, which then undermines the health of the infant.

Even naming body parts is still awkward for many women.

Violence against women means that one in four women have experienced male. violence. The nature of the women’s hospital makes women not only feel safer but to actually be safer from male aggression.

Pregnancy is one of the known danger points for male domestic violence.

Giving birth or having gynaecological procedures can trigger trauma beyond the physical.

women's rightsSafeguarding vulnerable women, let alone babies, in a big city centre acute hospital will be very difficult.

A 15-year-old pregnant girl might walk into the Liverpool Women’s with confidence; Would she feel the same walking into a giant acute hospital?

Fertility issues, pregnancy, birth, post-natal experience and motherhood can all impact on women’s mental health.

 A safe place to recover and to ask for help is essential. Relationships built up with midwives, health visitors, doctors and nurses are essential for our physical and mental health and recovery from stressful and traumatic events.

If patients are not confident in the staff and in the environment in which they are being treated, this will affect the outcomes of their treatment.

Care, respect and kindness are great healers. They provide the environment in which good medicine and surgery can thrive.

Beauty and nurture are needed by all creatures; but in our warped society they are predominantly seen as ‘women’s’ virtues and often disrespected.

Most carers, but not all, are women. Women, who have been carers for all their adult lives, clearly respond with recognition and relief when they, as older patients, come into the Women’s Hospital. This culture could be extended from the Women’s to other hospitals, but we need this hospital as the seed bed. We want ‘bread and roses too’.

A women’s space is rare. A well-funded, well-staffed and well cared for women’s space is rarer still. We have such a space, to some extent, in the Liverpool Women’s Hospital.

Women and babies matter. In this time of Austerity, human rights and life are being discarded and ignored.

For all the women, all the mothers, all the babies, and all the men who love them, we demand that Liverpool Women’s Hospital is saved.

The future of the hospital as a whole is also important for the men who are treated at Liverpool Women’s Hospital in genetics, for some cancers, and for transgender issues.

20151204_094617This is a women’s issue for staff too. The women’s hospital employs many female professionals and ancillary workers. (We are grateful too for the work of many males in the hospital). The problems facing women are also faced by the staff. The hospital needs to recruit and retain more staff. We know the new Junior Doctors’ contract is discriminatory against women.

 

Keep Our Health Care National

(These are some of the notes used speaking for Save Liverpool Women’s Hospital at rallies for the NHS on February 2/3rd 2018.)

Keeping Health  National
The NHS is at a tipping point. We demand that the NHS be funded properly and be fixed, that the running sores of privatisation be tackled. Lack of adequate funding and privatisation have caused real harm, and other plans are afoot that are doing grievous damage.
midwives cleaners etcIt is not the market that has kept the NHS afloat, stricken though it is, but the work, often unpaid and always underpaid, of the NHS workforce, of doctors and Nurses, midwives, the related professions, the porters, health care assistants, cleaners, and oft maligned admin staff. These rallies are to give you, NHS workers support as well as to loudly protest.
We want more funds for the NHS, we should match what other advanced countries spend on health.
We want our health service to be National, not regional, not local, but National.
To be for all of us, equally; babies, mothers, elders, employed, unemployed retired, carers, manual workers and office and shop workers, everyone regardless of class wealth or creed
We want it to be national so we can gain those huge economies of scale that have made the NHS the most cost effective health care system in the world in international comparison tables.

i-will-not-be-denied
Maternity care needs it to be national, to develop good maternity provision and to make the fight for good maternity care more powerful. We cannot leave a few women in each area fighting for good maternity care, it need as national service and a national campaign. Good care for babies in pregnancy, at the birth and in the months after birth, is crucial to the health and well-being of the community.
baby.
We want the NHS to be national so we can, by sharing our risks across a whole population of nearly 66 million, afford for everyone to have the best available treatment. We want it to be national so it can reflect our great national wealth.

We are the sixth richest country on the planet; we are the financial hub of the western world,
We want the NHS national, paid for from general taxation, paid for as a public good. A healthy population free of the fear of nofinance-2t being able to afford health care makes for a happier, heathier more productive nation
We want it national, so the workings of the NHS should be transparent and answerable to parliament for public scrutiny.
We want it national as some protection against the global economics, the economics of inequality.
“Last year saw the biggest increase in billionaires in history, one more every two days. This huge increase could have ended global extreme poverty seven times over. 82% of all wealth created in the last year went to the top 1%, and nothing went to the bottom 50%.
Dangerous, poorly paid work for the many is supporting extreme wealth for the few. Women are in the worst work, and almost all the super-rich are men. Governments must create a more equal society by prioritizing ordinary workers and small-scale food producers instead of the rich and powerful.” Oxfam
We want the NHS to be national so it is not private, nor for profit, nor rationed and not offering restricted care based on economics outcomes rather than patient care, as we find in an accountable care system. By being national, we can run the best system in the world without spending anything like as much as the Unites states does on health care.
We want it national so it is too big for corporations to swallow whole and privatise, as they have privatised the railways, water, the post office, British Telecom and electricity and gas. We want it national to give it some protection from free trade agreements.
We want it to be national so we can share research, professional development and expertise without cost barriers to that sharing.
We want it to be national, not broken up and privatised. The NHS is a beacon of humanity, of social solidarity and a contributor to the nation’s good mental health
But our National Health Service is being run by the Conservative government to its own bizarre ideological policies, policies that prefer to be spoken about only behind closed doors or behind blinding propaganda. They will never openly say they want privatisation but Jeremy Richard Streynsham Hunt, the Secretary of State for Health and Social Care since 2012 wrote a book about it and Simon Stevens head of the NHS, in his previous role coordinated a major paper on privatising health care for DAVOS
“Simon Stevens himself, who, at that time was head of UnitedHealth’s Global Division, acted as Project Steward of the Steering Board for the first World Economic Forum report, working with chief executives of leading healthcare companies, including Apax Partners, Novartis, Merck, Medtronic and Kaiser Permanente, as well as the Directors of Health at the World Bank, the WHO, and the European Commission.” Socialist Health Association

Too few beds

hospital bed
The NHS is underfunded, and short, by policy, of beds. So, we see the horrors of patients for hours on trolleys and even on the floor. Over 30 years the number of hospital beds has halved, as the population has increased
Germany manages to provide 8.1 hospital beds for every thousand of its citizens, compared to 2.6 in the UK. It employs 4.1 doctors per thousand people compared to 2.8 in the UK; People with private insurance don’t jump the queues, because there aren’t any
The winter crisis was entirely predictable. We are short of doctors, nurses, midwives and other medical professions, and this is from appalling government planning. This rundown is policy. This is not from stupidity, it is deliberate. Who cancels bursaries during a shortage of nurses?
We must have a fully funded NHS, paid for by general taxation. It is a matter of life and death.
steves-stop-stps-put-spanner-in-works_square

We do not want the National Health Service broken up into 44 footprints, STPs and Accountable care systems and organisations, or ACOs by any other name. We want a national health service. No corporation could run the NHS as a whole so it is being broken into bite sizes pieces covering a geographical area, at a size that the private sector is used to running in the USA.
In our area, Merseyside and Cheshire, we are expected to make nearly a billion pounds worth of cuts, and the NHS bureaucrats are working towards an ACS, whatever people might tell you and it lacks any basis in law or democratic scrutiny.
Keep Our NHS Public highlight the dangers
“They incentivise rationing of services and – even more concerning – denial of care and so are fundamentally at odds with social solidarity and the values of equity and universalism that underpin the NHS;”
The plans currently being implemented expect, “Acute providers to (make) downward adjustments to budget projections to reflect national efficiency expectations such as the requirement for acute providers to reduce activity growth” They say they will reduce spend in acute settings. “If the budget does not align with affordability most appropriate response amenhands off our NHSding service scope”
This means that the STP plans increasing cuts not increased spending, over a long period.
So we campaign for the NHS to be a fully funded national health service.
We have to change this government to make it so
We need every person who can give some time to the campaign to do so. The only way we can win this is by a huge campaign.
For our mothers sisters daughters friends and lovers and for the babies
For the men too, young and old, we need the NHS.Christine jones

with thanks to Christine Jones, Romona McCartney, Alan Gibbons and Steve Carne for images

Pop Up Maternity Unit, Maternity Review, the Women and Children Vanguard

baby

A pop up maternity Unit? Really? In the middle of the crisis in the NHS? During a crisis in ambulance attendance times? During a crisis in Midwife recruitment and workload ? During a financial crisis for the NHS?

We would ask:

Why is this safe?

Who will oversee its safety?

How will its work and its staffing be planned?

Will it be staffed day and night?

Where is the risk assessment?

Where is the Equalities assessment?

Who will manage its policies? Stringent policies in a maternity units save lives. The Morecambe Bay scandal proved that; for a critical view of Morecambe read this

What ambulance stand by is planned? Ambulances on the Wirral right now are not exactly speedy.

ambulances

The Merseyside and Cheshire Women and children’s Vanguard have made a very strange decision to open a pop up midwife unit in a children’s centre in Seacombe, on the Wirral.

What is going on?

We need better births, greater care for women and babies, fewer still births, fewer maternal deaths.Women should have more care in pregnancy, in labour, after the birth and in the baby’s first year of life.

We need many more midwives, working under less pressure, more obstetrician, more neo natal nurses and all the related professions.

We need more pediatrics (baby and children’s) doctors and nurses.

We need much better mental health support around pregnancy and early motherhood.

We need breastfeeding support to be expanded funded and staffed by well-trained and well paid staff, linking with volunteers who are themselves breastfeeding.

We need support for infant nutrition for bottle feeding mum’s, not leaving this to big business who exist to make a profit.

We need good public health, removing environmental hazards like traffic, traffic pollution,unhealthy food products and stress.

So we do need a lot from our NHS maternity and pediatric services

The Maternity Review and Better Births is a long-term plan from the government, led by Conservative peer Baroness Cumberlege

It is slathered in words about choice, that women must have choice about the way they give birth.

The context of crisis cuts and massive underfunding in the NHS and its multi faceted privatisation deprives the maternity review of any credibility.

Under the banner of the Maternity Review the national NHS have set up Vanguards or pilot schemes to develop their plans. One of these Vanguard areas is Merseyside and Cheshire

If this seems to good to be true, it is too good to be true.

Whilst in other areas maternity units are closed against the wishes of local women, and while we need many more midwives, and junior obstetrician, this government conducts expensive experiments about which kind of midwifery unit is required.This is not in response to local requests but as part of a national plan.

Women in many parts of the country are fighting to save local maternity services. Save Liverpool Women’s Hospital Campaign went to Barnsley to help their protests at not being able to have babies in Barnsley. Personalisation does not go as far it seems as keeping maternity services local

Maternity Campaigns across the country are objecting to long journeys to give birth. A man from the NHS said it was ok to travel for 4 hours in labour.

We have significant lack of choice in real life.

There is also the spread of a for profit private midwifery contractor commissioned by the NHS in Merseyside and Cheshire.

Many services in the NHS have already been put out to private contractors.

Cheshire and Merseyside and Children’s Vanguard is doing some good, in that it is commissioning some additional mental health support for new mothers and we can see this at Liverpool Women’s Hospital

However some of what it is doing is of serious concern. Some background is required to make this clear.

Kinds of Places to give Birth

There are a number of places where women can give birth. These places are:

In an obstetric unit where there are specialist Doctors and where doctors are being trained and where research is being carried out. Midwives work here also.

More complex cases are dealt with in obstetrics units.These units operate as a resource and centre for other providers, when births which were expected to be straightforward become complicated.It is here that planned and emergency Cesarian sections take place, and where women can have epidural anaesthesia

One alternative is a midwife led unit alongside an obstetrics unit.This is staffed by midwives, not doctors, and is intended for women who are likely to have straightforward labour. If there are difficulties in labour mother’s can be transferred to the obstetrics unit.These units (and certainly the one at Liverpool Women’s Hospital) allow a more homely, less medical approach to childbirth.

Some areas of the country have a midwife led unit not attached to an obstetrics unit.These are called free-standing midwife led units.They have the advantages of an alongside Midwife led unit in that they are less medical, but are without the down the corridor access to the obstetrician.If there is a need to refer to an Obstetric team the woman would be transferred in an ambulance.In some parts of the country this is the main kind local provision.

Then there are home births using NHS midwives. For very low risk mother’s this is a great service. Again if things get complicated the women in labour can be transferred to the obstetrics unit by ambulance.

Another option is birth with a private independent midwife, where a qualified self-employed midwife works directly to the woman in pregnancy, in labour and after the birth and is paid by the mother not the NHS. Again if there are problems the woman is transferred to the hospital.

(We are not aware of any independent midwives working in our area but would love to talk to them if they are around.)

There is also a for profit company, contracted by the NHS, employing midwives not in the NHS to provide home births.The NHS pays for the service but it is not part of the NHS, it is a contractor.

If the woman in labour has difficulty the woman is transferred by ambulance to the obstetrics unit, but the private midwife has to hand over all care to the hospital.

A very few wealthy women use private maternity hospitals mainly in London.

Some of the poorest women without recognised residency rights in the UK but living and often working here have no right to free maternity care.How they cope varies from woman to woman but is rarely good for mum or baby.

So we have an array of services.

The Merseyside and Cheshire Women and Children’s Vanguard wants to set up an additional free-standing midwife lead unit in this area because they say women must have this additional choice.There is no free standing Midwife led unit in the area. So in their wisdom they are setting up a pop up centre, in a children’s centre in Seacombe. run out of Arrowe Park Hospital but not on the hospital site. Incredibly it has been described as somewhere which will not be staffed until the woman phones a midwife, says she is in labour and arranged to meet the midwife there.We think this is peculiar.

‘Pop up’ birthing centre offers new choice to pregnant women

A nationally pioneering ‘pop up’ birthing unit based in Wirral’s Seacombe Children’s Centre will provide enhanced choice to expecting mothers in the area.

Containing facilities for women to give birth, the community unit will be open from March 2018 and offer women a safe alternative to hospital birth in a more family-friendly environment closer to home.

Based at the local children’s centre, the unit will encourage women with a low risk of complications (something established clinically during discussions between a woman and her midwife) to give birth in a non-medicalised setting where wrap around services are also available to support families postnatally and beyond.

As the first birthing centre nationally to launch in a multi-purpose community setting, the new facility will provide key insight into the cultural effectiveness and uptake of more community-focused birthing options. The facility will be run by experienced, highly skilled midwives from Wirral University Teaching Hospital NHS Foundation Trust (WUTH), and if successful, could inspire the development of permanent freestanding midwifery led units (FMLUs) across the Cheshire and Merseyside region.

The Seacombe pop up is opening in response to NHS England’s Better Births Report (2016), which identifies that the 87% of women nationally will give birth in a hospital, but only 25% of women would choose that as their first choice. This is backed up by guidance provided by the National Institute for Health and Care Excellence (NICE), which states that freestanding midwifery units are “associated with a higher rate of spontaneous vaginal birth” compared with births in other settings.

Catherine McClennan, Programme Director for the Improving Me Cheshire and Merseyside Women’s and Children’s Services Partnership (the NHS programme driving the initiative), said: “We have been working with local women and healthcare providers to explore new models of care that provide meaningful choice to families. Our pop up birthing unit based at Seacombe Children’s Centre is the first of its kind nationally, and has been driven by the voice of women. I’m delighted that we’ve been able to lead the way in offering people a more personalised pregnancy journey.”

By supporting women to give birth in a community setting, the unit aims to offer a more relaxed and familiar ‘home from home’ experience. They are also more likely to be looked after by a midwife that has helped them throughout their pregnancy and remain in a private space (with their partner/family welcome to stay with them) throughout the duration of the birth.

Debbie Edwards, Associate Director of Nursing /Head of Midwifery at Wirral University Teaching Hospital, said: “We welcome the opportunity to be involved with the roll out of the Birth Centre, which will make a big difference to the choice that women have regarding their place of birth. The unit will provide women and their families with an optimum birth environment.”

Cllr Bernie Mooney, Wirral’s Cabinet Member for Children and Families, said: ‘‘I am really proud that Seacombe children’s centre will be home to the first community-based birthing unit nationally. The unit will provide women with a real choice about where they can give birth safely and comfortably and that is a huge step forward for families in Wirral.’’

Improving Me is a partnership of 27 NHS organisations across Cheshire and Merseyside aiming to improve the experiences of women and children. The Partnership is one of NHS England’s Vanguard New Care Model initiatives and an Early Adopter for the Better Births recommendations.

ENDS

Follow @WirralCouncil on Facebook & Twitter

Contact us at: pressoffice@wirral.gov.uk or tel: 0151 691 8039/8089/8445

“The unit will provide women and their families with an optimum birth environment.”

What does this even mean? The women who might use such a service are the very very low risk mothers, those suitable for home births. So not first time mothers, not anyone with diabetes or epilepsy or is over weight. Is it safer than an obstetric unit? Safe than an alongside midwifery unit?

Is it home? with all the benefits of home birth?

No its an experiment funded as part of the process of deciding the cost the government will pay for maternity care.

Personal Budgets

Another peculiarity of the Vanguard is the idea of personal budgets.The review suggested a personal budget of £3000, somewhat less than the cost of a complex caesarean section and more than an uncomplicated vaginal delivery. The Personal budget concept only makes any sense if it is preparing for privatisation where mother’s would” buy’ different bits of care from different private providers. However women are not that daft.

There is another kind of privatisation, that which involves all of a city regions health and care services being put into an ACO and that ACO being put up for bids from global for profit corporations

To build the personal budget figure, women at Liverpool Women’s Hospital and other places are trialling choosing a menu of extras (that should not be extras) like extra breastfeeding support, or hypno-birthing classes.These costs are minor compared to delivering a comprehensive maternity service.

There is much to be concerned about.First of all maternity is a service not a production line which has each little action costed.

A comprehensive service is less expensive than a lengthy menu of choices, and should give room for choice.Money is wasted by having these market systems

The Obstetric unit needs to be there in the background to assist all the other options. It should not be costed just by the number of births it hosts. Other services are made safer by its existence. It could be a sign of success if these units were used less because women had had easier labours.That success, were it to be achieved, should not be a reason for cuts

Giving birth at home is supposed to be the cheap option but for home births to be safe there is a need for ambulance and Obstetrics back up services.

In couple of years time the maternity tariff ( how much maternity services are paid by government) is supposed to be reviewed. Supposedly, the menu of choices being offered to women trialling the personal maternity budgets will feed into these decisions.

We think these “additional services” should be standard.

Another thread in this tapestry of peculiarity is that of hubs.

In Liverpool maternity services through the Vanguard, the CCG, Healthy Liverpool and more, are planning maternity hubs not for labour but for ante natal and post natal services.

This is part of integrating health and social care services.Health visitors have already transferred to social services At present community midwives for pre and post natal care are linked to 29 GP practices

They are to move to hubs in certain areas, we are told to put them in pram pushing distance.Now how can 5 places be in pram pushing distance in a city? Is it not more likely that 29 GP surgeries would take less pram pushing?

Health Visitors are no longer employed by the NHS and are employed by the Council.

Once a service is provided by social services the patient has significantly less rights than they have as an NHS patient.Social services can be charged and the “client” does not have automatic rights to the service.

Women need to be telling their MPs now that the maternity tariff should be generous, not inadequate and destructive as it is now.

Sustainability and Transformation plans are being run out across England. Local population level medical and social care systems are being constructed.These systems are solar to US models. The system is put out to contract which can be bid for by some company or body, not necessarily the NHS. Health and Social care are being integrated, even across local government boundaries.The NHS is free at the point of need, paid for from taxation, and providing the best available treatment.

Social care is means tested and has no obligation to provide the best treatment or care.Staff do not have the same education training, obligations or working conditions or trade union recognition.

Health care is free at the point of need.Social care is not.

Providing population level care with a fixed budget must mean rationed medical care. This rationing of services has already started for example rationing fertility treatment, hearing aids, cataracts and more is underway in some areas.
Maternity is the most common reason to use the NHS.Costing maternity for accountancy purposes, and reducing that cost it is essential to the Accountable Care system.The courts have defacto stopped this move to ACOs untill it has been discussed in Parliament, thanks to a crowd funded legal case by campaigners

Integration of health with social care is essential to that system.

“National” matters. Huge benefits are found in our National system, benefits in research, professional education, in maintenance of standards, in regulating treatments and much more.

The right to access to the “best available treatment”is essential especially on giving birth, for mother and baby.This would be under threat in a city region population level care contract or ACOs.

Local Maternity Systems

The maternity review wants to deliver a local maternity system just like the accountable care systems. If anyone ever doubted that this was part of the national plan to regionalise the NHS, and break its national system, to cost it so as to be attractive to international bids then they should read this

“The learning from the process for Pioneers, to get to a position to be able to offer a PMCB, provides some key experience and lessons for other LMS, looking at the Better Births ambition for all women to have a personalised care plan in place for their whole maternity pathway. It has also flagged areas for wider development to support this transformation in the system. In response to this, we are developing a number of national tools that will be available for all LMS:

  • A model service specification for maternity services
  • A model qualification criteria, to support the procurement process
  • A decision aid for women on the standard pathway, to support their place of birth decision, and accompanying professional guidance
  • A checklist for quality information for women
  • A minimum standard for clinical governance and safety protocols across an LMS
  • Case studies on lessons learnt from Pioneers and wider developments.

We hope these tools will support LMS in their transformation plans and we are excited to work with LMS who want to drive forward the personalisation agenda, both through the bespoke support offers that are being developed, and through direct discussion on the tools and experience that we can share with systems as they develop their plans.

As maternity systems begin to deliver real personalisation of services, we are excited to share and learn from the excellent local initiatives already in place across the system. If you would like to know more about how we might support your LMS or share your experience or challenges with us, please get in touch: england.maternitypioneers@nhs.net

Women want, and say so daily, a fully funded National Health Service, local maternity care, including fully supported home births, local alongside Midwife lead units and safe Stand Alone midwife units.

We most definitely do not went wholesale privatisation, as we would see in an ACS or a privatisable local maternity system

A further blog post will go into this in more detail.

How will Liverpool Women’s Hospital be affected by a merger of The Royal Broadgreen and Aintree Hospitals?

Our campaign wants to protect and improve health care for women and babies in Liverpool, Merseyside and the surrounding areas. To do this we must also protect and improve the NHS locally and nationally. We can’t have one without the other.We want to keep our hospital, not to be part of a city wide hospital, but we need a fully funded NHS to get this.

Just as we work for maternity issues nationally, we care for the NHS nationally

We care about is happening locally to the NHS. The mess ups and damage could fill a book.There have been some staff change in the local managers but its still the same people.

ambulances

We know the NHS is in crisis this winter. Running down the NHS is part of the strategy to take the NHS into the private sector to make money for the very rich.

But how does all this affect women and babies using the Liverpool Women’s Hospital?
We need well-funded care, the best available treatments, from well-trained, well paid and well rested staff. We need the safest equipment and a building and grounds that are place of healing and respect.

This is not a pipe dream. It is easily affordable if our government funds the NHS at the same kind of level as it did in 2009.The government would need to stop paying billions to private business and bring the NHS back ” in-house” and repeal current legislation.

So what is going on with this big suggested merger?

There are great big faults in the NHS from recent policies. We have to thank the staff for sticking at their work and keeping a deliberately holed ship afloat

beds

Far too many beds have been removed from the system locally and nationally. Its been a mantra of the current NHS management to cut beds and its been a disater.

The internal market in the NHS has been immensely costly and inefficient.

The trusts model of hospitals just has not worked. Many are in debt. Just two years ago these debts were described as catastrophic, now they are normal and reflect reality under funding or cuts.

Read more

What is Accountable Care?

An ACO is a single organisation which holds a long term contract to oversee a bundle of services for fixed funding.

The idea is that Hospitals, GPs, District Nurses, Health Visitors,Therapists, Care Homes and Home Care will all come under one budget, allocated by who ever holds the contract. This could be an NHS trust, but it could be Virgin, Circle, a US health insurance corporation, or a new company.

An Accountable Care System (ACS) can develop into an ACO

In an ACS, Commisioners, together with health and social care providers, agree to manage resources together, govern themselves and share risk and gain.This will force the NHS into an alliance with social care, which is private and means tested, to manage grossly inadequate resources on both sides.

That will undercut the NHS Constitution which guarantees ” a comprehensive service, available to all…[with]a duty to each to each and every individual that it serves…Access to NHS services is basefon clinical need,not an individual’s ability to pay…”

In Liverpool this is being developed under the title Liverpool Integrated Care Partnership Group.

It is part of imposing £22 billion pounds of cuts to the NHS national budget.It means rationing health care. It owns the door to top down privatisation, turning tax funded public services into private profit.

Local Authority Social Care budget is already cut to the bone.

Private care homes are extremely variable in quality and cost.Care homes are run to make profit.

Cuts in the NHS and cuts in Local Authority budgets are deliberate government policy.

Social care, like old peoples homes, was put into the private sector years ago and it has not been a great success.

Combining an NHS damaged by cuts, local council services damaged by cuts,and a ramshackledcare home system will help noone.

The NHS needs much better funding.We need to s pendand more of our national wealth on health care, as it was before the banking crisis.

The ACO system will let private companies manage the NHS to make profit.It will ration care and make it worse for patients.

This has never gone through Parliament.

Information for this post comes from Keep our NHS Public.

This proposal will be discussed at a meeting on Thursday 11th January 1pm Cunard Buildings.

We will explore what that means for Liverpool Women’s Hospital in another post.

A healing environment?

ENVIRONMENT

 

Liverpool Women’s Hospital is a specialist hospital that specialises in the care of women, babies and their families in a safe friendly environment. It opened in 1995 and is located on Crown Street, Toxteth in a modern landmark building (NHS Choices).

 

In 2013 a new development of the reception area incorporated a comfortable seating area, cafe, shop and a play area for children. It opens up onto a landscaped courtyard with seating, a herb garden was planted for use by the hospital chefs and a memorial garden was opened to offer bereaved families a private space within the hospital grounds.

 

Another garden “The Garden of Hope and Serenity was opened in 2016.

 

“This garden is a lovely area where our women, families and staff can relax in the sunshine and escape life on the wards” (Kathryn Thomas, Chief Executive at LWH).

 

The idea for this garden came from nurses at the gynaecology unit who recognised that women and families visiting the Emergency department would benefit from a space away from but near to the department to have an area of calm to process their thoughts and feelings.

 

There is a wealth of literature that confirms the importance of trees and gardens for patient recovery and should not be ignored. A much cited study, published in 1984 by environmental psychologist Roger Ulrich was the first to use the standards of, modern medical research to demonstrate that gazing at a garden can sometimes speed healing from surgery, infections and other ailments.

 

Although it is clear that this will not cure disease, it has been proven that just five or six minutes spent looking at views dominated by trees, flowers or water can begin to reduce levels of anger, anxiety, stress and pain. This can allow other treatments to help healing and induce relaxation that can be measured in physiological changes in blood pressure, muscle tension or heart and brain activity.

 

Studies have shown that loud sounds, disruptive sleep and other chronic stressors can have serious physical consequences and hamper recovery (Ulrich,1994).

 

Henry Marsh, the celebrated neurosurgeon and writer has stated:

 

“……… these big hospital are horrible places really, the very last thing you get in an English hospital is peace, rest or quiet which are the very things you need the most”. He goes on to say that the garden he created at St. George’s Hospital,” ….. is probably the thing I am proudest of.” (The Observer).

 

Not all gardens are equally effective. A study found that tree lined vistas of fountains or other water features, along with the greenery of mature trees and flowering plants appealed the most. The more greenery versus hard surfaces the better (Cooper Marcus and Barnes 1994).

 

The plan for the new Royal hospital include a landscaped garden. According to Brian Zeallear from NBBJ:

 

“Through creating smaller buildings around the periphery and having public roads and pedestrian corridors through the site, we can stitch back the existing city. The centre will feel like a public square. The hospital is in a dense urban area but once the landscaping is done….it should make you feel you are in nature through the manicured grass, trees and water features”.

 

However sitting in a public square surrounded by public roads is hardly the restorative qualities of greenery, flowers and other nature content envisaged by Ulrich.

 

Liverpool Women’s Hospital is at present situated in a quiet, landscaped and safe environment. Although it is in a fairly central location it is protected from the sounds and pollution of traffic.

 

There is now substantial evidence on the adverse effects of air pollution on different pregnancy outcomes and infant health. The evidence for the impact of air pollution on infant mortality, primarily due to respiratory deaths in the post natal period seems to be solid (WHO 2005).

 

Less consistent though still suggestive of a causal link to air pollution are lower birth weight, a higher incidence of preterm births and intrauterine growth retardation. Moreover the evidence shows clearer relationships for particulate matter and traffic related air pollution than other pollutants.

 

The intrauterine, perinatal and early childhood periods, during which the lungs are developing and maturing are very vulnerable times. These are times when the lungs are more susceptible to injury by air pollutants. Exposure during these periods reduces the maximal lung functional capacity achieved in adult life and can lead to increasing susceptibility, in adulthood, to infections and the effects of pollutants such as tobacco smoke and occupational exposures (Vierira 2015).

 

Also there is sufficient evidence of a causal relationship between exposure to lead to neurobehavioural deficits in children in terms of cognitive impairment (WHO2005).

 

While it is impossible to avoid all air pollutants, advice from many sources include, remaining indoors when air pollution is high and even when air pollution is low it is best to avoid polluted roads (Greenpeace 20017). Campaigns to avoid exposure to air pollutants include moving school entrances from busy roads and the use of pram covers to protect babies being exposed to harmful particles.

 

In the face of all the evidence of the harmful effects of air traffic pollutants on neonates, it is inconceivable that the environmental effects of building a hospital for women and babies in the middle of one of the most traffic dense areas of the city, have not been considered.

 

Liverpool Women’s Hospital is a specialist hospital that specialises in the care of women, babies and their families in a safe friendly environment. It opened in 1995 and is located on Crown Street, Toxteth,  in a modern landmark building (NHS Choices).

 

In 2013 a new development of the reception area incorporated a comfortable seating area, cafe, shop and a play area for children. It opens up onto a landscaped courtyard with seating, a herb garden was planted for use by the hospital chefs and a memorial garden was opened to offer bereaved families a private space within the hospital grounds.

 

Another garden “The Garden of Hope and Serenity was opened in 2016.

 

“This garden is a lovely area where our women, families and staff can relax in the sunshine and escape life on the wards” (Kathryn Thomas, Chief Executive at LWH).

 

The idea for this garden came from nurses at the gynaecology unit who recognised that women and families visiting the Emergency department would benefit from a space away from but near to the department to have an area of calm to process their thoughts and feelings.

 

There is a wealth of literature that confirms the importance of trees and gardens for patient recovery and should not be ignored. A much cited study, published in 1984 by environmental psychologist Roger Ulrich was the first to use the standards of, modern medical research to demonstrate that gazing at a garden can sometimes speed healing from surgery, infections and other ailments.

 

Although it is clear that this will not cure disease, it has been proven that just five or six minutes spent looking at views dominated by trees, flowers or water can begin to reduce levels of anger, anxiety, stress and pain. This can allow other treatments to help healing and induce relaxation that can be measured in physiological changes in blood pressure, muscle tension or heart and brain activity.

 

Studies have shown that loud sounds, disruptive sleep and other chronic stressors can have serious physical consequences and hamper recovery (Ulrich,1994).

 

Henry Marsh, the celebrated neurosurgeon and writer has stated:

 

“……… these big hospital are horrible places really, the very last thing you get in an English hospital is peace, rest or quiet which are the very things you need the most”. He goes on to say that the garden he created at St. George’s Hospital,” ….. is probably the thing I am proudest of.” (The Observer).

 

Not all gardens are equally effective. A study found that tree lined vistas of fountains or other water features, along with the greenery of mature trees and flowering plants appealed the most. The more greenery versus hard surfaces the better (Cooper Marcus and Barnes 1994).

 

The plan for the new Royal hospital include a landscaped garden. According to Brian Zeallear from NBBJ:

 

“Through creating smaller buildings around the periphery and having public roads and pedestrian corridors through the site, we can stitch back the existing city. The centre will feel like a public square. The hospital is in a dense urban area but once the landscaping is done….it should make you feel you are in nature through the manicured grass, trees and water features”.

 

However sitting in a public square surrounded by public roads is hardly the restorative qualities of greenery, flowers and other nature content envisaged by Ulrich.

 

Liverpool Women’s Hospital is at present situated in a quiet, landscaped and safe environment. Although it is in a fairly central location it is protected from the sounds and pollution of traffic.

 

There is now substantial evidence on the adverse effects of air pollution on different pregnancy outcomes and infant health. The evidence for the impact of air pollution on infant mortality, primarily due to respiratory deaths in the post-natal period seems to be solid (WHO 2005).

 

Less consistent though still suggestive of a causal link to air pollution are lower birth weight, a higher incidence of preterm births and intrauterine growth retardation. Moreover the evidence shows clearer relationships for particulate matter and traffic related air pollution than other pollutants.

 

The intrauterine, perinatal and early childhood periods, during which the lungs are developing and maturing are very vulnerable times. These are times when the lungs are more susceptible to injury by air pollutants. Exposure during these periods reduces the maximal lung functional capacity achieved in adult life and can lead to increasing susceptibility, in adulthood, to infections and the effects of pollutants such as tobacco smoke and occupational exposures (Vierira 2015).

 

Also there is sufficient evidence of a causal relationship between exposure to lead to neurobehavioral deficits in children in terms of cognitive impairment (WHO2005).

 

While it is impossible to avoid all air pollutants, advice from many sources include, remaining indoors when air pollution is high and even when air pollution is low it is best to avoid polluted roads (Greenpeace 20017). Campaigns to avoid exposure to air pollutants include moving school entrances from busy roads and the use of pram covers to protect babies being exposed to harmful particles.

 

In the face of all the evidence of the harmful effects of air traffic pollutants on neonates, it is inconceivable that the environmental effects of building a hospital for women and babies in the middle of one of the most traffic dense areas of the city, have not been considered.20151204_094642Voucher_47272BD320151204_094642entrance

four-boys-born-here

Beware the

Beware those who advocate a new wave of volunteering as a solution to the NHS.
We need to be aware and to beware of what the privateers in their private conferences call the “Indian” model.This model means bringing in volunteers (read family) to do personal care, feeding, laundry etc to make health care cheaper to provide.

It will damage the employment of health care assistants and porters even some admin workers.
There is no need for this. The UK can afford health care. A fully funded, fully staffed NHS, is necessary and achievable within a budget similar to that which most advanced countries spend on health. A service fully funded from taxation and not for profit system will be more cost efficient and more effective both in individual treatment, in population level health out comes, and professional development for staff.

They would have us believe that comprehensive health care is unaffordable. It is not.However you will see programs and newspaper articles that argue this unaffordability time and again.

Volunteers in a fully funded system will add to the whole health and social care system
But if health is to be permanently put out to commissioned services, and, through the ACOs being pushed remodeled brought now, changed to resemble l regional rail franchises, then we will have to use the Indian model to help these privatised enterprises make profit

Volunteering will be press ganged by an understanding that without the volunteers our people will suffer individually when most in pain.

We can’t afford those who take profit from sickness.We can afford the NHS fully funded from taxation and not used for profit.

The Maternity Jigsaw

So what is going on with Maternity at the end of 2017?

We write this from the standpoint of the campaign to Save Liverpool Women’s Hospital but in reality it is a much wider issue

Liverpool Women’s hospital is a large maternity hospital which also provides gynaecological care and a range of other services .

In this analysis of the issues facing NHS users, we are focussing on the maternity aspect but start with the wider context. This sia first draft of an article we are likely to amend

Context

The UK is a very rich country. Far poorer countries spend a greater proportion of their wealth on health.

The NHS was founded and ran for decades as a service

funded directly from taxation,

publicly provided,

free at the point of need,

providing the best available treatment

and

as a comprehensive service so the overwhelming majority of the population used it as their health care.

What is happening now?

  1. The NHS does not get enough money from the government. The UK uses less of its annual wealth (GDP) to pay for health than other advanced countries do. This is policy not accidental.
  2. The NHS is a very cost efficient way of organising health care but these efficiencies cannot compensate for the overall lack of funds
  3. Large parts of the NHS funds from the government are diverted from patient care to pay for Capital building costs through PFI
  4. Staff have worked way beyond their stated duties to stop the service crashing, but this is unsustainable long term. It is damaging for staff and patient care. Staff wages and pensions have been deliberately held back
  5. The internal NHS market created under Labour Government has also proved very wasteful of money and of staff time. The creation of Trusts to run hospitals has made vital cooperation between hospitals very expensive and distorted staffing patterns.
  6. Attempts by hospitals to share services have themselves been complicated by privatisation, and the breaking up of services into so called discreet parts, for example bloods.In Liverpool one service covers the city but it is a stand alone company.
  7. The structure created by the 2013 Act of Clinical commissioning Groups and bundling services into commissioned packages has proved very expensive
  8. The use of private companies to deliver services has been more costly than NHS delivering in house, and scarce money has gone to private companies to make profit.
  9. Staff planning has been disastrous. Not enough doctors, nurses, midwives have been trained, and the reliance on overseas recruitment for doctor’s nurses and other health care workers is now especially in the Brexit situation, caused serious problems. The withdrawal of bursaries is likely to make this worse. There are not sufficent midwives coming through to replace those retiring and leaving the profession
  10. The plan for the NHS is called the Five Year Forward View, but even this is not a steady picture but one that is ever changing
  11. There has been fluctuations in medical fashion between local general hospitals, specialist hospitals and big acute hospitals, The conversation about which is the correct model has been largely within professional circles without popular democratic involvement and has been circumscribed by available resources and dominant political views.
  12. A propaganda point that we need fewer beds has proved woefully wrong.
  13. Staff training appears to be coming more specialised and less general/ holistic
  14. A new system is being developed which, it appears, might remove the trust CCG model and replace it with Accountable care systems. We use the term “it appears” because nothing has gone through Parliament ot other democratic processes, but that is the way it looks now.
  15. The ACO system is designed for private profit, for rationed service not patient care
  16. The parallel crises in funding for social care and elder care are also impacting on and being impacted on by NHS problems
  17. The crisis in Local Authority funding is caused by the years of Austerity.
  18. The ACOs appear to be bringing all three sectors into one underfunded and for profit umbrella
  19. Co-payment is being suggested so people will pay more for less services. Free at the point of need is at risk.

So where does maternity fit into this?

Maternity is the most frequently used service in the NHS

Maternity is commissioned by CCGs

The maternity tariff, the money paid by the government to providers of maternity care is insufficient to provide the service our babies deserve

There is no future for the human race without babies. Babies are a huge source of joy to the world.

UK maternity services are certainly better than prior to the NHS, better than the USA but not as good as the best in the world, in terms of outcomes for maternal mortality and health or for the numbers of stillbirths and babies born with health issues

There is a shortage of midwives, obstetricians and neo natal nurses and linked professionals. Those we have are over-worked, in some cases to burn out. The replacement by newly trained staff cannot match those leaving.

The plan for Maternity is called the Maternity Review.

The maternity review describes enhanced choice for mothers in the kind of place they give birth, yet across the country places to give birth are being closed. Four hours travel in labour is seen to be safe. Closures of maternity provision is rampant.

For profit providers are being brought into the maternity service; locally one to one midwives are the private pioneers

The model for maternity supposedly employed in the NHS is set out in the Better Births

Huge priority is given in the words of the maternity review to mothers’ choices but that is in strong contrast to the reality of maternity unit closures across the country. You can choose if you want extra maternity classes but not to give birth in your own town!

Maternity vanguards, or women and children’s vanguards, do not answer to local structures but are super-imposed on them.

There is an ongoing problem of resources in the system and units temporarily closing to mothers in labour is becoming common. Such closures are short term while the mothers already there are delivered. What happens to the mothers in labour turned away is another story.

https://www.ifs.org.uk/uploads/publications/bns/BN215.pdf

“MUs also face pressure from daily fluctuations in demand. This is an inevitable feature of maternity service provision. Occasional closures are probably unavoidable, unless the NHS is prepared to operate with excess capacity for much of the time. However, the patterns we observe in closures by day of the week and month of the year suggest that, in some instances, closures could be foreseen and avoided through improved planning. Whether the costs of that improved planning and additional resources exceed the costs to mothers in labour of units closing is another question”.

The women in labour turned away face major problems

Prof Mary-Ann Lumsden, vice president of the Royal College of Obstetricians and Gynaecologists (RCOG), said the UK remained a safe place to give birth. “However, the pressures on maternity services are growing, which could compromise the experience for women and their families. Stretched and understaffed services also affect the quality of care provided to both mothers and babies,” she said. “Unit closures may be due to insufficient midwifery, obstetric or paediatric staff, as well as inadequate capacity. If the UK governments are serious about improving the safety of maternity services, these staffing and capacity issues must be addressed as a matter of urgency.”Lumsden said it could be distressing for a woman in labour being turned away from a hospital, although stressed that closures were “relatively unusual”. She said units worked as part of a network that could help provide alternative care at a nearby hospital – “though this is less than ideal”.The RCOG has produced recommendations on how units can have medical staff available at all times in the face of changed working patterns, reduced trainee availability and financial constraints.

For profit maternity providers, commissioned by the NHS but nor supervised within or employed by the NHS, are operating locally and nationally.

There are 4 major kinds of maternity provision around actual delivery of the baby;

  • The Obstetrician/ Consultant led services in hospitals
  • Midwife lead units alongside Obstetrician led services
  • Stand alone midwife units
  • Home births

Some home births are assisted by NHS midwives, some by midwives employed by for profit companies and some independent self employed midwives.

A few wealthy women give birth in private hospitals like the Portland in London

Liverpool Women’s Hospital

There is a determination to close one hospital in Liverpool as an infamous Panorama programme made clear.

LWH has and will have a problem financially until the maternity tariff is improved

The Merseyside Women’s and Children’s Vanguard appears to have the ability to make decisions not made by either the Liverpool Women’s Hospital or the Clinical Commissioning Group.

The Sustainability and Transformation partnership (?)for the Merseyside and Cheshire Region also impacts on decisions about maternity care, linking to the Vanguard

Issues to do with national staffing planning and consequent shortages, funding structures, Trust structures and the internal market impact on the LWH’s ability to employ consultants in all the fields they would like. Long term lack of investment in the neo natal unit and City wide problems with organisation of blood services all present problems

Current thinking seems to be that the Women’s hospital should be co- located with an acute hospital and the children’s hospital but given that Alder Hey Children’s Hospital and the Royal are new build hospitals such expenditure seems unlikely.

The Royal site which is favoured by the CCG and the LWH board is miles from the children’s hospital. We think its important that babies in intensive care are close to their mothers. We want to neo natal intensive care to stay at Liverpool Women’s Hospital. We are less keen on the idea of babies still needing care being discharged earlier from neo nate units

The Royal is also in a traffic hot spot, likely to get worse in terms of traffic as the Clatterbridge unit and the life sciences buildings come into operation on the site

The precious safe space element of the women’s hospital is largely ignored yet violence against women and children is a feature of our society and sadly of pregnancy.

Charging Migrants for NHS; thin end of the wedge?

Charging   Migrants for NHS;thin end of the wedge?

Women and babies suffer first from health service cuts, so Save Liverpool Women’s Hospital Campaign is very concerned about cuts and about charges. A real life case brought this to life in our campaign meeting.

The  plans to introduce direct charging to patients is one of the most feared aspects of the Government plans for the NHS.We are seeing the early steps in this and birthing-ballneed to say NO!

The National Health Service is funded directly from  the tax ordinary people pay, be it income tax, VAT or one of the myriad of other taxes.

The NHS was founded in 1948, in the debris of war. It was founded to be free at the point of need, funded by taxation, not for profit,  a universal service providing the best available care

We do pay personally for prescriptions and for dentistry and for opticians, costs that once were included in the NHS. We also have the mixed up mess of  paying for care for the elderly, sometimes even if they are too unwell to care for themselves. Social care remains a part private responsibility, part social services, and part NHS mess. Social care for the elderly can  be personally very costly. We need a similar funding system to the NHS.

However no-one using the NHS is asked to fork out tens of thousands for Cancer care or for transplants or complex care for  very poorly babies Medical treatment is still free at the point of need

We are not alone in being concerned at this.  Many doctors  are concerned at charging being  brought in

So in 2017, we see that some services have been transferred to the private sector and  we find ourselves having to pay for some services. This was from earlier waves of privatisation. A huge wave of privatisation is growing in the NHS which will be described in a different  posting. But worry about  privatisation pales against the time when we may be forced to pay for treatment or go without treatment, if we cannot afford to pay

Our service is very different from the US model. It is not a service to sell, or an insurance based system. It is a universal service funded by taxation.

In some other countries most notably the USA people get health care according to how much health insurance they or their employers buy. No insurance, no treatment, or treatment at huge cost. Sometimes  the insurance refuses to pay and people lose their homes and cars to pay for it, or, rather than risk their family becoming homeless, people accept a preventable death or long-term damage. The insurance system operates a de-facto rationing system for care.

Charging some people has been in the NHS for some years but the system has just changed

women-on-the-march-2It started with  charging Migrant women for maternity, hence the link with our campaign.This has been damaging to pregnant women  as described in the British Medical Journal article linked here.  Lots of articles were put in the press to support the government claims of rampant health tourism but the statistics do not back this up. Now the government is  spreading the net.

It is simply not true that Health Tourism is a big cost to the NHS.The most reliable estimate is 0.38% of the budget. Compare that to the cost of PFI hospitals where the profit on one hospital is more than 10 times the cost (see earlier article)  and it’s a tiny amount. Collecting the fees will cost more than the  treatment so no extra money will feed back into the NHS.

It is adont-give-up-the-fight smokescreen and a dangerous one. It is laying the groundwork for charging more and more groups of people. Women and babies suffer first from health service cuts so Save Liverpool Women’s Hospital Campaign is very concerned about both cuts and charging.The  plans to introduce direct charging to patients is one of the most feared aspects of the Government plans for the NHS.

So in 2017 we see that some services have been transferred to the private sector and  we find ourselves having to pay for some services. This was from earlier waves of privatisation. A huge wave of privatisation is growing in the NHS which will be described in a different  posting. But the many forms of privatisation pale in insignificance against the time when we may be forced to pay for treatment or go without treatment, if we cannot afford to pay

Our service is very different from the US model. It is not a service to sell, or an insurance based system. It is a universal service funded by taxation.

In some other countries most notably the USA people get health care according to how much health insurance they or their employers buy. No insurance no treatment, or treatment and then a bill which the insurance refuses to pay and people lose their homes and cars to pay for it, or, rather than risk their family becoming homeless, people accept a preventable death or long-term damage

Charging some people has been in the NHS for some years but the system has  recently changed

 

Migration

Migration means to move to a different country for  one of many different reasons. It is not tourism where people come for a holiday. During the  misnamed Irish Famine huge numbers of Irish  people moved to Liverpool and beyond. Whole Welsh communities moved to Liverpool too. A community of Welsh miners migrated to Patagonia where the Welsh language survives there still.. When the Scots were forcibly driven from the Highlands  to make room for sheep farming, the Highland clearances,  whole communities moved to England, Canada, the US and Australia. More recently tens of thousands of UK people moved to Australia and New Zealand

A Migrant is someone who lives here. Not a visitor. Some are mega rich and live in million pound pads in London but most are working people, doctors, nurses, carers,  engineers, social workers, hotel staff, scientists,cleaners. Some migrants have full legal status here. Some have interim leave to remain and some are still applying. Some are from Europe, some are not. They are needed in large numbers in the NHS and the care sector.

The poorest are the most likely to have difficulties with their papers and migrant women are amongst the poorest.

Someone working and paying taxes here in the UK should not be charged additionally for health care. Health care is paid for through  general taxation

If they end up with an outstanding bill for health care on their records, getting their papers or citizenship can be much harder and the threat of deportation hangs over them.

The NHS is funded directly from taxation and provides a universal service, that is a service for everyone.The NHS is recognised as a wonderful public service across the world and its seventieth birthday next year will be celebrated across the world. It is the most cost efficient  health service in the world https://www.theguardian.com/society/2017/jul/14/nhs-holds-on-to-top-spot-in-healthcare-survey

Taxes

Taxes in the UK come not just from income tax but from indirect taxes like VAT. Indirect taxes raise more money than income tax.Everyone who buys anything except food and children’s clothes pays VAT and other taxes

Other health care systems spend huge amounts of money recouping money from patients but the NHS does not need to do this because it is funded from taxation. Employing people to chase other people to get payments or to refuse to pay out on an insurance policy or to tell people they are not eligible for treatment, really does help to curing sickness or protecting health.

Health in the UK is delivered to all people just as our beaches and open spaces, roads and street lighting  are open to all.This public  health provision system is cheap in comparison to other countries and is efficient, both in money-saving and in saving lives and promoting health.

Sick or infectious people who are NOT treated are a cost to themselves, their families, their community, people they meet and the wider society. A country functions better with  universal health care.It manages epidemics more efficiently and it allows research that leads to better health outcomes. More people keep fit and healthy and able to be employed or to study or to take care of others.

Wasteful use of resources. Damaging to health.

Employing people to chase up charges is not an efficient use of resources.The USA is a fine example, they pay much more of their National wealth on health care, its one of the biggest bills families face, yet their health care outcomes are not as good as the publicly funded NHS and it costs much more

It makes more sense to  train those people as doctors nurses or some other useful role in the NHS.

Any sick person with an untreated illness is eventually costly to society. Any infectious disease not treated a threat to the whole society. TB used to be a real threat to the health of this city. Universal health care has turned it into a rare illness, or at least not a dangerous epidemic, here in Liverpool

But this is much more so for pregnant women. Denying care in this situation  damages two people who can be hurt the baby and the mum, and the rest of the family can suffer too.We are only two generations away from the time when more women died in childbirth, than men died in the mines. We are only two generations away from women losing many babies in childbirth.

The NHS has a long way to go before it is really good at saving babies but t is a world better than generations past and a lot better than the USA.

This government and the previous one have been following some unpleasant policies and ones that damage health and health care.

It appears to be true that we are moving towards an US style  health system where people might have to pay directly according to the treatment, they need which raises the question what of those who can’t pay.

Let’s nail some of their propaganda on this

  • A payment system is not  more efficient. It is wasteful and inefficient.
  • It pays the money to  insurance companies and to admin which should go to the treatment of ill-health and protection of good health.
  • It puts people off seeking early and therefore cheaper treatment
  • The UK is not poor. It is very rich. It can well afford to spend 11% of its GDP on the  health service.
  • The US spends much more for much worse outcomes because it wastes money on the charging and rationing system it uses.

 

Some of the very rich don’t pay their taxes.

This government’s policies have resulted in real wages falling more than any other country except Greece  since 2008. This government operates as a global economy  more answerable to global corporations than to its own poor. Meanwhile the very rich are taking huge profit from the NHS. The wealthy in this country hide their money in many offshore accounts and invest massively abroad.

The Government should put more money into the NHS. Much of the money which it  pays in now is wasted in privatisation projects.

Many people who have come here to work, work in the NHS. The migrant workforce in the NHS is not replaceable.

The UK should have trained more doctors and should be training more nurses, midwives and related professions, but instead  they have cancelled bursaries for nurses and midwives which shuts those professions off from older women and those from less well off families. Their planning for doctor numbers is a full failure.

Many people who live here either as workers or as carers within families  have to pay a premium on their visa to cover NHS care. They also pay just as the rest of us do through taxation.The new charging system could affect some people who have lived here for many years as we have seen in other home office blunders threatening to deport  and even deporting Grandmothers who have children and grandchildren here and have lived here their adult lives

Migrants tend to be younger and healthier than the average UK resident.

Some migrants can be here totally legitimately, yet not have the correct paper work because of delays in the home office. Migrant women living here need maternity services yet some women were the first to be denied  free NHS Care.The results of this are best described by the Royal College and Maternity Action reports attached. It we made posts of some of their reports, we doubt that we would be believed, so please take it from them, instead.These are the reports by the Maternity Action and the Royal College of Midwives. 

Claiming medical care

Medical records are  crucial to safe treatment. The  standard booking in procedure at a hospital  pulls up the patient’s record, if they have one. Very healthy people, people who are not registered with a GP or people whose records cannot be found are those who will be challenged.

At this point it is not just eligibility for treatment but what happens if they are deemed ineligible and what happens if they can’t pay.

The decision on delivering the treatment or not should still be that of the doctor treating the patient based on need, not an admin person from the hospital. Unless admin respect this, these mistakes will be costly in terms of health as people put off going to the hospital until they are really ill. It will also be expensive in terms of administration and litigation problems  which are going to occur for everyone. And then there are the bailiffs going after some of the poorest people in the country because they went to hospital Many UK families do not have Thousands of pounds  in the bank.

Liverpool Royal Broadgreen Hospital Trust posted on our Facebook page a link to their charging forms

Our campaign, along with many other NHS defence campaigns, across the country want a return to the original NHS  system of a universal service  funded by taxation.

If such a service is restored and continues to thrive other  people in other countries will campaign for a similar service in their own country, as Bernie Sanders and Socialists do in the US.

Just as we have suffered major cuts in service through austerity many countries in Africa and the global south  had forced vicious cuts especially to Maternity  through “restructuring”. This gives a summary of the problem.

Let’s keep campaigning for

  • a return to a fully publicly funded NHS
  • treatment according to need
  • full bursaries for NHS staff in training
  • For more doctors to be trained
  • For health care to be funded to the same level as other advanced European nations
  • For an end to privatisation.
  • For the UK to invest in preventing stillbirths and maternal deaths

Save Liverpool Women’s Hospital will cooperate with other health campaigners to stop charging for health care in the NHS service for everyone.

 

A Manifesto for Maternity #eachoneofwomanborn.

#eachoneofwomanborn. #born in the NHS.

We ask that this manifesto for maternity be shared and discussed by all maternity and NHS campaigners. We welcome discussion.

A manifesto for mothers and babies in the NHS

  1. Increase the maternity tariff. The existing maternity tariff, the money the government allocates for each birth does not pay for sufficient midwives for safe births, let alone for happy births
  2. Bring back bursaries for midwives and nurses
  3. Make full maternity care available to all mothers, no exceptions
  4. Ditch the sweet talking Maternity Review. No personal budgets. No loss of beds. We want a fully funded NHS maternity system, not a choice of private providers.
  5. Respect women’s choices in labour. Listen to the mother.
  6. Home birth, midwife unit or hospital birth, they all need to be in in the NHS with NHS staff fully supervised and in the training loop.
  7. Make obstetric care available in our local hospitals. No four hour journeys for women in labour.
  8. No pressure to give birth at home. Home birth must be a free choice, with full hospital back up available
  9. Full NHS insurance for all NHS home births. No handing over responsibility. No home births on the cheap.
  10. Give women more time with their midwives. More midwives per mother.
  11. No cuts in maternity beds
  12. No woman to be left alone in labour
  13. Help women with breast feeding. Mums need support after birth too. Breast feeding is far too low in UK, yet women want to breast feed for their babies.
  14. Support mums in the early days with baby.
  15. Invest in the start of life
  16. Support maternal mental health
  17. Train more paediatric doctors and nurses.
  18. Research reasons for premature birth
  19. Improve pediatic intensive care
  20. Staff our labour wards so no forced emergency closures. Plan staffing 8 months in advance. It’s kinda natural
  21. Nationalise the private maternity companies taking NHS contracts
  22. Fund research into still births, and birth injuries
  23. Improve procedures for induction of labour
  24. Fully fund neo natal intensive care
  25. Recruit more midwives, nurses and doctors,neo natal intensive care nurses and related staff.
  26. Ditch the STPs and their cuts
  27. Keep all our EU staff and make them very welcome
  28. Fund improved ambulance services and train all staff including dispatchers around birth issues.
  29. Fight maternal and child poverty

For our babies, for our mothers, for our sisters, for our lovers