The Background Case: Save Liverpool Women’s Hospital

Our campaign to Save Liverpool Women’s Hospital has a petition with over 60 thousand signatures, more than 40 thousand on line have more than 20,000 signatures on our paper petition. We presented a copy of this paper petition to the last  ICB meeting. We are still collecting more signatures.

We have been campaigning for a fully funded, fully staffed Liverpool Women’s hospital on the Crown Street site, campaigning for maternity rights, and women’s and babies’  health for many years.

The Liverpool Women’s Hospital website tells us “Each year we deliver over 7,500 babies, carry out over 49,000 gynaecological inpatient and outpatient procedures, care for over 1,000 poorly & preterm newborns, perform around 1,000 IVF cycles and have over 4,000 genetic appointments taking place. We believe that this along with a strong dedication to research & innovation makes us the specialist health provider of choice in Europe for women, babies and families.

Liverpool Women’s Hospital building on Crown Street was opened in 1995. It is a low-rise building on a garden site. A twenty-million-pound neonatal unit was recently added. Our fight to save and improve this hospital goes on.

There have been plans to move or close Liverpool Women’s hospital for several years. There was talk that there were too many hospitals in Liverpool and one had to go. This was s reported on the BBC panorama programme and quoted widely in the local press. We wrote about this in a previous post.

The Pandemic and the chaos around the building of the new Royal Hospital held up the plans for a few years. Then last year a company called Carnall Farrar were commissioned to write a report on the issues around Liverpool Women’s Hospital, referring back to the original plans. We wrote to Carnall Farrar asking to be included in their consultations but they wrote back declining to do so.

We intend to put out our case to Save Liverpool Women’s Hospital in detail in future blog posts but it is important that the background to the issue is clear and in the open.

The discussions about the future of the Liverpool Women’s Hospital take place against the background of the greatest crisis yet in healthcare in  England. We have a severe shortage of staff, a shortage of hospital beds, declining health especially amongst those less well off, huge waiting lists, the lasting impact of the pandemic and an inadequate social care system. We urgently need to recruit and retain more midwives so women’s experience of giving birth begins to improve. The Royal College of Midwives last year said there were 2,600 midwife vacancies and that is against the present staffing level a level which we feel is itself inadequate.

Staff and supporters on the picket line for better pay and working conditions in 2023

Healthcare goes on in the NHS day after day, babies are born, many people get treatment. Seven million people though are on the waiting lists. Health is deteriorating partly from poverty, and the pandemic, but also from lack of appointments and procedures from the NHS. Pioneering work on endometriosis is provided at Liverpool Women’s Hospital. But the whole health service is in trouble. The NHS is like a huge ocean liner leaking and listing lacking essential maintenance and investment and the staff are jumping ship. Nurses are on the picket line not just for pay but because of the state of the service. Staff leave not because they hate the job but because they cannot do it properly. The NHS system is underfunded and some of the money we do have is wasted on the market system. Extra funding is much needed but it must not be diverted into the for-profit sector. The market system introduced in the last 20 years has caused severe damage. The NHS needs more funds but above all to revert to a fully public service model of health care. so the money goes to healthcare not to profit. The NHS can be fixed but not if it is also expected to make profit for healthcare corporations,

There is also a shortage of money to build new hospitals and repair existing ones. It has been made very clear that there is no money to rebuild Liverpool Women’s Hospital, it is not even on the mythical 40 Boris hospitals list.

The Health and Care Act 2022 set up 42 Integrated Care Boards to run health care in England. We objected to this model from the start, modelled as it is on the US Accountable Care System. The Act was passed and is now being implemented. Our local ICB is the Cheshire and Merseyside ICB

The  Carnell Farrar report to the Cheshire and Merseyside ICB makes suggestions which recommend putting women’s services into a big acute hospital (and that means the Royal.) It does not discuss where the babies should go.  We will go into much greater detail on this report in future posts.

The Carnall Farrar Report makes it clear why the report matters not just to Liverpool but to the whole of Cheshire and Merseyside.  The government, we are told in the report, intends the ICB in Cheshire and Merseyside to cut £350 million!

The Cheshire & Merseyside ICS allocation per head to NHS organisations remains higher than all other core cities with the overall allocation due to decrease by c.£300 million over the coming years. Alongside this the new Specialised Commissioning allocation will mean that Cheshire and Merseyside will be allocated £50 million less income from specialised commissioning. Local government in Liverpool and across Cheshire and Merseyside has also seen one of the largest decreases in real terms spending power since 2010 with a decrease of £700 per head of the population”.

Liverpool has the greatest extent of deprivation in England as measured by the Index of Multiple Deprivation (IMD), with two in three people living in deprivation, and eight in every hundred people living 4th in the most deprived one percent of the country. With respect to income, Liverpool is the most deprived5thlocal authority, and the most deprived with respect to employment and living environment.

Much of this morbidity and mortality is avoidable and despite significant improvement over the last 20 years, the rate of avoidable mortality in Liverpool has remained consistently 50% above the national rate.

This represents an additional 740 people dying every year in Liverpool with the leading causes of these deaths being cancer, cardiovascular disease, and respiratory disease.” Our emphasis

This background to the discussions around Liverpool Women’s Hospital is important.  We are not discussing how best to spend an abundance of funding. We have had a decade of underfunding, privatisation, understaffing, and problems with staff retention and pay. Nationally we have a record of declining health for women. The government itself issued a report on this. Maternal deaths nationally are also a problem, as are the deaths of babies at birth. Women’s experience of giving birth is deteriorating; the experience of “being with women” giving birth is also getting worse for midwives. Moving the hospital solves none of this.

Austerity policies helped cause this decline in women’s health. These problems happened during major reorganisations of the NHS, all focussing on bringing in a market-based model, with many different kinds of privatisation.

The various kinds of privatisation are:

  • Outsourcing
  • Commissioning
  • Paying financial consultants and companies like Carnall Farrar  whose report cost £130,000, (enough to pay for a midwife for  at least two years)
  • The HSSF arrangements are where certain companies are listed to be given NHS contracts.
  • The agency staff companies
  • Giving our data to the likes of data giant Palantir
  • The use of the US model, the “Integrated Care System” is designed to restrict treatment and make money for the big health corporations. This we believe was at the heart of the Health and Care Act 2022
  •  Giving money to private hospitals to do NHS operations, and sometimes giving them money even if they did not do operations for the NHS
  •  Giving money to Spec Savers to provide eye checks and hearing checks.
  •  Developing waiting lists that create a market for private medicine.

We need a public service model, not a market-based one. The US market-based model of health care has poor health outcomes, especially for working-class people and most especially for women. Thirty million people in the United States have no healthcare cover. The US system does however make a ton of profit for their big health corporations many of whom are now involved in the NHS. Prime Minister Sunak recently held talks with these companies and such companies are embedded into NHS planning. Simon Stevens who used to head up the NHS previously worked for the United Health Group. Wikipeadia says “UnitedHealth Group is the world’s seventh largest company by revenue and the largest healthcare company by revenue, and the largest insurance company by net premiums” 

We need that money currently diverted to the private sector resources back into a fully funded NHS. We need to plug that drain.

The Maternity Crisis This does not get due consideration in the report

Nationally and locally the NHS needs many more midwives and midwives’ conditions of work need to improve Please see our other blog posts on this. We have report after report saying maternity must improve, we have reports saying gynaecology has the longest waiting lists, and reports about how women’s life expectancy and life expectancy in good health are deteriorating, especially for poorer and for black women.  This is national, not just local. Having a stand-alone hospital has not caused these chronic problems.

Specialist Hospitals Liverpool has several specialist hospitals. The specialist organisations within the scope of this review were:

•        Alder Hey Children’s NHS Foundation Trust

•        Clatterbridge Cancer Centre NHS Foundation Trust

•        Liverpool Heart and Chest NHS Foundation Trust

•       The Walton Centre NHS Foundation Trust

Specialist hospitals are funded directly from the national centre unlike the acute general hospitals and take their patients from a wide area. Liverpool Women’s Hospital has about one-third of its funding as a specialist hospital as it takes referrals from a wide area, as does Alder Hey Hospital. The specialist hospitals are not yet within the control of the integrated care board and might not be for another year.

What does Carnell Farrar say about Liverpool Women’s Hospital?

In their statement to stakeholders, Carnall Farrar says their priorities are.

1) Solving the clinical sustainability challenges affecting women’s health in Liverpool.

2) Improving outcomes and access to emergency care, making optimal use of existing co-adjacencies at the Aintree, Broadgreen and Royal Liverpool Hospital sites.

3) Significant opportunities to achieve economies of scale in corporate services.

Why is Liverpool Women’s a priority given all the other issues facing the NHS?  We can see no grounds to believe that closing moving or dispersing Liverpool Women’s Hospital would be an improvement for women’s health. To do so in this climate of cuts shortages waiting lists and staff shortages would make things much worse.

The Liverpool Women’s Hospital does need some further improvements (as do other hospitals) including a better blood bank. It needs some more diagnostics systems, it needs more staff and close cooperation with other hospitals, as do the other specialist hospitals.

We will write further about  the ongoing fight to save Liverpool Women’s Hospital and the NHS and NHS staff pay in other posts

Our campaign will continue to fight for the NHS, for women’s health and for each and every baby. Please support us in this.

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