Officially there is no preferred case for the future of the Liverpool Women’s Hospital.
However a preferred solution is being spoken about. This is merging (or in some other way being associated and co-located) with an acute trust, probably the Royal Liverpool Hospital. These proposals, we are told, are nothing to do with money, entirely separate from the huge crisis of the NHS.
Liverpool Women’s hospital has a financial problem. So have most other hospitals. The trusts with least financial problems are in mental health and we all can see the impact of such money savings in the appalling situation for mental health provision.
Liverpool Women’s Hospital has a financial problem based on the national scandal of a totally inadequate maternity tariff. The government does not pay hospitals enough to employ sufficient midwives. There are specific recommendations for safety and the tarrif does not allow this to be met. Nationally Maternity is under funded, under staffed and under resourced. Maternity units are being closed across the country.
Maternity is the most common reason for admission to hospital and there is a determination from Government to reduce this. In other sections of the blog we have discussed why we do not agree with the Maternity Review. These are serious objections and we will come back to them in another post.
All the NHS is at risk from shortage of money, from ideologically, and profit driven privatisation and from attempts to blame the population for being old, fat and otherwise at fault. The number of hospital beds in the UK does not match other advanced countries yet the idea of cutting bed numbers is still being touted.The idea of closing one hospital in Liverpool was floated back in 2015.
Liverpool Women’s Hospital is the last Women’s Hospital in the country (Birmingham Women’s hospital seems to have become part of the nearby acute hospital). We have made a more detailed case for a women’s hospital elsewhere in this blog. We are not men. Our needs are distinct and worthy of full support.
In April 2015 the case against the hospital emphasised the financial problems. It was said that by joining another larger hospital the deficit caused by the maternity tariff could be subsidised by another hospital. The NHS funding crisis now means that no hospital in the Merseyside area can subsidise the maternity tarrif.
There is a major move in the NHS towards specialist hospitals rather than general hospitals. A general hospital treats all conditions. Specialist hospitals concentrate on particular conditions. Broadgreen is the Heart and Chest specialism, the Walton centre is a major neurology hospital, the Royal and Fazackerley do major trauma. Specialist hospitals deal with patients from quite a wide area. Patients are moved between hospitals for different treatments. Movement of patients between hospitals is part and parcel of the move towards specialism. Acute trusts, just to be confusing, operate major specialisms.
“NHS hospital trusts in Merseyside
- General acute trusts: Aintree University Hospital; Arrowe Park Hospital; The Royal Liverpool and Broadgreen University Hospitals; Southport and Ormskirk Hospital; and St Helens Hospital
- Specialist trusts: Alder Hey Children’s Hospital; The Clatterbridge Cancer Centre; Liverpool Heart and Chest Hospital; Liverpool Women’s Hospital; and The Walton Centre”
The case for change has portrayed moving some very sick women from the LWH to other hospitals for different treatment as something to fear. Roger Phillips described it as dangerous. Yet where ever patients are moved to, they might need moving to another hospital. Angela Eagle MP queried Roger Phillips comments with the LWH. Both to Angela Eagle, and to other complainants, the idea of the hospital being dangerous was rebutted. It is not dangerous.
We were told of a great problem of the lack of a level 3 Intensive care unit. When Freedom of Information unpicked this, the numbers involved are low. At first the Hospital said two women were involved. Later versions said it was five,in a year. As we know more, we will publish this.
Unpicking this scaremongering, typified by Roger Phillips comments, lead to focussing on the need for the hospital to be nearer other specialisms, situated at different hospitals.
We are told of the need of the hospital to be associated with an acute hospital, yet any acute hospital it associated with would still have the maternity tariff issues, and would still have to move women between hospitals.
The emphasis has been on the “risks” to women of moving to a hospital a mile down the road. The empahasis in on the small minority of women with unusual and serious conditions.
The issues around maternity provision.
There is much to be improved in maternity care in the UK. Yet Liverpool Women’s Hospital is one of the very best maternity centres, despite the huge poverty of the city.
Merseyside and Cheshire are a vanguard area for the maternity review. Private providers have been commissioned in this area. Home births are the preferred option for developing private providers. Private providers don’t do the huge investment required to build expensive hospitals.
Private providers use a model of care called case load maternity. It has not worked well. If enough money were available case load maternity would be a good idea for NHS maternity services. Home births on the cheap are not a good idea.
More than half of women giving birth to their first child at home have to be transferred to hospital and for lower but still large numbers of second and subsequent babies. Having a baby at home is great but it is not a cheap option. We still need obstetric services within easy reach. A baby in difficulty at birth has a finite time to reach the hospital. We are told it’s ok for a women in Speke to have to be taken by ambulance to the centre of Liverpool, despite the crucial time constraints for the baby, yet it is dangerous for a woman, fully supported by the hospital staff, to move one mile?
In the “engagement” meetings recently, the needs of the more than 8,000 women per year giving birth in Europe’s largest maternity hospital were given very little mention; we were to focus on the exceptional cases.
Moving the birth of 8000 babies to the very centre of Liverpool traffic is a risk to their health, as covered in another post.
In recent statements about Sustainability and Transformation Plans, it was stated that there would be no capital monies available. Each of the new builds in the area have been built on PFI which is the equivalent of a mortgage to be paid addition to all other expenses.
It is also clear, that for the USA model to be imported here, large groups of hospitals must be created. Each of the informed campaign groups warn of this. How in this context could the need to provide a safe and respectful place for women and babies be protected?
Liverpool Women’s Hospital on another site would still have the maternity tariff and shortages of midwives to worry about, still have the overall NHS financial issues to worry about, still have privatisers snapping at its heels, still have the problems of the maternity review. These make a veritable mountain of difficulties
Still more important is the danger that the focus on the needs of women and babies would be subsumed in other dangers.
Save Liverpool Women’s Hopsital for all our mothers, sisters, daughters, friends, lovers and of course for the babies.