The Dis-Integration of the NHS. No to the White Paper.

People change the world when they need to do so.

Deborah Harrington from Public Matters spoke to a meeting of campaigners and trade unionists across Cheshire and Merseyside, our local ICS area. We want the NHS back to the Bevan Model of healthcare, the most efficient, the most integrated service in the world, before the privatisers started leeching off it.

Health care should be

Free at the point of need

for everyone,

paid for by the government

and provided by public service , not by profit making companies

Another great Liverpool Woman who stood up for the poor and fought cholera.

It was women and trade unionists who fought to found the NHS a century ago and we will step in again now.

During the Pandemic, whilst doctors and nurses worked long hours in difficult conditions, the NHS bureaucrats have devoted money and man hours to a major reorganisation of the NHS, which puts into place much that has been planned through the STP. This will embed the role of big International for profit health care companies. These companies are there for profit.

It will reduce local accountability and stop using individual clinical need as its planning base

Would that instead of such plans, they had prevented in hospital transmission of Covid. Please watch and share the video. We will need the biggest campaign ever to stop this White Paper, and the campaign starts small but starts immediately.

We too can change hearts and minds and force change for the better

Women from the cooperative women’s guild demanded that maternity care be available for all free at the point of need. We don’t all want greed and capitalism

You may have heard of a big US corporation Centene taking over GP services, but these corporations are in the NHS nationally and in STPs/ ICS

They are advising the NHS on reorganisation on multinational corporation lines. Hancock has just brought in a top bureaucrat r for the NHS from a big US health care corporation. Please watch the video. Please ask for a speaker at a meeting. Please step up for our NHS.

We don’t remember Polio, you and me.

Public meeting Wednesday 17th February 2021

We don’t remember Polio, you and me. When we look at our little ones running around, playing, making a mess of freshly tidied rooms, it’s about the furthest thing from our minds.

Maybe some of us older mums will have heard snippets of stories from our parents. “Jackie’s friend had it” or “Some lad who used to knock around with your Uncle.” But that’s all they are, stories from a time gone by that soon become vague memories. We never have to retell them ourselves.

Leg braces are a rare sight these days and Iron Lungs you only see in history books.The fight against Polio is still there with vaccines and vaccines that need updating. None of our kids will ever have to wake up alone and afraid on a ward encased in a machine that breathes for them because of Polio.

The fight against polio is still going on in Pakistan and Afghanistan

Polio won’t ever paralyse our babies or snatch their little lives from them too soon, because our parents and grandparents didn’t stand for it. And when it comes to Covid, neither should we.

There was no cure for Polio back in the day and even now with how far we have come, there still isn’t. The reason you don’t hear about it anymore is because our Parents and Grandparents got rid of it the same way we’re trying to get rid of Covid, by vaccinating us against it. Their bravery to take the first step made sure that disease today is only talked about in history books.

People are starting to see the long-term effects of Covid now and it’s easier to see in children. Up to 100 children a week end up in hospital, many in Intensive Care, with what’s being called Long Covid. 75% of the worst cases are in kids from Black, Asian and Ethnic Minority backgrounds. Doctors still don’t know if there’ll ever be a cure.

We have the chance to be as brave as they were and save hundreds of our kids . So lets take it.

Let’s get rid of Covid.

Come to our community meeting about getting rid of the virus. Its on Zoom but we hope to put it on facebool live too.

Speakers will discuss the virus, vaccines, public health measures, how to reach all sections of our communities , pregnant women and new mothers, long Covid and the effects of the pandemic on the NHS.

There will be plenty of time for Questions & Answer sessions and public discussion

Please respond to this reorganisation of the NHS

Act to save our NHS

During the pandemic, the upper echelons of the NHS and the Government haver been implementing a structural reorganisation. The reorganisation breaks the national part of the NHS and integrates private companies into the reorganisation. It is being done without laws going through parliament.

The deadline for the response is 8th January, and the link to the consultation is https://www.engage.england.nhs.uk/survey/building-a-strong-integrated-care-system/

We have joined with other organisations to try to raise awareness of what is happening. Many people will be aghast that this is happening at all, but during the pandemic, when all eyes should be on the virus, is doubly scandalous.

We are reproduce here the letter from Keep Our NHS Public. Other organisations are circulating in essence the same message. What follows is from the material produced by Keep our NHS Public

Integrating Care: Why NHS England is getting it wrong

NHS England (NHSE) is consulting on their latest plans for ‘integrating care’, including changes to legislation.

The proposals include a top-down re-organisation of the NHS in England abolishing CCGs, replacing them with 42 Integrated Care Systems (ICSs), statutory bodies under tight financial control from the centre and with even less public accountability. The result will be massive new opportunities for the private sector through the ‘Health Systems Support Framework’ (HSSF). While ICSs will find it difficult to work in real partnership with others such as local authorities in addressing health inequalities, proposals will allow private companies representation on an ICS Board.

Despite the short notice we hope you can respond to the consultation, which has a deadline of 8th January.

We attach a template response to the consultation giving a range of possible answers for you to adapt.

We also attach background papers from Keep Our NHS Public:

     * Our summary of what lies behind the “Integrating Care” proposals

ICSs are an organisational form adapted from the US health insurance market, and the HSSF is central to their development. This Framework has 83 NHSE-accredited companies, 22 of which are US-based. We expect legislation will result in a flood of contracts, much as the government has dished out thousands of Covid contracts, bypassing proper procurement.

     * KONP’s response to the legislative proposals

These include a deregulated market economy in healthcare where even the existing, limited safeguards to protect social, environmental and labour standards are removed, and where a bidder’s track record is not taken into account.

Further detailed critiques of Integrating Care are available on the KONP website. These include a critique of the proposed structure and management of ICSs as revealed in NHSE’s Health Service Support Framework; critique of NHSE’s proposal to bring social care under NHS management; and proposals for real democratic accountability in the planning and oversight of NHS services as well as links to recent articles on ICSs in OurNHS/Open Democracy and The Lowdown (see https://keepournhspublic.com).

The Government has yet to publish a BillOnce it has, we look forward to your involvement in resisting this drive to disintegrate the NHS through financial mechanisms and increased corporate influence.

To reiterate, the deadline for the response is 8th January, and the link to the consultation is https://www.engage.england.nhs.uk/survey/building-a-strong-integrated-care-system/

Please do not worry about creating a long academic response. Please just respond. Try to keep a copy of your response and send it to  savelwh@outlook.com

Respond even if it is late.

Please write to your MP and please try to make sure your members know about this

Dear —

Integrating Care: Why NHS England is getting it wrong

NHS England (NHSE) is consulting on their latest plans for ‘integrating care’, including changes to legislation.

The proposals include a top-down re-organisation of the NHS in England abolishing CCGs, replacing them with 42 Integrated Care Systems (ICSs), statutory bodies under tight financial control from the centre and with even less public accountability. The result will be massive new opportunities for the private sector through the ‘Health Systems Support Framework’ (HSSF). While ICSs will find it difficult to work in real partnership with others such as local authorities in addressing health inequalities, proposals will allow private companies representation on an ICS Board.

Despite the short notice we hope you can respond to the consultation, which has a deadline of 8th January.

We attach a template response to the consultation giving a range of possible answers for you to adapt.

     * Our summary of what lies behind the “Integrating Care” proposals

ICSs are an organisational form adapted from the US health insurance market, and the HSSF is central to their development. This Framework has 83 NHSE-accredited companies, 22 of which are US-based. We expect legislation will result in a flood of contracts, much as the government has dished out thousands of Covid contracts, bypassing proper procurement.

     * KONP’s response to the legislative proposals

These include a deregulated market economy in healthcare where even the existing, limited safeguards to protect social, environmental and labour standards are removed, and where a bidder’s track record is not taken into account.

Further detailed critiques of Integrating Care are available on the KONP website. These include a critique of the proposed structure and management of ICSs as revealed in NHSE’s Health Service Support Framework; critique of NHSE’s proposal to bring social care under NHS management; and proposals for real democratic accountability in the planning and oversight of NHS services as well as links to recent articles on ICSs in OurNHS/Open Democracy and The Lowdown (see https://keepournhspublic.com).

The Government has yet to publish a Bill. Once it has, we look forward to your involvement in resisting this drive to disintegrate the NHS through financial mechanisms and increased corporate influence.

To reiterate, the deadline for the response is 8th January, and the link to the consultation is https://www.engage.england.nhs.uk/survey/building-a-strong-integrated-care-system/

In solidarity,

Keep Our NHS Public

NHSE CONSULTATION: building a strong, integrated care system across England

Please amend and adapt the wording below in your response to avoid any batch rejection of critical responses

 What is your name?  
 In what capacity are you responding?  
 Are you responding on behalf of an organisation?  
 Do you agree that giving ICSs a statutory footing from 2022, alongside other legislative proposals, provides the right foundation for the NHS over the next decade?
 Strongly disagree   comments or additional information: a)This is a very ‘top down’ exercise with little justification other than the hope it will allow tighter controls on spending. b) Claims that functioning ICSs have already demonstrated significant improvements in patient care are only wishful thinking and not evidence based. c) The plan for ICSs is not focussed on improving care for patients but on binding NHS organisations by financial controls and plans written by the ICS with advice from companies accredited under the Health Systems Support Framework. d) The NHS needs re-integration by abolishing the 2012 H&SC Act altogether and removing the competitive market and the purchaser-provider split. e) Facilitating even more contracting out of services and management structures including the private sector is not ‘integration’ but ‘dis-integration’. f) NHSE/I legislative proposals include the removal of Public Contracts Regulation safeguards over social, environmental and labour standards, and the ability to rule out bidders on the basis of their track record. It will expand the scope for scandals like the PPE contracts awarded without procurement to firms with no relevant experience. g) Other legislative proposals would embed “population health management” as a binding aim for all NHS organisations, without evidence that this will improve patient access to universal, comprehensive healthcare, free at the point of need, publicly provided and publicly accountable, funded through general taxation.  
 Do you agree that option 2 offers a model that provides greater incentive for collaboration alongside clarity of accountability across systems, to Parliament and most importantly, to patients?  
 Strongly disagree   comments or additional information: a) By “collaboration”, the plan includes collaboration with the private sector, which we oppose. b)  There is very little accountability built into the system and large organisations are inevitably far removed from the needs and concerns of local communities. CCG mergers reduce the opportunity for local public involvement; Option 2 goes even further. c) Any reorganisation of the NHS should be looking at increasing accountability and democratic control rather than weakening it.  
 Do you agree that, other than mandatory participation of NHS bodies and Local Authorities, membership should be sufficiently permissive to allow systems to shape their own governance arrangements to best suit their populations needs?  
 Strongly disagree   comments or additional information a) Allowing management consultants and private sector representatives to sit on governing bodies undermines the public sector ethos which is key to the NHS. b) ICSs as proposed will only facilitate top down control. c) The NHSE Health Systems Support Framework (HSSF) strongly prioritises financial savings over patient need. The HSSF is designed to implement systems of patient and data management needed for insurance-based systems rather than clinical priorities and local need. The majority of companies accredited through the HSSF are major corporates, including many involved in health insurance in the US and elsewhere. d) This approach is incompatible with what patients and communities want and need and with NHS founding principles and values.  
 Do you agree, subject to appropriate safeguards and where appropriate, that services currently commissioned by NHSE should be either transferred or delegated to ICS bodies?  
 Strongly disagree   comments or additional information Specialist services require national commissioning in order to ensure consistent standards across the country  

Keep Our NHS Public (KONP) Overview Response to Integrating Care – The next steps to building strong and effective integrated care systems across England1

Introduction In the midst of a massive Covid epidemic, NHS England (NHSE) is driving through a far-reaching topdown reorganisation of the NHS, based on proposals in the Long Term Plan (2019). They are consulting until January 8 on the details of new legislation which they expect the government to enact early this year to give legal legitimacy to changes which are already under way. We are concerned that the implications of these changes for the accountability, availability and access to services and values underpinning the management of services have been barely noted within a tumultuous 2020. Noting the serious concerns that have been raised by the Local Government Association and others, including NHS Providers, we are asking all politicians, from every party, to take a stand against these damaging proposals.

Restructuring of the NHS in England .

At the core of the re-organisation are Integrated Care Systems (ICSs), bodies described by NHS England (NHSE) as NHS organisations that work in partnership with local councils and others to take collective responsibility for managing resources and delivering NHS care. ICSs have been driven from the top by NHS England, and in many areas resisted at local level by councils, GPs and campaigners.

However a 39-page NHSE document “Integrating Care,” seeking new legislation allowing the whole of England’s NHS to be run through ICSs by 2022, claims they are “a bottom-up response.” The proposals reduce the number of commissioning organisations from almost 200 to just 42 new “Integrated Care Systems” (ICSs). This has required merging (and eventually abolishing) local Clinical Commissioning Groups (established as public bodies by the Health & Social Care Act 2012), and replacing the 44 ‘Sustainability and Transformation Partnerships’ (STPs) set up in 2016.

The mergers inevitably result in larger bodies, more remote from the needs and concerns of any local community, and therefore a loss of local accountability. This point has been powerfully argued by the all-party Local Government Association (LGA), which represents the leaders of 335 of England’s 339 local authorities. Their response states: “We are concerned that the changes may result in a delegation of functions within a tight framework determined at the national level, where ICSs effectively bypass or replace existing accountable, place-based partnerships for health and wellbeing…. 1

https://www.england.nhs.uk/integratedcare/integrated-care-systems/ 2

Calling this body an integrated care system is to us a misnomer because it is primarily an NHS body, integrating the local NHS, not the whole health, wellbeing and social care system.”

The Health Service Journal, aimed at NHS managers, has also shown how vague the proposals are: “ICSs will be given a single pot of money from which to manage spending priorities. But there is no framework for how this will be spent that assures fairness, value for money and quality outcomes.”

29 of the proposed 42 ICSs have already been approved by NHS England – even though they lack any legal status, and almost all are functioning behind closed doors with no public accountability. The remaining 13 STPs2 are required to become ICSs by April, or face the intervention of an “intensive recovery support programme.”

The LGA calls for the establishment of alternative structures involving genuine partnership with local authorities and, through them, links to local authority services and responsibilities that are vital components of the wider determinants of health.

Keep Our NHS Public (KONP) has issued a response to the lack of public accountability inherent in ICS structures, and set out proposals for developing genuine public accountability. The Report is on the KONP website here. KONP also rejects the assumption, repeated frequently throughout ‘Integrating Care’, that social care might be managed through NHS ICS structures. KONP campaigns for a publicly provided national care, support and independent living service.

At local level, we argue it is essential that social care continues to be managed by local authorities, retaining essential links to wider local authority responsibilities such as housing, education and leisure. KONP’s critique of the approach to social care set out in Integrating Care is here.

New legislative proposals Integrating Care seeks new legislation that would provide the formal legal basis for ICSs that they currently lack, as well as changes to existing procurement requirements. KONP argues for the abolition of the commissioner-provider split, believing the NHS should be provided and managed directly as a public service, not through commercial contracts. However we argue that what is worse than a managed market in health is an unmanaged and unregulated market.

The failed £multi-billion Covid-related contracts, including those for PPE or Test and Trace, dished out with no proper procurement procedures, have revealed what this can mean in reality.

NHSE wants to scrap Section 75 of the 2012 Health & Social Care Act which requires significant contracts to be put out to competitive tender, and to remove contracts from Public Contracts Regulations.

The prospect of changing the law so that more and more large NHS contracts could be awarded without any due process or public scrutiny is seriously worrying. KONP’s detailed response to the legislative proposals in Integrating Care is here.

Values underpinning the management and direction of ICSs Under proposals for ICSs, all providers will be bound by a plan written by the ICS Board and financial controls linked to that plan. Private companies may support the Board and potentially have a place on the Board, as well as being contracted for services.

NHS England has established a Health Systems Support Framework (HSSF) to facilitate easy contracting by ICSs. The Framework consists of organisations accredited by NHS England to support the development of internal structure and management of ICSs, and, potentially, also to play a longterm role in direct management of ICSs. A quarter of the 83 organisations approved by NHSE to take on contracts with ICSs, and potentially also take seats on decision-making Boards of ICSs (as has happened in North East London) are American-based, offering expensive data-based systems designed to benefit US insurance companies and private hospital chains.

Research in the USA and experience in England has exposed the lack of evidence that data-led attempts at “population health management,” or targeting the small number of patients with complex medical and social needs, can either reduce demand or cut costs. However, such approaches do facilitate the development of private insurance pathways running alongside NHS care.

Digital technology and number-crunching are among the more lucrative areas in which private companies are seeking profitable NHS contracts, and this is a strong theme running through the HSSF. However digital and data are also areas of notorious recent private sector failures – including the Covid-tracking app, the privately-run test and trace system, Capita’s long delays in contacting professional staff offering to return to fight the pandemic, and the £10 billion saga of the NHS Programme for IT.

And while Integrating Care argues for the need to establish ICSs as “statutory bodies” with real powers, notably “the capacity to … direct resources to improve service provision,” there are real fears that NHS England sees ICSs and ‘system-wide’ policing of finances as a way of more ruthlessly enforcing cash limits and “control totals” limiting spending across each ICS, with growing lists of excluded “procedures of limited clinical value”. These approaches to structure and management of ICSs pose a major threat to the NHS, distorting and undermining the core values and ethos of the NHS.

Conclusion Integrating Care raises serious concerns for the future of the NHS and social care services, concerns that we set out in detail in papers available on the KONP website, along with proposals for alternative structures and why social care should remain the responsibility of local authorities. Our concerns, based on hard facts, are widely shared by councillors, senior NHS management, GPs and seasoned analysts. NHS England’s proposed changes threaten to make the NHS less locally responsive, less accountable, more dominated by US and other management consultants and contractors, and more focused on policing cash limits than meeting the needs of patients. NHS England’s priorities should be on strengthening the NHS in alliance with local government and communities, not creating new remote bodies or adopting systems meant to maximise profits of private health insurance. Keep Our NHS Public (KONP) January 2021 https://keepournhspublic.com/

Rebuild and Restore the NHS

We are calling for, and will begin to campaign for, a much better health service for all our families,  fully funded  providing all the services we need

Please join us in this huge endeavour. If football fans can make their US owners think again, so can we.

We are starting now

We are working with many other campaign groups,. Keep our NHS Public have petition below.

https://keepournhspublic.com/campaigns/legislative-changes/integrated-care/integrated-care-system-petition/

All the Merseyside and Cheshire groups are holding a public campaigning meeting on May 10th at 7pm

Public meeting by zoom in Monday 10th May ( click on the link)

We put out this call  to all who care about the NHS, to all who campaign for   the NHS, all who work in the NHS. Our grandparents and parents had to fight to create the health service in the first place, free at the point of need, provided as a public service and providing all the treatments required.  We are echoing their call, more than 70 years later. The NHS cannot be run for profit. Give us back the NHS. End the cuts for cash scandal. We will try to get this message out across this city, across the whole of Cheshire and Merseyside region. We will work with  the national campaigns too. Please help us.

There are major problems in midwifery, in deaths of babies under one, and in women’s health, We will continue to campaign on these issues  Look out for our Autumn National Meeting Maternity Matters. We are all too aware that maternity  has its own grave problems. We can, and do  win short term gains but longer-term funding and staffing maternity can only be solved in a renewed and repaired National Health Service.

Meanwhile we must protect every service we still have. Not one more bed closed, not one more service removed, not one more member of staff outsourced, not one more service given to the private sector.

Money spent on health care gives one of the best returns on investment in the world. It gives good money returns but much more important it makes people healthier and happier. We are worth it and as the 6th richest economy in the world, we can well afford it.

The decisions to slash the number of beds, to under recruit and under train staff numbers, to fail to stockpile equipment against a pandemic, to give  sweet making companies core NHS contracts were all wrong and cost us dearly in lives lost and staff exhaustion. Reducing staff terms and conditions was morally wrong and damaged the service

Our NHS staff are worth every penny and more.

The NHS model  of healthcare is much more cost  efficient, more effective in health terms and  much more fair than the US model.

The original NHS model gave the world’s most cost effective and the best treatment worldwide according to Commonwealth fund

We are going to campaign for a return of

  • A fully funded NHS, funded by the government
  • All treatment free at the point of need
  • Comprehensive treatment, all the treatment and medicines required
  • A national service, not a post code lottery. Keep the national in the NHS to share the risks more equitably.
  • Universal health care, no one excluded
  • A health service built on treating the whole patient not  just  specific ailments.
  • A health service built on cooperation not competition
  • Reduce the bureaucracy and expensive and  damaging financial consultants
  • A service delivered by public service, not by profit making companies
  • A researched based institution
  • Well-regulated and well-educated professions in the NHS
  • Good wages and conditions of work for all staff
  •  A mass five-year recruitment, retention and return drive for midwives, nurses and other professions
  • No student loans in the NHS
  • Sufficient beds to provide for all in fair reach of home
  • Re nationalised mental health care and beds
  • No more hospital closures
  • A new Independent Living Service distinct from the NHS
  • NHS workers to be employed by the NHS on national conditions of service
  • Full rights for all migrant health workers including full access to NHS health services for them and their families and an end to migrant charges
  • A democratic management structure and management style
  •  Public health to be nationally funded and locally delivered
  • Staff to be employed in patient care not in jumping through deliberately difficult financial loops
  • A comprehensive audit of NHS land and buildings including reports on disrepair, wear and tear and recommendations for short, medium and long-term  repairs, reinstatement and improvements

The NHS White Paper  finalises changes already implemented changes, made without legal status, They are very damaging  and will see  much more  private ownership and control, much more involvement of US health corporations and their subsidiaries in  health service in the UK. Lesley Mahmood from our campaign said “

Councillors, trade unions and elected representatives need to realise the ICS express train is about to crash through any idea of one National Health Service very soon as the government proposals look likely to be in the Queen’s Speech in May. 

This is not just another NHS reorganisation, bad as they have been. Previous privatisations have been about the Virgins, Sercos, Carillions and other privateers stealing cakes from the NHS bakery. The White paper on ICS is about splitting the NHS bakery into 42 parts and handing them over to the privateers. These multinationals will be sitting on the decision-making bodies, 83 major corporations, 22 from the US are already heavily involved in developing ICSs. Councils will find themselves lucky to have one seat at the table from half a dozen or more councils and no powers of scrutiny over closure of hospitals and services. 

While ‘integration’ sounds appealing, ICSs are about dismantling the NHS, ICSs are based on a US insurance-based model aiming to spend less on health & care. Fixed annual budgets won’t be based on need, resulting in more rationing and postcode inequality, fewer services, down skilling & outsourcing of jobs, local pay and further cuts on top of the 10 years of austerity in the NHS.

We challenge the use of  deceptive language in the Conservative Government plans for the NHS. They talk of accountable care, but  that  does not mean that they are answerable for that care but that the accountants can measure it

They talk of Population funding, sounding like improvements for the whole population but it means cash limits for different regions and financial incentives to restrict access to healthcare, “cuts for cash”

They talk of “integrated care” but far from integrating with social care it will disperse NHS funds to private social care companies

 This government said at the election that they would never privatise the NHS but are busy bringing private companies in, even to the major decision-making bodies of the NHS nationally regionally  and locally

You can move this resolution from keep our NHS Public at your Trade union branch. We will face lies and obfuscation, our arguments will be dismissed as scaremongering, but a victory will save  many lives and avoid much misery. If you value it, fight for it. Otherwise, we will be looking back at the time we had a proper health service and wondering how it slipped between our fingers, how it went the way that  dentistry free at the point of need, mental health provided by the NHS  and elder care went, how the hospitals could close, how once we had student grants and bursaries for nurse training.

They have   produced a list of companies called HSSF that can be given NHS work without tender, including  the employment of staff

We will campaign to show that population funding, integrated care and  accountable care will inevitably lead to charging, as we saw in the My Choice plan from Warrington Hospital

 Our campaign helped save Liverpool women’s Hospital because of the popular campaign. Such campaigns will have less power as local authorities will have less influence.

 This is not going to be an easy campaign.

 Look out for details of our campaign and please do get involved.

For all our mothers, sisters, daughters, friends and lovers and for the precious children,  reclaim  and restore our NHS.

Get in touch, join our campaign here….

Women in Defiance of Violence

A meeting with Sisters Uncut, Sistah Space, Women’s Lives Matter Yorkshire, Women Against Pit Closures, Save Liverpool Women’s Hospital, The Anti-Fracking Nanas, Kate Hudson Secretary of CND, Sandra Daniels representing the struggles of disabled women, Black Lives Matter Oxford, and contributions on the struggles of asylum seekers and the need to oppose the White Paper for the NHS, demanding that the NHS is not controlled by private companies but returns to the model the NHS was founded on.

The meeting is captioned and with BSL interpretation.

The opening song is Savage Daughter by Sarah Hester Ross

Certain themes unite us: Gender based violence in the home, in the workplace and education settings and in the street, the coming legislation on Police Powers, the NHS White Paper, the crazy intention to increase nuclear weapons, the need to address the climate catastrophe, the ongoing damage of Austerity which loaded more than 80% of the damage on to women, the damage done to Domestic Violence Services and  the threat of endemic Covid, the discriminatory benefits system and  the damage done to our communities and especially children by growing poverty.

We recognise the anger and pain that all who call that Black Lives matters during the trial for the murder of George Floyd

We mourn the dead of the pandemic.

Our campaign says the NHS must be free at the point of need, for all people not for profit, providing a comprehensive service, fully funded by the government. and not for profit The blood sucking big corporations must be dismissed from the NHS. WE demand a huge increase in funding for maternity and women’s health over 5 years to make our services the best in the world. We challenge the deaths o black women and babies in child birth

We demand better pay for NHS staff, and consistent recruitment and in service training for all NHS staff, over a five year period to tackle staff shortages and over work

Every gain we have made in two centuries have been through campaigning, protest and demonstration. That right is at risk. We oppose the policing bill and demand the right to protest

We raise the watch word Liberty

We will we will we will be free

#KilltheBill

Stop the corporate takeover of GP surgeries:

Our GP surgeries are where our care starts and where most of it is provided. Good primary care reduces the need for other interventions, but quickly identifies where fast hospital intervention is needed. Good care through pregnancy, childhood and adult life makes us, both as individuals and as society, healthier, wealthier and with more time to enjoy life in good health.

In Liverpool we have already seen major problems from commercial take overs of GP practices, as with the  situation in 2015 at Princes Park Health Centre (Now taken over by a different provider, who, we are told, do a good job. Tell us more if you know more)

Princes Park was once a historic innovating, socially conscious practice. We are awaiting the publication of a full history of the practice being written by Dr Katy Gardner

However in 2015 it was taken over by a private company and in February 2015 Keep our NHS Public  local campaigners wrote,

As soon as Princes Park Health Centre was handed to a private company – SSP Health Ltd (on April Fools Day 2013), patients, staff and campaigners started screaming about it, but no-one in power was listening. One of the SSP directors had already written to the Telegraph backing Lansley’s monster Health and Social Care Bill: the other runs over twenty companies including property and private medical care. Healthcare services at Princes Park Health Centre started to deteriorate from day one and it is clear that the priority for those running the practice has shifted from patients to profit. The authorities responsible for providing primary care services did nothing, so Keep Our NHS Public Merseyside took the trouble to organise a meeting in Arabic, English and Somali, giving voice to the community whose views had been ignored at every step.

The campaigners won. The CQC report on to the service was critical and eventually the service was taken over by a new provider

Around 90% of NHS transactions take place in primary care. If we are serious about saving our NHS, we cannot stand by while private companies, including US health corps, take over local GP surgeries and other primary care services.

Save Liverpool Women’s Hospital Campaign are supporting a joint campaigning group on this and we are grateful to them for some of the material we use in this posting.

 Our objectives are:

1. To reverse the Centene deal (Operose Health is its UK subsidiary).

2. To alert the country to the risks of Alternative Provider contracts.

3. To help inform opposition to the White Paper.

4. To show a link between Centene and other privatisation.

 We need to

  • expose the scale of the problem at local level
  • challenge the award of contracts, and
  • campaign against the Alternative Provider contracts that make takeovers possible.

What has changed in general practice?

Even NHS campaigners rarely understand how general practice works We think this urgently needs to change as it is too easily raided by big business

The key points are as follows.

  1. On a traditional family doctor contract (a GMS or PMS contract*), GPs are sub-contracted to run primary care services, indefinitely, on behalf of the NHS. They are not true businesses, because there are strict controls on the services they provide, the ways they can spend their money and how they treat their staff.
  2. When new Alternative Provider (APMS*) contracts were introduced in 2004, all that changed. GPs and private companies were offered the chance to run some surgeries differently on five-year rolling contracts. They were offered extra funding, encouraged to form chains and allowed to make profits for shareholders.
  3. In practice, the first of these Alternative Provider contracts were mainly taken on by GP partners who swapped contracts to try out the new model. But now we are seeing the practices and chains they built being hoovered up by the insurance giants.
  4.  There is much more detail on how GP services work here

Why this matters

The key difference between the contracts is that GP partners running a surgery for decades have a commitment to their patients, families and local areas. A US health corporation, with a time-limited contract, has a commitment to profits.

Let us look more closely at Operose and Centene.

Keep our NHS Public writes.

Operose already have contracts for twenty-one GP practices and several health services across England. Operose is a heavily loss-making subsidiary of the US-based health insurer, Centene Corporation which is registered in Delaware. Operose has paid no UK tax.  Centene could pull the plug on Operose at any time forcing the shut-down of a large number of GP practices.  In the USA Centene has been found guilty of fraud many times and is currently being sued by Ohio for fraudulent overcharging.  Operose Health’s publicity states openly that its market strategy is to exit NHS contracts that do not make a profit.  In one instance an Operose associate company pulled out of running Camden Road Surgery giving patients only 4 weeks to register elsewhere.

  • Since they cannot up their prices, these companies can only increase their profits by cutting back on staff costs and services.
  • When a private company like Operose Health becomes big in primary care, it will inevitably demand seats on the new NHS bodies that decide which services to commission and who to give contracts to.
  • There is serious potential for conflict of interest. Centene, for example, owns 40% of Circle Health, which in turn owns the huge chain of private BMI hospitals – which all make a significant amount of their income from treating NHS patients.

The following are all important elements of the ‘transformation’ of the NHS promised in the Health White Paper

The takeover of GP surgeries by US health corps,

the cuts to beds and A&E services in hospitals,

the restructuring of the NHS in England into 42 Integrated Care Systems,

the privatisation of areas such as pathology

the debacle of test & trace,

the takeover of back-office functions

 Please get involved in our campaigns and those of other NHS groups

This campaign has been launched by a concerned group of NHS campaigners and academics from around the country. It is backed by Keep Our NHS Public, 999 Call for the NHS, We Own IT, Doctors in Unite and EveryDoctor.

We thank our partners in this campaign for much of the material in this bulletin. Together we are stronger and we can make a difference

We Own it are also campaigning on this and have produced good videos.

We need you to help defend the NHS free at the point of need, fully funded not for profit, publicly provided and available to all.

The impact of Corona Virus on women

The pandemic has been very hard on all of our families. We will touch on the impact of the pandemic and the many specific ways it has affected women. This includes women as patients, as healthcare workers, as the bereaved, as pregnant women, as mothers and carers, as workers on the front line, as disbled people, as young women, as students We have written earlier about the need to make the UK a safer place to be born and to give birth.

More than 124,000 people have died in the UK from Covid 19 since the pandemic began and 4.21 million have suffered from the disease. Internationally the death rate stands at 2.59 million whilst 11.7million are recorded as having suffered from the disease. Staff have developed better ways of treating the disease, and scientists have worked hard to produce vaccines.

The experience of dying in hospital cut off from family is frightening and heart breaking. Untimely and unnecessary death is dreadful. Even when death is inevitable the manner of our passing matters. Thankyou to all the staff have done their very best. The staff who have helped families say virtual good byes, holding i-pads and phones for the very ill patients. and those who have held people’s hands as they died, all are owed a huge debt of gratitude. We thank also those who have laid out the dead and pushed the trolleys to the mortuary. We mourn all our dead and recognize the suffering of many more. We offer condolences to friends and family of those who have died.

Some of the healthcare staff who we have lost to Covid

We send our heartfelt thanks to all the doctors, midwives, nurses, linked professions, healthcare assistants, cleaners and porters, and admin staff who are working through this pandemic, under paid, and under protected. Our NHS staff have stood like a bulwark against the pandemic, at great personal cost.

We mourn our many dead. We thank all the undertakers and the women of the churches who conducted funerals when no priests were available.

We send our best wishes to those still suffering from the virus, men and women, young and old, Black, Asian, Filipina and White. We send condolences to the very many bereaved, to those who have lost partners, children, brothers, sisters, parents, grandparents, family, friends and workmates.

Each of the men who have died are  some mother’s son, many beloved partners, fathers, brothers, friends, neighbours, colleagues, work mates, neighbours. We fight for them too, for all in our communities.

We share the fury at the insulting pay deal offerred to nurses and the even worse one offerred to other NHS workers

We protest that it did not have to be this way. Effective, publicly owned, locally delivered, Find, Test, Track, Trace, and Support  would have significantly limited the impact of this pandemic. Effective PPE for staff would have saved lives  In the UK this responsibility rests squarely on the shoulders of the government. these essentials of public health are still not in place.

It is important to look at the impact of the pandemic, specifically on women. Although coronavirus physically affects men worse than women, women are being affected by the pandemic in multiple ways .We write as campaigners not academics, but only quote credible sources.

Women hold up half the sky  but hold up more than three quarters of the NHS workforce. The NHS workforce are owed a huge debt of gratitude for their dedication,  courage and sheer hard work. Sickness stress and death directly from Covid, and from the  overwhelming workload  have weighed heavily on the staff. We mourn the many NHS deaths.

We protest, however, that lack of decent PPE,  equipment, of high quality building ventilation, the lack of truly reliable testing and ineffective tracing, and of the chronic and long term shortage of staff  has led to many staff catching the virus in the hospital. We protest at attempts to gag staff from talking about these issues to the extent that we, the people, still do not know all of what happened.

WOMEN HOLD UP HALF THE SKY BUT HOLD UP SO MUCH MORE OF THE NHS

Our campaign shares the demand that the NHS be built back better after this pandemic. The pandemic must not be used as an example of best practice, nor an exemplar for the private sector as it is described in the White Paper The huge and expensive waste of money on Serco testing cost our people’s lives.

We salute the women who have worked to keep their communities fed and a deal saner than they would have been without the Mutual Aid. Providing food, school eqiupment, online support, phone calls and even passing chats whilst exercising has all helped. It has all knit our communities together and helped our mental and physical health

Even before the pandemic women’s life expectancy in good health was falling. Life expectancy in good health means how long a woman can expect to live in good health. Even though the government expects us to work until 68, but it is expected that by the age of  63.3 years on average women will no longer be in good health. “In 2017 to 2019, disability free life expectancy (DFLE) in the UK was 62.3 years for males and 61.0 years for females; there was a significant decrease of more than a year in DFLE since 2014 to 2016 for females, but no significant change was observed for males.” There are of course huge regional differences in this The wealthier you are the more likely to have an old age in good health. Austerity has taken a toll on women, and on the poorest people.

In the pandemic the infection rates of women and men seem to be similar, but women have lower death rate. Older people, women and men are more at risk. There are fewer older men than women so the death rate differences may reflect larger differences than at first appears. It is possible that estrogen may be protective factor. Underlying conditions have been used as an excuse for the deaths from Covid. Most women over 60 have underlying conditions and#s do many younger people.

We need to know how the pandemic has affected women, all women.

Many of our readers are users of Liverpool Women’s Hospital. The following two resources are worth using in pregnancy: https://your-healthy-pregnancy-tool.tommys.org/ and https://www.publichealth.hscni.net/publications/pregnancy-book-0. Also, this is the general advice from the NHS. Do not hesitate to ask for advice from your midwife during this pandemic, now more so than ever.

Advice on partners at the birth, now advises that partners be allowed at delivery and at key antenatal appointments.

You can find some information on pregnancy and the virus eight minutes into our meeting shown in this video

Fertility services have continued but have been limited by the pandemic. However, cuts and rationing had affected fertility services before the pandemic. That is another campaign we need to mount. Abortion services have continued with some disruption. The availability of medical abortion has been a usefule develpment in this pandemic. Please don’t hesitate to contact if you need help

Most pregnancies during the pandemic seem to have followed normal patterns. We could see no obvious problems (in a lay person’s reading) on Liverpool Women’s Hospital Board reports this month. We will continue to monitor this. The experience of birth has been more difficult especially for those women who were not allowed a partner at key appointments and the birth. Partners are now generally allowed. The latest research from Tommy’s found seven in ten pregnant women felt overwhelmed while pregnant, or during the early stages of motherhood, with 14 per cent saying they found it difficult throughout the duration. Stress does not help pregnancy and poorer women are the most vulnerable to stress. Worries about food, housing and heating are significant. The impact of stress in pregnancy can last for years.

The most recently published research from America indicates that Covid has been a risk for pregnant women.”Although data were initially unclear as to whether pregnant individuals are at increased risk of severe complications from COVID-19, a large study from the Centers for Disease Control and Prevention (CDC) provided data suggesting an increased risk. Among more than 450 000 symptomatic women of reproductive age with COVID-19 for whom pregnancy status was known, admission to an intensive care unit, invasive ventilation, extracorporeal membrane oxygenation, and death were all more likely among pregnant individuals than among nonpregnant women of reproductive age.3 Non-Hispanic Black individuals accounted for a disproportionate number of deaths. Symptoms in pregnant individuals (eg, cough, headache, muscle aches, and fever) were similar to those in nonpregnant women, although most symptoms were reported less often among pregnant individuals than nonpregnant women.3https://jamanetwork.com/journals/jama/fullarticle/2776447

Vaccine

The safety of the vaccines have not been specifically tested on preganat women but other vaccines have been shown to be safe, The general opinion appears to be that the risk of the disease is severe and best avoided, including possibly by using the vaccine. Please do check with your doctor

The Royal College of Obstetricians and Gynaecologists, the senior body on obstetrics posted these key points in March 2021

  • The latest advice from the Joint Committee on Vaccination and Immunisation (JCVI) is that COVID-19 vaccines should be considered for pregnant women when their risk of exposure to the virus is high and cannot be avoided, or if the woman has underlying conditions that place her at a very high risk of complications of COVID-19.
  • COVID-19 vaccines should only be considered for use in pregnancy when the potential benefits outweigh any potential risks for the woman and her baby.
  • Women should discuss the benefits and risks of having the vaccine with their healthcare professional and reach a joint decision based on individual circumstances. (our emphasis)
  • Breastfeeding women may be offered vaccination following consideration of their clinical need for immunisation against COVID-19.
  • Women trying to become pregnant do not need to avoid pregnancy after vaccination and there is no evidence to suggest that COVID-19 vaccines will affect fertility.
  • Having a COVID-19 vaccine will not remove the requirement for employers to carry out a risk assessment for pregnant employees, which should follow the rules set out in this government guidance.

Giving birth in the pandemic

Black and Asian women have worse outcomes in giving birth, even before the pandemic We don’t fully know the details of why, but as studies are published, we’ll share them. We have written about this before. Even with this awful discrepancy, the vast majority women, of every ethnicity, are safe. Some migrant women are subjected to high levels of charging for NHS services at 150% of cost. This has cost the lives of at least three women. We have long campaigned against any NHS charges.

“The MBRRACE-UK Confidential Enquiries into Maternal Deaths and Morbidity have highlighted before the disparities in outcomes for women from different ethnic minority groups. This year’s coronavirus pandemic has brought this disparity even more starkly to the fore, and we must not lose sight of the actions that are required to address systemic biases that impact on the care we provide for ethnic minority women…Pregnant women who are recent migrants, asylum seekers or refugees, or who have difficulty reading or speaking English, may not make full use of antenatal care services. This may be because of unfamiliarity with the health service, or because they find it hard to communicate with healthcare staff. Healthcare professionals should help support these women’s uptake of antenatal care services.”

Maternity Action reported in What price Motherhood.
Maternity care is undermined by charging, there will inevitably be poor health outcomes for mothers and babies. These are real people, not pawns in a game of political point scoring. It is difficult to see in the UK’s deliberately ‘hostile environment’ anything other than the inhumanity of bureaucracy flagged by Kafka. Charging guidance is deeply problematic, implementation is woeful and the research that informed these policies was flawed. Billing pregnant women at 150% of tariff cannot generate income from the destitute.

It is good to hear that the vast majority of pregnancies appear to have proceeded normally. However, during the pandemic some pregnant women did have virus issues.

Pregnant women who get ill with Covid. The NEJM reports that, internationally, ‘Although data on Covid-19–related risks to pregnant women and new-borns are limited, a recent study found that pregnant women with Covid-19 have 1.5 times the risk of being admitted to an intensive care unit (ICU) and 1.7 times the risk of requiring mechanical ventilation faced by non-pregnant women of childbearing age with Covid-19 but that pregnant women aren’t at increased risk for death.2Information on adverse pregnancy outcomes associated with Covid-19 is also limited. Intrauterine transmission of SARS-CoV-2 appears to occur rarely,3and no evidence has suggested an association between Covid-19 and birth defects; however, data suggest that preterm birth and admission to a neonatal ICU are common among infants born to SARS-CoV-2–infected women.’4

Women who must struggle to make ends meet are also at risk from the virus, from worse health and from problems in pregnancy.

Even without the pandemic post-natal mental illness has been a feature for some women. It has been estimated that, across the UK, up to 1 in 5 women develop some form of mental health problem during their pregnancy or in the year after birth. The majority (81%) of women who responded to this survey experienced at least one perinatal mental health condition during or after their pregnancy.‘ (RCOG2017). Suicide is a risk. Mental health has been badly damged by austerity cuts and privatisation The Government need to provide better mental health support for women in pregnancy and for the year afterwards

Health visitors were diverted from their roles as support for new mums art the start of the pandemic, and have struggled to be returned An increase in perinatal mental illness and poverty was reported by 81% of health visitors surveyed, while 45% had experienced more families struggling with issues related to substance abuse.. We must insist that health visters numbers are increased immediately.

Women are more likely to work in the most affected sectors and more women have been furloughed.

According to the Institute for Fiscal Studies, by May 2020, mothers were 1.5 times more likely than fathers to have either lost their job or quit since March, and were more likely to have been furloughed. The Fawcett Society also found 35% of working mothers have lost work or hours due to a lack of childcare support during the pandemic.The Fawcett Society found that half of employed women from minority ethnic groups and 43% of employed women from White ethnic groups are worried about job or promotion prospects due to the pandemic. This compared with 35% of employed White men. The data does not state if White minority ethnic groups are included in the 43%.

Mothers, especially those with young children have been particularly impacted by the pandemic. Women from black and minority ethnic group have been very badly affected. The full reasons for this have yet to be understood but we know that racism, poverty, housing and frontline jobs, issues childcare are all part of the equation. We are working to understand this and have discussed it in our meetings. This article, though grim reading, gives some explanation at least inthe London context.

The TUC reported that 70% of mothers who applied for furlough were rejected. 80% ot those people who applied for financial support for self isolation were rejected. People have to choose between having the money to eat or self isolation. Consequently it has been in the poorest areas where take up of testing has been lowest, and where the virus has persisted longest. Heartbreakingly infections have spread through families many of whom have lost multiple members inflrcting incredible pain on the surviving family members. Liverpool has worked hard to get the testing and the vaccine out to the communities. We were pleased to see a win for the campaign ( of which we were part) to make sure everyone living in the UK had access to the vaccine.No one is safe until we are all safe. Thankfully the government has offerred a vaccine amnesty to all. Please let us know if there are problems with this. We still camapign for everyone to access the NHS free of charge a free of fear of the Home Office and the Hostile environment.

The lockdowns have had a disproportionate effect on women’s workload, especially on women who are heads of households .Managing on lower pay whilst facing higher bills for heating and food and wifi for education has bee na real strain. Women in paid employment who are able to work from home are more likely to see an increase in unpaid care work due to school closures and often caring for older dependents. Compared with men, women perform on average 3 times as much unpaid care and domestic work even though this is rarely classed as work (International Labour Organization 2018). The pressure of supervising home schooling and directly teaching children of different ages has been difficult for many. The problems of having the necessary tech and even paper and pencils has caused stress. For some families it has been a lovely time, one children will always remember.

Poverty has been shown to be appalling in this wealthy country. Mothers, we know, face the worst wages in the country. Our child care is a disgrace. Individual providers do their best but we need a universal well funded national system of child care, and shorter hours of work so parents can spend time with their children in the precious years when they are young. The UK comes 27th out of 48 countires in how well our children are provided for. This in a very wealthy country. Good childcare easy to afford would make life better for children and parents.

It is also a scandal that so many children do not have enough good food..UN data showed at least 8.4 million people in the UK struggle to afford the food they need.Official statistics from March 2019 showed that the number of children in absolute poverty had risen to 3.7 million, up by 200,000 in 12 months. Government support for children fell dramatically once austerity began. Poverty affects children even during pregnancy and affects outcomes at birth. Low wages for mothers is a major factor.

As well as being responsible for the bulk of domestic duties women are also providing most of the Covid-19 care in hospitals. Approximately 77% of health care workers are women and they also make up the majority of health service work such as cleaning, laundry, catering and admin work, so are more likely to be exposed to the virus. The women who keep our  day to day life going, without whom all wheels stand still are often at greatest risk and lowest paid. According to a study by the think tank, Autonomy, and reported in The Guardian, there are about 3.2 million workers employed in the highest risk roles. Approximately 2.5 million are women and as many as one million of them will be among the lowest paid, many of them not entitled to statutory sick pay, putting them at greater risk as they choose between putting food on the table for their families or protecting their own health.

Mental health in the pandemic

The pandemic obviously increases the risk through stress and anxiety. The redeployment of health visitors away from new mums has not been helpful at all. We need more information on this. We would like to collaborate with those with experience of this and can share their insight.

The birth-rate has fallen in the pandemic, a situation seen at Liverpool Women’s Hospital and across the country.It is expected that the number of births in 2021 will fall further, for financial and social reasons.

Amanda Greavette

In the first quarter (Jan. to Mar.) of 2020, there were 152,521 live births, 153,464 in Quarter 2 (Apr to June) and 158,452 in Quarter 3 (July to Sept). Or on average, approximately 52,000 live births per month).

Women have been impacted by reduced service from other health services affected by the pandemic. Breast Cancer Now estimates that a total of 986,000 women across the UK missed their mammograms due to breast screening programmes being paused.

Men and women have different responses to the virus as the table below shows.

These two tables show cases of the virus and deaths from the virus by age and by sex.

Women are already suffering from poverty in the UK, whether from low pay, inadequate childcare, or from inadequate welfare payments, including the two-child limit on benefits.

We join the demand that support for people to isolate must be improved. We need much better sick pay for everyone. The virus can affect whole families because there is not room to isolate in small homes. We demand the kind of support made available in other countries. New York for example set up isolation hotelsThe aim of the isolation hotel program was to provide a safe and supportive environment for individuals who are homeless, living in crowded or congregate housing, or whose family and/or landlords did not want them to return home out of fear of potential exposure to COVID-19. https://www.liebertpub.com/doi/10.1089/HS.2020.0123

Domestic Violence

Lockdowns are putting women at higher risk of physical and sexual violence. The incidence of domestic violence in the UK has increased dramatically since the lockdown. Refuge, the UK’s largest domestic abuse charity, has reported a 700% increase in calls to its helpline in a single day (The Guardian). This at a time when the funding for women’s refuges has been drastically reduced. The Women’s Aid Annual Audit (28/01/20) showed that 64% of refuge referrals were declined last year. The number of bed spaces is now 30% below the number recommended by the Council of Europe. The key problems cited were all to do with inadequate funding. Only 5% of refuge vacancies listed last year could accommodate women with no recourse to public funds and less than a half had the capacity to accept women with more than two children.

Access to healthcare

Access to essential health services has decreased for the public during the pandemic. The consequences of reduced access to sexual and reproductive healthcare are particularly severe for some vulnerable women. The World Health Organisation has identified care during pregnancy and childbirth as a high priority essential service and all countries should prioritise to maintain this service (Geneva 2020). Women should have access to contraception, safe abortion and post abortion care to avoid unwanted pregnancies and sexually transmitted diseases.

https://www.who.int/teams/sexual-and-reproductive-health-and-research/areas-of-work/sexual-reproductive-health-and-rights-in-health-emergencies/covid-19

Sexual and reproductive health care should be the right of all women. Women who use drugs, are sex workers or who live in poverty are at particular risk of contracting Covid-19, as are asylum seekers living in overcrowded accommodation and immigrants of insecure status. Yet they may lack access to healthcare due to fear of discrimination, deportation or health care charges.

When a pandemic strikes women must be consulted about the response. There are five basic demands published by the Women in Global Health Security Summit.

  • Include women in global health security decision making structures and public discourse,
  • Provide health workers, most of whom are women, with safe and decent working conditions,
  • Recognize the value of women’s unpaid care work by including it in the formal labour market and redistributing unpaid family care equally,
  • adopt a gender-sensitive approach to health security data collection/analysis and response management and to
  • Adopt a gender-sensitive approach to health security data collection/analysis and response management

Marginalised and vulnerable women must be included in the response to the pandemic. Health care is a basic human right and should not depend on where you were born or the colour of your skin. We all deserve protection and to be treated with dignity. The cleaner needs PPE just as the doctor does.

Liverpool Women on the march in better times.

The impact has been on wealth as well as on health. The Parliamentary subcommittee reported that “Evidence shows that the economic impact has been experienced differentially by women – and in many respects, more severely. Women are more likely to have primary responsibility for childcare. They are more likely to work in the service sector, and to be in insecure or zero hours work. And more likely to be more dependent on social security, and in insecure housing. They are over-represented in jobs which are not eligible for statutory sick pay.

We also know that the gendered impact may vary by ethnic group and that in some BAME communities, it is men who are most likely to work in shut-down sectors. We must consider what needs to change in the short and long term as the country emerges from the pandemic.”

Poverty is a crime committed on our children by the Government and by the lie of Austerity.  Poverty kills children, and beyond childhood Fifteen years on Merseyrail takes fifteen years off your life”For half the people who have COPD, the condition is a reflection of childhood poverty.More than two in three children in some areas of the city of Liverpool are in poverty. Meanwhile the rich get quantitative easing with no means test, no demeaning questions about their sexual partners, no sanctions. The rich get huge amounts of money because the government says it will help the economy. We say putting food in kid’s bellies is much more important.

The Child Poverty Action Group reported before the pandemic “Even families with two parents currently working full time on the ‘national living wage’ are 11% (£49 per week) short of the income the public defines as an acceptable, no-frills living standard.

For lone parents, even a reasonably paid job (on median earnings) will leave them 15% (£56 per week) short of an adequate income because of the high cost of childcare. A lone parent working full-time on the ‘national living wage’ will be 20% (£74 per week) short of what they need to achieve a minimum standard of living.

Professor Ian Sinha, from Liverpool University and Alder Hey Hospital reported that “poverty hits children the hardest. Getting a job is not a solution. Most children in poverty have at least one working parent”.

During childhood, we are especially vulnerable to the main determinants of health: living conditions, family income, employment, education, access to health services. The pandemic can be conceived as an additional systemic shock to these determinants. In the shorter term, with the focus squarely on adults with covid-19, child health and social care services are being side lined. These include acute services for life threatening illnesses, outpatient services for chronic conditions, child protection services guarding against abuse and neglect, and preventive services that support early years development, routine checks, and immunisations. Global modelling predicts a stark increase in child mortality as a result of diversion of care.6 As soon and as seamlessly as possible, we must restore these services to full, and greater, capacity.5

Infants in more deprived areas are most likely to die. Listen to Ian Sinha here.

We must campaign to end child poverty and to improve the pay of mothers. Excellent family Allowances paid to the mother would really help.Wonderful people run food banks. However, the food available from food banks is not always nutritionally adequate. The pandemic is hitting children. Many children do not have access to food, let alone good, tasty food.   

Pregnant women have been shown little respect by many employers in this pandemic. Maternity Action and Pregnant then screwed have reported in detail. At our “Let’s Get Rid of the Virus” meeting Roz from maternity action said how difficult it is to enforce our rights at work. Women in trade unions fared much better. because they were not alone in making requests . However the scale of responses to petitions aboout maternity leave has been such that parliament( as opposed to the government0 have had to respond

Women have joined trade unions and become more active in trade unions during the pandemic.TUC general secretary Frances O’Grady said: “…. figures show that union membership was growing before the coronavirus crisis hit. And we know that in the last few months, thousands of workers have been turning to unions to protect their jobs, defend their rights and keep their workplaces safe”

Young women are in the eye of the storm

The Young Woman’s Trust reports that

  • an estimated 750,000 young women have had to go to work despite fears for their safety and protection against the virus.
  • half of young women who are parents (51%) said they were unable to apply for or left a job because they could not cover childcare costs, up from a third of young women when the same question was asked last year
  • a significant number of young women across England and Wales (43%) reported they had been offered a zero-hour contract (compared to 35% of young men) and
  • over half of young women (57%) said they were worried about their mental health up from 51% last year. [2]
  • Almost a quarter of young women with children said they had been discriminated against because of being pregnant, on maternity leave or returning to work after maternity leave (23%).

LGBT issues

A section of older lesbians and transwomen, who never married, socialise outside the home. This has been shut off during lockdown. Some have limited family support because of prejudice.  Some younger LGBT people are stuck at home, sometimes with less than supportive families. The pro-tem closures of fertility services impact the LGBT community too, as they tend to be older approaching services for help in conception. Many more issues are discussed here.

Disabled people Among women, the risk of death involving coronavirus was 3.5 times greater for more-disabled women – defined as having their day-to-day activities “limited a lot” by their health – compared with non-disabled women.For less-disabled women, defined as having their day-to-day activities “limited a little”, the risk was two times greater.

Disabled people are 3 to 4 times more likely to die of Corona Virus.  Disabled people account for 6 out of 10 deaths in the UK in 2020.Laws protecting disabled people were put at risk by Corona Virus legislation. 20% of men and 23% of women are disabled. The women’s budget group report that “Disabled Lone mothers lose out the most from tax and benefit changes since 2010; by 2021 they will lose 21% of their net income if they do not have a disabled child and 32 % if they do. A third of this loss is due to shift to UC.” During the pandemic disabled people have had services stripped away, services essential to their normal day to day lives. The pandemic has further disabled people. Similarly with disabled children. Pandemic legislation allowed these reduction of services. They must be restored

COVID-19 death rates of people with learning disabilities have been between four and six times higher than for the general population.” The government reported that  451 per 100,000 people registered as having a learning disability died with COVID-19 between 21 March and 5 June, a death rate 4.1 times higher than the general population after adjusting for other factors such as age and sex.

But as not all deaths in people with learning difficulties are registered on these databases, researchers estimated the real rate may have been as high as 692 per 100,000, 6.3 times higher.

Deaths were also spread much more widely across the age spectrum among people with learning disabilities, with far greater mortality rates in younger adults, compared to the general population. The death rate for people aged 18 to 34 with learning disabilities was 30 times higher than the rate in the same age group without disabilities, researchers found.

People who need social care 1.4 million people who need social care do not have access to it even before the pandemic. “Social care has been a victim of unprecedented cuts to public services since 2010, which have seen local authorities reduce their spending on social care for older people in real terms by 17% despite rising demand“.

Women are having to work late into their 60s thanks to the pensions heist at the start of Austerity. Retiring at 68 women can expect limited years of good health, men even less. Forcing older people into work in this pandemic is cruel in the extreme.

The Independent reported in July 2019 that “Women’s pensions £100,000 less than men’s due to gender pay gap and childcare commitments.1.2 million women approaching retirement age have no savings at all.

Just this week the government announced that many women had been under paid their pensions. other women working till 68to get a pension have been hard hit by the sheer weight of the manual work they have had to under take during the pandemic. We support reducingthe pension age for women down to 60 once again. The WASI women are correct. We would be quite happy for that to be available to men too.

Older women, after retirement ,provide a great deal of unpaid care within the family and community. Many organisations would be lost without them. Many care both for their elders and their grandchildren. The pandemic means that they have not been able to do this work, a loss for the community and to themselves as they have been much more shut in by the pandemic. Older women, especially grandparents, provide a great deal of childcare. Eighty percent of grandparents have provided childcare and many support the families financially as well. Grandparents very much value the chance to spend time with their grandchildren. The pandemic has broken many of these precious close family relationships. Hopefully, they will be rebuilt.

Older women have featured in care homes during the pandemic, others suffered by being cut off from family in the care homes, by being alone for exceptionally long periods and being cut off from family friends, cut off from their grandchildren and from the community, and from being out having fun with their friends, cut off from live music theatre, the cinema and more.

We will continue to look at how the pandemic affects women. Please send us any information or experiences you have.

Getting rid of the virus (meeting number 2)

At our second meeting in the series Getting Rid of the Virus we heard from Dr Fyaz Ismail, a scientist working at a local university, Karen, a nurse from Nurses United, Greg Dropkin from Keep Our NHS Public on the local figures for virus present, Peter Glover, a teacher and NEU Executive member, and Janet Newsham from Hazards Campaign and Sarah Morton from the PCS union. Sarah is a councillor for Clubmoor and works to support mutual aid in the neighbourhoods.

Public meeting on March 3rd 2021

 Fyaz started the discussion on the virus, how it works and why we have a Covid Vaccine when we still do not have a Malaria one. Fyaz gave a detailed explanation and encouraged people to have the vaccine.

It will take all of us to drive down and eliminate the virus, but the Government must act too, in increased support for people to isolate if they have symptoms, or live with someone who has tested positive. They must improve the track and trace, and open free hotel rooms up for self-isolating. Test Track and trace must come back into local public health and the council. Serco are not doing well at all.

The schools need better ventilation, smaller classes, extra classrooms, extra teachers, outdoor teaching, time for the children to play and to talk, and facilities to work ay home if needs be. Proper internet kit for all the children. The children need good food too to build their health and strength

If you would like a similar meeting in your community or area please do get in touch

Getting Rid of the Virus Public Meeting

Our speakers were

Dr Jess Potter: a respiratory consultant and clinical lead for tuberculosis at a busy district general hospital in London. Jess works with EveryDoctor – an organisation which campaigns for the working rights of doctors. Jess also campaigns for healthcare rights of migrants with Docs Not Cops and Medact.

Rebecca Smyth: Rebecca is a member of SLWH and SHA and works as a Senior Lecturer in Midwifery at The University of Manchester. As part of her work Rebecca has collaborated with the World Health Organization in producing international clinical guidelines and is an active member of ALLOUT (LGBT Staff network group)

Maternity Action: Ross Bragg works for Maternity Action, the UK’s leading charity committed to ending inequality and improving the health and wellbeing of pregnant women, partners and young children – from conception through to the child’s early years.

Dr  Hassan Burhan: Dr Hassan Burhan is a Respiratory Consultant at the Royal and have been treating patients with Covid since March last year. He is the North West Coast Clinical Research Network Co-Lead for Respiratory Medicine and is involved in Research to look for new treatments at Liverpool University Hospitals NHS Trust. Dr Hassan also has an honorary LSTM contract and was part of the management committee of the Oxford Astra Zeneca Vaccine Study at LSTM.

Part 2:

Comfort Etim:

Comfort is an Advocacy and Policy Officer at Refugee Women Connect, a Liverpool-based, women-only charity set up to support women asylum-seekers, refugees and survivors of trafficking. Refugee Women Connect works together to build a safe life in the UK for all women in the asylum seeker and refugee community.

Philomène Uwamaliya:

Since 2011, Philomène has been working as a Senior Lecturer at the Liverpool John Moores University in the school of Nursing and Allied Health. As a refugee herself, Philomène is highly committed to ensuring that support services and commissioners provide the appropriate care to asylum seekers.

Our next meeting, the second one in the series “Getting Rid of the Virus” is on March 3rd will look at getting the science working in the workplaces and for the workforce, with speaker from nurses’ organisations, teachers, and those working in the community. We want to look at why our communities are suffering so badly and what we can do to make them safer. The rich can live with the virus but it will kill our people.

We want to be rid of this virus, not to tolerate it and accept a certain level of ongoing deaths and disability. It is difficult indeed but possible to be rid of this virus.

We want every human to be able access NHS care in this country. Listen to Comfort Etim speaking of the damage charging and exclusions from care are causing in Liverpool.

We support Vaccines for all . Over 230 organisations have signed up to the call on the Department of Health and Social Care to ensure that everyone can access the coronavirus vaccine, regardless of immigration status, ID or proof of address.

The lockdown is horrible but is driving down the number of cases and number of deaths, but how bad would it be to face another surge, still more heartbreak, grief and suffering because basic public health procedures are ignored by the government?

We know most people are doing their absolute best to suppress the virus, if they can, and the scientists have worked wonders. We are forever in debt to the health care and social care workers. Sadly we depend too on the Government to put decent policies in place and that has been sadly lacking, especially on Track Trace Isolate and Support.. Individual effort has not, and cannot keep us safe.

We want Vaccines and excellent, efficient, local publicly run Find, Test, Trace, Isolate and Support systems where people who need support financially to isolate get it, unlike the current situation., where people cannot afford to stay home from work if they have symptoms because they would have no money at all, and maybe lose their jobs.(Being in a union has saved many jobs in this poandemic)

We want safer schools with real investment in buildings safety, ventilation and staff, smaller safer class sizes. We want fully equipped elder care; we want women to be safe at work especially in pregnancy. No one is safe until we all are safe. We want our children to have ample good quality food and shelter. We want employers forced to make their workplaces safe. All of this is quite affordable and would make the country wealthier and safer.

Changes are being made to the NHS, without publicity.

Our camapign has been working to understand and publicise changes that are happening in the NHS. This started out as a powerpoint used in meetings but grew as we learned more.

Cheshire and Merseyside NHS funding and many decisions have been moved to the Cheshire and Merseyside STP. There are instructions to merge the CCGs, and all 4 Cheshire CCGs have indeed merged. Merseyside’s CCGs have been told to merge with them. Ahead of this merger many decisions are now being made, without democratic oversight at this system level. It is hard enough to monitor what is happening at Liverpool CCG without trying to monitor a meeting covering all of Merseyside and Cheshire.  There have been articles in the press talking about setting a statutory framework for this move which means that right now they have no statutory footing, no basis in law.  However, it is through this “system” that funding is channelled to our hospitals, and decisions normally made by CCGs must fit into this framework.

 Our campaign first became acquainted with the Merseyside and Cheshire STP because it runs the big maternity vanguard for this area. We have our concerns about the level of resources given to maternity but that is covered in other blog posts

 The NHS faces a difficult winter with the pandemic not controlled, the vaccine in its infancy, tired and overworked staff and uncertain supply of key equipment. The pandemic should be the focus of attention, but instead fundamental changes are underway.  We believe these changes threaten the Bevan model of universal treatment free at the point of need. Big companies are making a fortune from the pandemic funding, funding that should have gone to the NHS.

 One of our aims, together with other campaigns and trade unions is to gather a conference of those who wish to defend the NHS across Merseyside and Cheshire. Please get in touch if you can help or would like to help in any way. The NHS will last whilst there are people prepared to fight for it. We are, are you?

If any group wants the power point, with or without commentary, we can let you have it but its too big to share by email. Contact us and we will find a way. Or one of our camapign will present it on a zoom meeting for you and answer questions and gather your information.

Please do feed back to us with your experience, your knowledge. Meanwhile Defend the NHS now more than ever