Author: Mary

Encouraging and collating discussion about workers' struggles and struggles for socialism locally, nationally and internationally

Keep spreading the word

Speak out for the NHS. The NHS matters in this election and after it.

Don’t leave it to the politicians.

The NHS came from the people and the people must organise to get it back!

Restore and Repair the NHS.

 Cheshire and Merseyside NHS campaigners are taking a campaign van around the area to remind people of the need to Restore and Repair the NHS.Politicians should heed the needs of the people before the needs of the banks

This article gives information gives more information than the leaflet we are giving out

We say to any government, you must repair the damage of the last two decades, and rebuild the service after years of cuts. The capacity of the NHS to provide adequate timely treatment was cut as the population aged. But it made big money for the very rich. We want the NHS back for the people, not for profit.

Join our campaigns until the politicians restore and repair the NHS.

The Royal College of Nurses has declared a national emergency in the NHS.

Doctors are warning of large numbers of avoidable deaths from NHS shortages.

Doctors say the pressure on the NHS is unsustainable.

The NHS is very important in this election and the next government must restore and repair the NHS.

Please join the campaign to Restore the NHS.

Our health, our life span and our very lives depend on the NHS and on public health services

Life expectancy in Cheshire and Merseyside is lower than the national average for men and women. Access to health care is crucial in this. Will you willingly give up years of your life, and the lives of those dear to you, to fund privatisation and poor healthcare?

The NHS is underfunded. Our local Integrated Care Board said in May 2024 that “provider financial plans exceed the level of funding available” Providers are hospitals. The hospitals have huge waiting lists and dreadful A&E waiting times. They need the money. Maternity desperately needs funding.

The damage to the NHS has been deliberate. Privatisation, underfunding, deskilling staff, closure of hospitals and beds, organisational “reforms” using expensive financial consultants, PFI, and poor building maintenance; it all adds up to Government policy and it has been lethal.

 Privatisation involves public money being paid to private companies to provide a service and allows the private company to make a profit and to deny care to some patients. That profit is money that could go to the public service. They are not more competent nor more efficient. £10 million pounds a week goes to private profit according to We Own It. The ICS structure is based around “commissioning services” pushing ever more of the NHS budget into  the private sector.

The NHS is headed by a banker, not a doctor, and a banker with a history. The NHS has been deliberately underfunded.

We say, go back to the full NHS model!

Mend the NHS in its many services –

Maternity

Fund and staff maternity services to equal the best in Europe. We need more midwives. Can we say that again? We need more midwives. Did they hear that? Say it again WE NEED MORE MIDWIVES. There have been so many reports on the state of maternity services, we need action now. Women and their families are angry about what’s happening in maternity.

Children’s Health

The health of our children is worsening. Ensure every child has timely access to full healthcare, at birth, in the community, at the GP surgery, at Accident and Emergency, and in planned care in the hospital. Bring back health visitors.

GPs

The GP service must be restored and be staffed by qualified doctors. The government must allow spending on doctors as well as ancillary services. A good GP puts years on your life. GP services have been cut with overall funding cuts of 20% per patient per year since 2016.

Mental Health Care

Mental health services must be renationalised and brought back into the NHS and staff trained and paid to NHS standards. The damage is disgusting.

Dental Health Services

Everyone has (or did have) teeth. Our dental health services must be made available to everyone. The damage is immense. Change the contracts to ensure this. Bring back NHS dentistry.

Hearing Services

Audiology must be brought back in-house to make sure everyone has access and no one has to pay privatised prices. Hearing aids are free on the NHS if you insist on using the NHS. These hearing aids are just as good as the ones  for which people pay hundreds

 Ophthalmology

Eye health services must be brought back into the NHS to ensure quality of service, and access for all and to prevent unnecessary treatments that make profit. When so much of the service is farmed out to for-profit companies  and the NHS just does the most complex the whole training system fails

A&E

Accident and Emergency Services. Waiting for hours in A&E is an awful experience as is being treated in a corridor. According to new estimates, long waits in A&E departments may have caused around 30,000 ‘excess deaths’ last year. The stress on staff is also unbearable. We say No more winter crisis. Employ the staff, provide the buildings, and open more hospital beds.

Healthcare for all, free at the point of need. End the policy of charging for some services, reduce prescription costs, and stop discrimination against migrants, who pay twice for the NHS and are charged at 150% of costs yet pay all the same taxes as everyone else.

Our data

The NHS as a national service for over 75 years is gold dust as far as big data companies, health insurance companies and the US health corporations are concerned, the information about our health care, our symptoms and treatment must return to being confidential. Palantir has been given a huge sum of money to manage our data. Kick out the big US data firms and the other private firms who are getting rich off of our data.

Staffing

All vacancies in the NHS must be funded and recruitment processes must be positive and wide-reaching, including winning back many nurses and midwives who have left. Say no to two-year trained staff, no to the use of Physician Associates except in situations where they are in real-time supervision. Workforce planning must be based on training and employing more qualified doctors and nurses to meet the needs of the people. Student debt in medical nursing midwifery and allied professions must be abolished, and bursaries re-introduced so ordinary people can afford to train.

Pay the NHS and social care staff well. This will help keep staff and reduce their stress.

 Social care

Social care covers services to the frail elderly and to disabled people people of all ages both at home and in care homes. Councils are starved of funds and stupidly went along with the policy of privatising their own care homes. Now care homes are privately run,  by for-profit companies and do not provide a universal service but a service where and when they can make big profits. Most are privately owned by big companies and hedge funds. This is more public money going to shareholders. Neither are care services free at the point of need but charge large fees to users who do not qualify for NHS funding or Local Authority funding.  Children’s social care is in a shockingly bad state and adult social care needs radical reform. If you are interested in this area see the End Social Care Disgrace campaign

The private sector. This is no solution to the healthcare crisis. They don’t have the full range of treatments or facilities and are dependent on the NHS for backup. Most doctors who work in the private sector also work in the NHS. The NHS has103,277 general and acute beds  while the private sector has about 11000

We all need healthcare. The need for the NHS is crystal clear. All the parties say sweet words about protecting the NHS, but we have to hold them to these promises. (bar one- Reform wants to bring in an Insurance/market-based system)

The NHS is the most cost-effective structure and the most equitable system for healthcare.

Give the NHS an immediate boost to its funding.

Renationalise the NHS. Make it once again a national service. Stop privatisation.

A healthy population is obviously more effective than one with millions of people waiting for treatment. Millions of people denied treatment or kept waiting for years is morally unacceptable and bad economics.

Run the NHS for healthcare, not for profit. Sack the privatisers!

Make our health care a national service again.

Healthcare free at the point of need for every human, as it was in 1947.

While this campaign would be pleased to see the government that has done such lethal damage to our people’s healthcare kicked out on their ear, neither main party has committed in its manifesto enough money to tackle the dreadful state of the NHS.

The incoming government must fund the NHS to prevent the next still worse winter crisis. It must address the issues around maternity, GPs, dentists and NHS pay, or the people will be very angry, just as the current government is blamed. It took many years to win the NHS and might take years to win it back but the campaign will go on if you give it your support

The campaign to restore and repair the NHS must go on !

Make a mark for maternity in the general election.
https://amandagreavette.com/birth-project-gallery/#masonry

Save Liverpool Women’s Hospital, the national maternity service, and women’s and babies’ healthcare. While we fight for Liverpool Women’s Hospital, we fight also for the whole NHS.

“As we go marching, marching
We battle too for men
For they are women’s children
And we mother them again.”

Together ordinary women and men can make a difference, and can put huge pressure on the government to improve our services and maintain that improvement. We cannot leave it to election promises, especially as neither main party at present is supporting the full restoration of the NHS.

The NHS is seen as the most important issue in the forthcoming General election.

Our campaign focuses on Liverpool Women’s Hospital. So, we asked local pregnant women for their thoughts.

“I think the most basic thing that women giving birth need is to feel safe, and to be able to have confidence and trust in the people who care for them before, during and after the birth of their baby. Continuity of care is so important, and while this is challenging to deliver, this should be the goal wherever possible. The Women’s has suffered some serious problems in the recent past, and work needs to be done to restore trust and confidence for the women and families who rely on this vital service. Women need to be able to access midwifery-led care, and be supported in their choices around birth and beyond. I want to feel secure that I will be offered treatments that will be beneficial (nothing unnecessary), that the midwives and doctors will listen to me and answer my questions, that they will seek my consent before they intervene, and that the quality of care and communication will be consistently of a high standard. I have experienced both excellent care and coercive and traumatic care at the Women’s in the past. I understand that there are serious system pressures that affect staff throughout the trust, but no woman should leave the postnatal ward feeling traumatised and vulnerable. Staff need all the support and training necessary to ensure this does not happen. Research demonstrates that birth trauma is a national problem, and I would like to see the Women’s taking a leading role in addressing this silent epidemic. As a tertiary centre and leader in obstetrics and foetal maternal medicine, the Women’s should be setting standards, not struggling to meet them.”

Another comment was:

“We need more focus on women with complex social needs as they have terrible experiences once they go in to deliver.”

We agree and say.

  • Fight to save and improve Liverpool Women’s Hospital.
  • Restore and Repair the whole NHS.

We need a national health service, funded at least as well as other European Countries, publicly provided, not for profit, available to all humans in the country, free at the point of need. This model is the safest and most economical model of healthcare. The US have a dog’s dinner of a healthcare model but it costs much more than the NHS and has many more preventable deaths.

The UK does not spend enough on our healthcare and wastes billions on private profits.

If UK spending per person had matched the average across the EU14 during the decade, then UK total spending per year would have averaged £227bn between 2010 and 2019 – £40bn higher than actual average annual spending. Matching spending per head to France or Germany would have led to an additional £40bn and £73bn (21% to 39% increase respectively) of total health spending each year.

Governments know this and choose to involve big US corporations in the NHS so they can make a fortune, as our service runs on empty. The years of closures and mergers have done great harm and the last thing we need is more health care corporations to rip us off.

The U.S. has the lowest life expectancy at birth, the highest death rates for avoidable or treatable conditions, the highest maternal and infant mortality, and among the highest suicide rates. The U.S. has the highest rate of people with multiple chronic conditions and an obesity rate nearly twice the OECD average.

The years of closures and mergers have done great harm. In August 2023 a report said that “roughly 81 hospitals closed in the past 21 months, 6.6% of total hospitals.” 

Liverpool Women’s Hospital requires about 25% more funding. This is because eighty per cent of its work is maternity, and maternity is badly funded nationally. However, funding for the whole ICB (NHS) in Merseyside and Cheshire is also a problem. One of the hospitals that cannot safely work within the given budget is Liverpool Women’s Hospital. The Board of Liverpool Women’s Hospital has set a budget for safety and must be supported in this.

The Cheshire and Merseyside Integrated Care Board provides the bulk of funds to the hospital with a small amount coming nationally from funding for specialist services. The ICB in turn gets its funding from NHS England. NHS England funds maternity through what they call the maternity tariff. This maternity tariff is inadequate for safe care. NHS England gets its funding from the Government. The buck stops with the Government.

The ICB said it has serious funding issues in its most recent report;

“Colleagues will be aware that the financial planning round for 2024-2025 has yet to be concluded. This is largely because provider financial plans [providers are the Hospitals and non-hospital trusts our comment] exceed the level of funding available and we remain in an iterative process [iterative means going back and forth] with NHS England as we seek to find the right balance between further cost improvements [cost improvements means cuts] and maintaining the core quality of services.
5.2 At the time of writing this report we were forecasting a deficit for the year in the order of c£150million (2.24% of turnover). We will be able to report back to Board verbally at its meeting in May [This meeting was cancelled].”

Sadly, Maternity does not feature in the priorities of the ICB despite reporting that many more women experienced a delay in induction of labour. This means that a woman has been told that her baby needs to be born soon and has come into hospital, to have the baby and then is kept waiting (and worrying) for more than 12 hours.

The NHS came from campaigns over many years from ordinary people, from trade unions in mining towns and working-class women’s organisations especially the Cooperative Women’s Guild who left behind a great record of their work in 1916 in the book ‘Maternity: Letters from Working Women, Collected by the Women’s Co-operative Guild’. Eventually, Nye Bevan founded the NHS as part of the 1945 Labour Government. It dramatically improved women’s survival giving birth, and the survival of babies.

Linked problems.

Women and children have been hardest hit by austerity and this has affected our health The prospects are grim indeed. In Liverpool “The life expectancy of women will fall by one year, and they will be in good health for 4.1 fewer years than they are currently. Although they are starting from a lower base, men will live 6 months longer than currently, and more of that time – 1.8 years – will be spent in good health.

Tell everyone who wants your vote to commit to real improvements in maternity services, a real commitment to the NHS. But do not leave it to MPs, get involved in the campaign to restore the full NHS and Maternity care. Suffragettes did not have a voice in parliament but they made themselves heard. We can campaign as well as our great-grandmothers.

Save Liverpool Women’s Hospital. No mergers, no dispersal of services. We need more midwives. Fund all the maternity hospitals well. Staff them well. Staff should not be pulled from ward to ward just to manage day-to-day demands. Each ward should be well-staffed. Fund postnatal support. Fund safety-critical improvements. Fund and staff the specialist work of Liverpool Women’s Hospital. Make treatment timely and safe, without long waits for induction of labour. Make maternity services improve women’s mental health not damage it.

We need more midwives, and midwives need a professionally safe workload and good pay. It is hard to stay focused professionally if you are not sure where the next meal or heating bill is coming from or if you are working extra shifts to make ends meet.

Find out more about maternity here

Every life starts at birth.

As the suffragettes said

“Do not appeal, do not beg, do not grovel. Take courage, join hands, stand beside us, fight with us.”

It takes a weird level of cruelty to cut services for the birth of a baby but that is what has happened. Our campaign is far from alone in raising these issues. The government knows quite well what is happening in maternity. Multiple national reports have shown the crisis in maternity services for mothers and babies. These are some of the reports, all reported to Parliament.

1. Care Quality Commission,

2. Donna Ockendon,

3. Bill Kirkup

4. Morecombe Bay,

5. Maternity Services in England House of Commons Health and Social Care Committee

6. Birth Trauma report

7. Report into the quality and safety of  maternity services

8. Saving Babies Lives Report

The government responded with endless cuts to the NHS budgets. This year’s funding allocation for the NHS in real terms, taking into account inflation, is the worst in many years.

Improving maternity outcomes needs to be everyone’s business. Let us make it our business.

There are other NHS problems. Mental health care has been sliced, diced and privatised. Dentistry is simply unavailable to many people; GP services are in serious trouble through underfunding and crazy schemes to reduce our contact with a GP. Meanwhile, reports show that having contact with the same GP adds years to our lives

The service must respect and work with mothers. There should be continuity of care, not an impersonal production line.

Eradicate racism from the maternity service.

https://amandagreavette.com/birth-project-gallery/#masonry

Fund the whole NHS.

No cuts or closures.

Raise the funding paid to all hospitals for maternity.

Raise the Birthrate plus staffing standards.

Protect and improve mother and baby health.

We support campaigns for the safety of mothers and babies in other ways.

You can take action now for the NHS as we enter the election campaign Send these questions to your candidates.

Join our campaign. Spread the word.

Mourn the baby and  defend Abortion Rights

This was  published on X(Twitter).

It shows how the US  right-wing policies that restrict abortion inflict terrible damage on women’s bodies, mental health, and rights.

“My heart is broken: As friends & family know, my wife was pregnant with our 2nd child, & about to begin her 2nd trimester. A few days ago she had severe pains, & bleeding, and had to go to the emergency room. There, it was discovered that our baby no longer had a heartbeat. Devastated doesn’t come close to what that feels like.
Unfortunately for people like us, because of the current laws in the state of Texas, that was only the beginning of this nightmare. Jess (my wife) had an “incomplete miscarriage”, and what needed to happen, what was best for HER, and her health, was to terminate the pregnancy, and get the baby out.
The doctor gave her a medication that would move this process along, and sent her home. Where, apparently we would be handling it ourselves. We were told it might take a couple of attempts before it worked.
I’ll let you decide how you feel about that.
After a long, painful night of the equivalent of early labor, the baby was still with her. So, we went back to the Emergency Center to get the 2nd dose. A new doctor was on call. He was an older man. You could hear him in the hallway as he said, “I’m not giving her a pill so she can go home and have an ab*rtion!”. Being well aware that our baby no longer had a heartbeat. Then, he came into the room to say, and I quote: “Considering the current stance. I’m not going to prescribe you this pill”. Then, just sent us on our way.
The “CURRENT STANCE”?! Did he really just say that?! 
No one should ever have to hear their wife say: “Get this dead baby out of me!”.
Can you even imagine how that must feel?
The pain, and the bleeding continued. So, we decided to go to another hospital, about an hour away. There was a female doctor on call there, and we thought we might have better luck.
I should probably mention, the procedure to get the baby out is called a D & C. It’s scary, & traumatizing, but sometimes necessary in situations like ours. Especially in emergency circumstances.
So we get to the next hospital. They take Jess in, ask her a bunch of questions, do a new scan… confirm that the baby is still there, with no heartbeat, and then disappear… for hours. Only to come back in and keep asking the same questions over and over. It’s becoming clear that they’re primary concern is NOT my wife’s health. Instead, they seem to be worried about the legalities involved.
So, they decide it is not “enough of an emergency” to perform the D & C.
They do, however, prescribe another, stronger, final dose of the medication for us to try again… at home.
So, we go home to try again. Another long day/night of early labor pains. Only to discover my wife UNCONSCIOUS in the bathroom. Having to pick my wife’s cold, limp body off of that bathroom floor, not sure if I was about to lose her, is something I will NEVER forget.
She had to be rushed to the hospital.
By this point she had lost so much blood, and bodily fluid, her body gave out.
They were able to stabilize her, give her the fluids she needed, and we came back home yesterday afternoon. We were also able to confirm that our baby was no longer with her.
Now, not only do we have to live with the loss of our baby… we have to live with the nightmare of what we just experienced because of political and religious beliefs. MY WIFE’S HEALTH SHOULD HAVE COME FIRST. PERIOD!
God knows what mental and emotional damage this has done.
If you consider yourself a staunch “pro-lifer” … 1) You’ve never been through what we just went through, and 2) You should take a long, hard look in the mirror and reevaluate your reasons for supporting such a cold, barbaric, ignorant point of view.
It’s not that black & white, and it’s never going to be.
If you think your “Pray To End Ab*rtion” sign in your yard is “Christian”, I suggest you revisit the teachings of Jesus and try again. If you support these laws that make ab*rtion illegal, and result in people being put through what we just were, you should be ashamed of yourself. I’ve never been so angry, or heartbroken… and the devastation I’m feeling must pale in comparison to what my poor wife is feeling.

Make the NHS the talk of the workplaces.

Take the fight for the NHS into all our workplaces. Make repairing and restoring the NHS a topic of conversation at work. Blow the whistle on the damage to our NHS. There are nearly thirty-three million people at work in the UK. More than 6 million of those workers are in a trade union. Talk at work also gets back into the community. People at work are powerful. Make the NHS the talk of the workplace.

Support the NHS workers.

The magnificent work and skill of NHS staff just about keep the hospitals functioning and saving lives and health day after day, but there is a terrible toll on lives caused by Government policies on on the NHS with almost 300 avoidable deaths a week attributed to the situation in our Accident and Emergency units.

Who was Nye Bevan?

Nye was a miner and strong trade unionist who became an MP in 1929. He retained his loyalty to his class through his political life. In the 1920s there was no national health service. In the mining areas limited health services were organised by subscriptions collected by the miners, but such services were not available elsewhere. Working-class families often had no access to healthcare, especially for women and children. There was a huge demand for better healthcare from the unions, working-class women’s organisations and other organisations of the labour movement. Nye was part of that pressure. In 1945 after World War 2 Labour won the general election and Nye became Minister of Health. Against much pressure from the establishment, Nye set up the National Health Service.

The national health service was free at the point of need, paid for by taxes, and available to everyone, rich and poor young and old, every religion, every colour. It was a coordinated national service, providing all the available treatments. GPs and hospitals, baby clinics and public health. The NHS made a huge difference to working-class lives and especially in the lives of babies and women giving birth Until 2017 it was the best health service in the world. You can find out more in Ken Loach’s film Spirit of 45

How people at work can help win back the NHS?

Talking to other people at work is a powerful way to spread the campaign and to counter Government and press lies. Every great campaign starts with one-to-one conversations. The media does not report the crisis in the NHS at all accurately. Spreading the word at work can make a huge difference.

We can build solidarity across working people to restore the NHS

Solidarity: Unity or agreement of feeling or action, especially among individuals with a common interest; mutual support within a group. ( Oxford Dictionary)

Workers on the railways, in the water industry, in power, and in telecoms already understand the damage of privatisation.

It is working-class people who suffer most from poor healthcare. Working-class people live shorter lives and are more likely to have long-term health conditions, and these health conditions tend to be more severe than those experienced by richer people.

Maternity suffers badly from these policies as many posts on this blog show. This underfunding is costing lives and most of those lives are those of the babies from the least well-off areas.

Investment in healthcare pays back into the economy many times over. No country can be successful with nearly ten million people waiting for healthcare.

Restore and Repair the NHS. Stop the rot now!

The Neonatal Unit at Liverpool Women’s Hospital

Much wonderful healthcare is still available in the NHS, thanks to the huge sacrifices made by NHS workers but the damage is real.  Nearly ten million people are waiting for healthcare, while  US health corporations are profiting.

The Government spends 18% less per person on healthcare than the average in the EU, and less than half what is spent in the US, where health is much worse. The NHS system is cheaper and more effective than privatisation.

Funding for health services in England comes from the Department of Health and Social Care’s budget. The Department’s spending in 2022/23 was £181.7 billion.  This money is a honeypot for privatisers and local and international health companies.

Join your voices for our health care. Demand it back. Demand better!

The healthcare system in the United States is appalling. However recent governments have supported bringing US health corporations into the NHS. In the US health insurance costs about as much as the mortgage and does not cover everything. Many millions go without. “The U.S. has the lowest life expectancy at birth, the highest death rates for avoidable or treatable conditions, the highest maternal and infant mortality, and among the highest suicide rates.” Despite this failure, it is the US model of healthcare that is being brought into the UK by the government. “NHS monies are flowing to private companies, including firms with a dismal track record in the UK and some whose US parents have faced multi-million-pound penalties from state and federal authorities“.  Centene, Operose and United Health are all big US names involved in the privatisation of the NHS, including owning GP practices.

Trade Unions and working-class women’s organisations fought to found the NHS and those organisations can help to win it back. Demanding universal healthcare free at the point of need must have sounded far-fetched in those early years of campaigning. It is hard work today too but we can do it.

Private healthcare cannot be as good as a national comprehensive service. It is a far worse system in the USA. Private healthcare has to make a profit. A barrister who got cancer found his private health insurance premium doubled to £163,000 per year.

Profit-centred policies, hidden behind sweet words are reshaping our health services.

These policies are destroying our services, providing fewer services, fewer beds and massive staff shortages. But it provides more profit for health corporations and management “consultants”.

Reverse privatisation, charging, service cuts, closures, understaffing, down-skilling, low pay, and lethal waits for treatment.

The privatisation lobby is infecting Labour too, so the fightback is down to us all.

Everything I’m hearing is that they (Labour) will kick-start private sector investment much more proactively than the Tories were able to do” Henry Elphick, deputy chair of the European Healthcare Investor Association, an umbrella organisation for private capital providers investing in healthcare

The Conservative government has restricted funding, not met pledges about building new hospitals, and indeed closed more hospitals. It failed to maintain and repair existing hospitals, and promised many more GPs and now we have fewer GPs , but they have fed money into the pockets of big business.

Accident and Emergency services are in serious trouble. “Almost 300 deaths a week in 2023 associated with long A&E waits ….” This is from the Royal College of Emergency Medicine, the professional organisation of Emergency doctors.

Thanks to Government policy, the NHS is short of staff, yet newly qualified doctors and those who have finished their training to become consultants cannot find work. Many NHS staff leave because of the stress at work and poor pay. This is whilst patients wait in pain.

We want to make the NHS once again a  great national, comprehensive, universal service, publicly owned, publicly provided, providing timely care, free at the point of need. Good health care is an excellent national investment in the health happiness and wealth of its people.

Demand a return to the original NHS, once the best in the world. (This is according to a regular survey from US Think Tank the Commonwealth Fund.) The health minister once had a legal duty to provide for the health of the nation but that was removed in the 2022 Act

They got rid of the legal responsibility to provide for our health “The Secretary of State must continue the promotion in England of a comprehensive health service designed to secure improvement—(a)in the physical and mental health of the people of England, and(b)in the prevention, diagnosis and treatment of physical and mental illness.”https://www.legislation.gov.uk/ukpga/2012/7/section/1/enacted

The NHS Government funded, providing timely healthcare for all, including all the services, publicly delivered by qualified staff with decent pay and conditions, as designed by Aneurin Bevan. This is the cheapest, most cost-efficient and humane way to provide health care.

Kick out all privatisation. Every penny of government health spending must go to patient care, to the staff, to equipment and buildings, not a penny to the privatisers’ huge corporations.
Expand the services.
Demand timely treatment for all, rich and poor, young and old.

According to BMA research, the number of doctors per 1,000 people in England is 25 years behind comparable OECD European Union nations, second lowest only to Poland.

The Government has brought in a US-style, service-cutting system through the 40+ ICBs. This redesigns the NHS on US lines and diverts funding (especially from our hospitals) to reward those who cut them back. Fewer services are being provided in the NHS, as the needs increase. Pressure is put on patients to use private healthcare.

If YOU spread the word, we stand a chance of getting our services back.

Government policy costs lives, especially the lives of working-class people. It means avoidable deaths and more years of ill health.

What has happened to dentistry and mental health services can happen to every service. Wages and conditions in the NHS have fallen in real terms. Staff are working way beyond their duties just to keep the service afloat.

People power can be very powerful. That’s how many changes have been achieved


End the “I.C.S.” There are now 42 Integrated Care Systems across England. These bodies are not Integrated, don’t control Care and are not a real System) This model is designed for cuts, privatisation and damaging restructuring.

The NHS model is more cost-effective, and more efficient than the US model or social insurance models. However, no model of health care can run effectively if it is being ripped off by big business and denied adequate funding.

Union members working together will be heard

The NHS is your inheritance yet it is being taken from you. Make sure you leave a functioning NHS to your children and grandchildren

How to fight back for the NHS
#Spread the word. Talk at work.  Spread the word in the communities. Challenge elected representatives #Talk to one workmate about this each week #Raise the issue with your union.
#Challenge the  government lies, Challenge the private healthcare lobbyists in the Conservative party and those in Labour
#Demand a full-service NHS

They say we can’t afford the NHS. Oh yes, we can!!

Excuses for poor healthcare that are straight lies

Lie 1. The NHS has problems because we have so many old people. Nonsense. The government has known how many old people there would be for decades.

Lie 2• The NHS just needs more funding just needs more funding. No, the money has to go to patient care and staff pay not into the pockets of companies like Optum.

Lie 3 The UK can’t afford the NHS. Nonsense! The UK is the 6th largest economy in the world and good healthcare makes it richer

Multi-national companies are gloating over the Americanisation of the NHS – and the fat, fast profits they can make at the expense of the sick and dying

There is another aspect of privatisation is the bringing in of the US model of Accountable Care. The US government pays big companies for some people’s healthcare. The companies make their profit from the difference between what they get from the Government and what services they provide.

Of course, the final form of privatisation is when people have to pay for all their treatment. Some people already have to pay for treatment in the NHS at 150% of cost. Women giving birth can be charged £14,000 to give birth.

Make the NHS the talk of the workplace.

The Women’s Cooperative Guild were working-class women who campaigned long and hard for healthcare publishing a famous book “Letters from Working Women” in 1916. The banner is in the Museum of Liverpool Life

This article is written on behalf of the coordinated NHS campaigns in Cheshire and Merseyside which includes the Trades Councils in the area, Unite Community branches, Keep our NHS Public, Save Liverpool Women’s Hospital, Socialist Health and other groups. We can help with leaflets, posters, speakers and information Please Contact us via saveLWH@outlook.com or by mail to Save Liverpool Women’s Hospital Campaign c/o News from Nowhere, 96 Bold Street Liverpool

What on earth is going on with our GP services?
The fight to save the Tuebrook GP practice

When Save Liverpool Women’s Hospital campaign are out and about people often ask about GPs. Why can’t they get appointments? Why don’t we know our GPs like we used to do? Why are some practices closed? Which bits are privatised? Why are some doctors unable to get work? Why are so many people who are not doctors employed at GP practices? Why, when need is increasing, are there fewer GP practices in England than at any time since 2016? Why are GPs in dispute with NHS England? Why are GPs so overworked? Why when people are less healthy do we have less healthcare?Why is less spent on GP practice than in 2018? If we want to Restore and Repair the NHS we need to know what has already happened to this much loved and very valuable service, what is happening now, what the privatisers have in store for us next and knowing all this we need to talk about how we can win it back.

Sheila Altes answers some of these questions. We welcome contributions to this discussion. The condition of the NHS means that many more patients and their families and friends need to know more.

General Practices

General Practitioner (GP) practices are not private companies, they are independent contractor organisations set up to deliver NHS services for the NHS. Staff working in general practice are usually employed directly by the GP practice and not by the NHS.

Every partnership of GPs must hold an NHS GP contract to run an NHS commissioned general practice. These set out mandatory requirements and services for all general practices as well as making provisions for several types of other services that practices may also provide if they choose to.(The Kings Fund 2020).

There are 3 types of contracts in England:

General Medical Services (GMS), Personal Medical Services (PMS) and Alternative Provider Medical Services (APMS).

The majority of GP practices hold GMS or PMS contracts.

General Medical Services (GMS)

GMS contracts are negotiated nationally every year between NHS England and the British Medical Association’s (BMA) General Practitioners Committee (GPC England). The GMS contract is then used by the commissioner to contract GP services in a geographical area to deliver ‘core’ medical services.

Personal Medical Services ( PMS)

This is another form of contract. Similar to the GMS but negotiated and agreed locally by the commissioner with a practice. It is soon to be phased out.

The core general practice contract sets out the geographical area the practice will cover. They must have a register of patients and provide the essential medical services set out in the contract. There are other requirements such as standards of premises and workforce and key roles and responsibilities including complaint procedures, insurance, liability and governance. They must provide essential services for registered patients and temporary residents who are or believe themselves to be:

*ill with a condition from which a recovery is expected

*terminally ill

*suffering from chronic disease.

They must provide ongoing treatment and care.

Alternative Provider Medical Services (APMS)

This new type of contract for the provision of NHS services was introduced in 2004. This allowed the contract to be held by a private company or a not- for- profit organisation; the contract no longer had to be between a named GP or GP partners and the NHS.

This effectively opened up primary care to private companies owned by directors and shareholders. So instead of GPs who had worked in an area for years, who knew their patients, primary care could be delivered by a private company who employed salaried GPs.

APMS contracts were advertised with a fixed amount of payment over a long term usually 10 years. As long as mandatory services were met and any services covered in the contract, then any money not spent was profit for the company and its shareholders. If the company or organisation held several contracts then economies of scale come into play (Lowdown 20/3/21). Further profits were made by down- skilling and reducing the workforce. These efficiency savings (cuts) don’t go to the NHS but to the shareholders.

This gave rise to the entrepreneurial GPs who set themselves up as directors of these companies and made huge sums of money. SSP Health comes to mind. In 2013 they took over the management of 22 surgeries in Liverpool. One of these surgeries was Princes Park Health Centre. Under their management it went from being a flagship model of primary care to being ranked in the bottom 300 out of 8000 GP surgeries in the country. A campaign by Keep Our NHS Public Merseyside focused on the difficulties of the patients at Princes Park. This campaign forced SSP Health out of Liverpool and their contracts for all but 2 of the surgeries were awarded to other providers. However they are still active in the North West and manage over 40 surgeries. Details of the KONP campaign can be found on:

www.labournet.net/other/1502/konp1.html

Even though the majority of GPs are independent contractors, the use of APMS contracts attracted many private companies who began to take over primary care.

Funding

GPs who hold a GMS or PMS contract are paid for services provided, both mandatory and additional services, where they have been agreed. Additional income is generated by the Quality Outcomes Framework (QOF). This is an incentive scheme that allows practices to earn points for performance of good practice, Achievement is measured for indicators in 4 areas known as ‘domains’: Clinical Domain, Organisational Domain, Patient Experience Domain and Additional Services Domain.

In the clinical domain, there are approximately 20 areas where points can be achieved. For example, registers of patients with long term conditions such as : asthma, chronic obstructive pulmonary disease, chronic renal disease, cardiovascular disease, hypertension, diabetes etc. If a certain percentage of these patients are reviewed annually and are found to be on the appropriate medication for their condition or if control of their condition is achieved within guidelines set out by NICE, then points are awarded and payments made.

The system is open to abuse and can become a box- ticking exercise. Unscrupulous practices can manipulate the registers remotely.

This system is operational in England, Northern Ireland and Wales. Changes to the framework for 2023/24 were imposed by NHS England but rejected by GPC England and NHS England has committed to a review of the system. More information can be found at:

Quality and outcomes framework (QOF) www.bma.org.uk

Money is also paid based on the size of the practice population and “weighted” according to certain criteria. The average payment per” weighted patient” was £104.73 in 2023 (NHS England).

“Weighted” list size is a measure of workload on the basis that it represents a measure of time expected to be spent on consulting. Certain types of patients place a higher demand on practices than others, for example: elderly patients, patients with mental health issues, non-English speaking patients, or if the practice is in a deprived area where patients are more likely to have complex conditions.

The practice must pay all its salaried employees and the running costs of the practice. The partners do not get a salary but get paid out of the practice income. They are also liable for any losses made by the practice.

Further funding was made available to general practices if they became part of a Primary Care Network.

Primary Care Networks (PCN)

PCNs were introduced in England as part of the NHS Long Term Plan published in February 2019.

A PCN consists of several general practices working together, so instead of a general practice caring for a few thousand patients a PCN will have between 30,000 and 50,000 patients on its list. Each PCN will have its own Clinical Director, who doesn’t have to be a GP. Governance structures will be determined locally and recorded as part of a Network Agreement. Funding will be made available to GP practices in PCNs via the Network Contract Directed Enhanced Service (DES).The contract will be in addition to existing GMS,PMS and APMS The contract will be between the commissioners and the individual practices and the money will be channelled through a single bank account directed by the network.

Additional staffing will be required to deliver the seven National Service specifications of the DES. They are:

*structured medication reviews

*enhanced health in care homes

*anticipatory care (support that focuses on people with long term conditions with the aim of reducing the risk of their condition worsening that would result in a hospital admission)

*personalised care ( patients have more choice in the way their care is planned)

*supporting early cancer diagnosis

*cardiovascular disease case finding

*action to tackle inequalities.

The additional staff needed included physician associates, first contact physiotherapists, social prescribing link workers and clinical pharmacists. Funding is given for these via the Additional Roles Reimbursement Scheme (ARRS). Underfunded and understaffed general practices cannot use these funds to employ other GPs, with the result that many salaried GPs and locums cannot find employment.

Digital -first primary care became a new option for every patient, they would have the right to choose telephone or on- line consultations instead of face- to- face consultations. This could be with their own practice or a digital provider. A framework was created for digital suppliers to offer their services to networks on standard NHS terms. This represented a golden opportunity for software companies to jump on the bandwagon and also to access patient data, invaluable to health insurance companies.

The Long Term Plan was published in February 2019 and PCNs were to be formed by June 2019. Forcing successful and struggling practices into networks in such a short time did not give them the support needed to deliver priorities: all part of the plan. NHS England then published a list of approved suppliers of support and development available on the Health Services Support Framework. They included: Centene, Virgin Care, Optum, KPMG, Deloitte, Ernst & Young, PwC, McKinsey, Cerner, Atos and many more global corporations. This proves the intention is to stream NHS public funds into these corporations (Green,J.,2019)

The aim was to cut GP appointments and also the number of GPs needed to care for patients. Only patients with complex needs will see a GP, the rest will be sign posted by a “care navigator” to less skilled clinical staff.

Investment and Impact Funding (IIF) is another source of funding linked to networks rather than practices. The fund is an incentive scheme focusing on supporting PCNs to deliver high quality care; there are indicators that focus on where PCNs can achieve this. In 2023, the number of indicators was reduced from 32 to 5. Payments were made if the PCN achieved a certain percentage of people receiving flu jabs, learning disability health checks, fast track referrals for lower gastrointestinal cancer and patients being seen within 2 weeks of booking an appointment. This reduction in indicators freed up funds to be moved to the Capacity and Access Payments. to facilitate the Same Day Access scheme.

In this scheme, when a patient phones the GP practice, they will be put through to a centrally controlled system. If they want a same day appointment the call will be transferred to a Same Day hub where a ‘care coordinator’, not a doctor, will triage the patient on to someone else at the hub, also not a doctor, who will decide how to deal with the request. Each hub will be staffed by physician associates and only one senior supervising GP.

This caused serious concerns in North West London, where the scheme was being forced on the PCN from 1st April 2024. They were concerned that the plan could potentially cause serious threats to patient safety and could lead to the replacement of fully trained GPs by cheaper, less well trained staff (GP Direct. February, 2024). Patients could be sent anywhere within the group of networks, which would make continuity of care difficult. There is increasing evidence that a high level of continuity of care results in better health outcomes (NICE. February 2019)

The plan had been designed by KPMG, one of the 4 big accountancy multinationals, paid to design it and to train GPs how to use the service.  No patients, residents and a minority of GPs were consulted. After a huge backlash the North West London ICB were forced to retreat but did not abandon the plan, only to introduce it more cautiously (Health Campaigns Together, Spring 2024).

PCN Incorporation.

PCNs are not legal entities. They cannot hold contracts, employ staff or own property. This means there is no corporate model, it is the practices themselves that have to enter these arrangements on behalf of the network. Rather than have a lead practice employing staff and managing funds on behalf of the other practices, a corporate vehicle can be used to manage PCN activity and funding between members.

Forming a corporate vehicle involves merging the PCN practices into a single practice. In this way they can become  limited companies with shareholders. Once the corporation vehicle is formed, assets, staff and contracts can be transferred into the corporate vehicle.

The corporate vehicle may provide administrative activities or could sub-contract responsibility for clinical services delivered under the DES contract. It can enter contracts in its own right, own property and be responsible for employing staff.

If networks are forced to merge, as outlined in the North West London plan for Same Day Access hubs, then a company can be formed via a corporate vehicle. This is an attractive opportunity for private equity firms to invest in the company as income from the NHS is virtually guaranteed.  In order to make a profit, private equity companies invest in companies for a limited period, they then restructure it and make efficiency savings, usually by reducing services, cutting corners and reducing staff. They fund the investment partly with their own investors’ money and by borrowing. Once the contract ends, they share the profits with their investors and pay off the debt. Depending on the contract they often leave the debt with the company invested in. Private equity companies don’t have shareholders so there is little transparency.

The responsibilities of GPs in the UK have increased, partly due to the austerity imposed by the Government in the last 10 years. Income inequality affects health, and poor health puts a greater demand on healthcare. The reduction of bed capacity in secondary care, causing ever increasing waiting lists adds more pressure on GPs as they care for patients awaiting hospital treatments (Pulse 4/10/2023).

The extra administrative work necessary to obtain funding adds to the pressure on GPs .The new GP contract proposal for 2024/25 will see an uplift of only 1.9%, while, according to local intelligence, overheads have increased by 15%.

Dr. Katie Bramall-Stainer, chair of GPC England, states in response to the new GP contract proposal:

“They know as well as we do, that can only mean practice closures, staff redundancies, loss of the GP workforce, fewer GP Nurses, reduced activity, reduced access and an unacceptable experience for patients” ( BMA 28/2/2024)

By understaffing, underfunding and overstretching primary care, it is little wonder that the numbers of GPs has fallen. There needs to be a recruitment and retention of GPs, adequate funding and an end to private providers in the NHS. We need to continue with our campaigning to restore our NHS to its original founding principles of a universal health service, funded by taxation and based on need and not the ability to pay.    

Sheila Altes April 2024.

REFERENCES

British Medical Association (BMA) 28th February 2024

Responding to the new GP contract for 2024/25

www.bma.org.uk

British Medical Association

Quality and Outcomes Framework (QOF)

Changes to the framework in England 2023/24

www.bma.org.uk

GP Direct

Same Day Access Hub Proposal- February 2024

www.gpdirect.co.uk

Green, J. 2019

Large scale integrated primary care networks.

http//:calderdaleandkirklees999callforthenhs.wordpress.co

Health Campaigns Together – Spring 2024

Row over exclusion of GPs from ‘improved’ GP services in NW London.

GPs across the world- why do GPs have the most stress despite not working the most time.

Pulse 4th October 2023

www.pulse.today.co.uk

NHS England

Health Systems Support Framework

www.england.nhs.uk

NHS England

Managing regulatory and contract variations.

www.england.nhs.uk

National Institute for Health (NIH)

Calculating adjusted weight list sizes

www.ncbi.nim.nih.gov

The King’s Fund – 11th June 2020

GP funding and contracts explained.

www.kingsfund.org.uk

The Lowdown -6th October 2023

Private equity investing in UK healthcare

Homepage

The National Institute for Health and Care (NICE) 2019

Continuity of Care and Support.

www.nice.org.uk

Liverpool Women’s Hospital. Great work and great problems.
This banner in Liverpool Life museum is from one of the campaign groups for women’s health in the early twentieth century

Women and babies in Liverpool are entitled to the highest standard of healthcare. Our grandparents and great grandparents fought to found the NHS and left us this as their legacy. The NHS was a national service providing excellent healthcare, publicly provided and government funded. The new NHS did magnificent work for infant and maternal mortality.

In the last twenty years though, there have been years of cuts and privatisation in healthcare and years of poverty and subsequent ill health in Liverpool. A report to Liverpool city council this year said that, without change, “The life expectancy of women will fall by one year, and they will be in good health for 4.1 fewer years than they are currently.”

It is time to demand better.

Campaigning for the whole NHS

We are campaigning to Save Liverpool Women’s Hospital and to restore and repair the NHS. We want to see improved funding and staffing and to see the whole NHS move back to its original model of a national public service, publicly provided, providing universal comprehensive and timely care for everyone free at the point of need and funded by Government. If you have not yet signed our petition please do so.

Healthcare staff have worked way beyond what should have been needed to keep some good services going. Every day people are grateful for their work, their kindness and humour but sheer human effort cannot compensate for inadequate funding and too few staff.

Liverpool Women’s Hospital provides some excellent services but it has some serious difficulties too.

The Liverpool Women’s Hospital board meeting on 9/05/2024 reported some excellent staff work, including improved methods of helping premature and very premature babies survive and thrive. It also reported the success of moving early pregnancy loss to its own area, a development much valued by the mothers involved. Previous meetings have seen patients reporting their experiences too. In April there was a very positive report from a patient about her experience of the care she received from the Rainbow Clinic as a previously bereaved mum. We have also seen excellent presentations about the pioneering work on endometriosis and menopause at different meetings. The Hospital website says Every day on average, 24 babies are born in Liverpool Women’s Maternity Unit and another three babies are born prematurely and cared for in our Neonatal Unit.  Most of Liverpool’s babies are born at Liverpool Women’s Hospital and sick and tiny babies are cared for in the beautiful new NICU ( Neo Natal Intensive Care Unit)

Entrance to the NICU

The Liverpool Women’s Hospital is undertaking a major anti-racism drive to improve outcomes for patients and staff. We very much welcome this initiative. It is essential to save lives.

The core problem for Liverpool Women’s Hospital is under funding. This underfunding stems from the national underfunding of maternity as well as the general under funding of the NHS. This longterm underfunding has meant years of cuts. The NHS organisational changes from 2012 to create Trusts and Foundation Trusts also wasted many resources that should have gone to patient care.

Liverpool Women’s Hospital also has a long waiting list for cancer patients and waiting lists for gynaecology appointments. Some more staff have been appointed and hopefully the list will be dramatically reduced.These waits cost lives and health. The Chief executive reported that

“NHS England’s tiering process for cancer performance is designed to provide accountability and additional central support for trusts that are most at risk of missing national cancer targets. Trusts are categorised into tiers based on their performance, with Tier 1 being the most challenged and requiring the most support. Trusts may move between tiers based on their performance improvements or deteriorations.
In a letter received on 26 April 2024 from NHS England, it was confirmed that following a review of cancer performance, and in agreement with the regional team, the Trust will be in Tier 1 for Cancer from the week commencing 29 April 2024. The move to Tier 1 will involve regular meetings to discuss delivery progress and any required support from the relevant parts of NHS England.

Last year the hospital had a poor Care Quality Commission report for maternity and it has taken work to improve on this.New management is in place and they have plans to ensure that improvements are happening.

Our babies, our mothers, deserve much more.Every mother every baby treated at Liverpool women’s deserves the very best. Poverty from low wages, low benefits and poor housing is costing lives, and causing long term ill health. Inadequate health services are part of this.The Care Quality Commision report last year showed how much harm has been done by this underfunding and under staffing. The management must also be responsible for some of the damage mentioned in the Care Quality Commission reports.

The funding issues at Liverpool Women’s means that to meet the current level of service it needs twenty five percent more funding. Money is spent very carefully but for basic safety to be met, that extra spending is essential. At present the required money is being spent and temporary support funding has been made available, by the ICB or national NHS. However this situation puts the hospital into whats called Level 3 of the National Oversight Framework which could bring in management decisions not based on the needs of staff and patients, as the government clamps down on public spending.

Many studies show that money spent on good healthcare repays for itself many times over. At birth this is especially so as bth injuries can last a lifetime.

Neither merging the hospital nor dispersing its services will change that fundamental financial situation. Only an improvement of maternity funding will make a real difference.

Screen shot from page 52 of the LWH Board meeting 9 05 24

The underfunding of maternity leads to staff overwork and reduced services. Government safety figures for staffing are met but we say these safety figures are inadequate. The Government funding does not provide sufficient staff to deliver the kind of service patients and staff require. yet money is squandered on private companies and financial consultants.

There are national problems with maternity services described in many prestigious reports, as well as the Ockendon and Kirkup reports. No report has yet managed to shift the Government’s policies. We believe we need a huge campaign to win back the NHS.

A large part of Liverpool Women’s Hospital Maternity spend is on the maternity Incentive scheme, a government owned insurance system, run on a business model. Liverpool Women’s Hospital meets all the requirements of this scheme and so gets a refund from hospitals that do not meet all the safety requirements. This is an unbelievable situation..

Payouts from the fund are higher than the funding for maternity.If maternity were well funded fewer babies would be damaged and have to claim through the courts from this insurance fund.

In this crazy situation the hospital is still expected to make cuts (CIPs).

Our demonstration last October.

We have written before about how planned Cheshire and Merseyside ICB funding will not repair the situation patients experienced last winter. This poor experience was seen in many aspects, including A and E, care in corridors, access to GPs, access to NHS dentistry, and inadequate mental health provision. It will be worse next winter.

It was no surprise to hear there will be no new Hospital built in the next decade, nor does Liverpool Women’s require a new building. we believe that the new building idea was floated to make the idea of merging Liverpool Women’s Hospital into the big acute hospital more palatable. The existing building is less than thirty years old.However the drive to make fundamental changes remains, with merger or dispersal being the most likely recommendations. WE want to keep a distinct women’s hospital.

In the April Board meeting of Liverpool Women’s Hospital it was reported that work is in progress for major changes.

“the Women’s Hospital Services in Liverpool Programme. As part of the roadmap, the initial phase of the programme had been outlined, with an emphasis on the importance of openness, transparency, and continuous engagement with the public.
The development of a clinical case for change was scheduled for the spring and summer of 2024, with publication expected later in the same year. Feedback from this engagement phase, gathered during the winter of 2024/25, would then inform the approach to designing future services, with further development of potential options anticipated to commence in early 2025.” So the threats to Liverpool Women’s Hospital are still very real.

A meeting has been held with other Liverpool hospitals about the future for Liverpool Women’s Hospital and women’s health in the other hospitals in Liverpool.We have not yet been able to see which issues the other hospitals raised. Public consultation is promised this year.

No hospital can exist in a vacuum. Every hospital should be working in a mutually supportive system. The NHS was founded to be a national service, not a collection of competing hospitals. System working was damaged by the 2012 Act and the drive to privatisation. Cooperation and system working is required for the future of the other specialist hospitals in Liverpool, like the Heart and Chest and the Walton Centre.

Our campaign to Save Liverpool Women’s Hospital and to restore and repair the NHS has huge public support and is growing steadily.

The future of Liverpool Women’s Hospital is no safer this week.

Save Liverpool Women’s Hospital News May 2024.

Liverpool Women’s Hospital will not get a new building on the Royal Site. This announcement has been expected for some time. The BBC covered the story this week. On Radio Merseyside our campaign was asked to comment. We said that we were not surprised . The Hospital should stay on the Crown Street site and that what matters is proper funding, staffing, and resources because our babies deserve the best.

Our huge petition says.

Save the Liverpool Women’s Hospital.

No closure. No privatisation. No cuts. No merger.

Reorganise the funding structures, not the hospital.

Our babies and mothers, our sick women, deserve the best.

What’s happening with the  Liverpool Women’s Hospital?

There has been a press announcement that there will be no new women’s hospital built on the Royal site in the near future.

This announcement does not mean the future of Liverpool Women’s Hospital is safe, far from it. Public consultation about its future will be launched shortly.

The announcement is not a surprise to anyone who has followed the story of Liverpool Women’s Hospital or the story of broken promises from the Government about building new hospitals, even those in dire physical conditions.

For example in Leeds, the people were promised a new Children’s Hospital. In the meantime, services were dispersed to different hospitals to allow demolition. Now the new Hospital is not going to happen.

Nationally, maternity is underfunded and understaffed and has seen terrible scandals. We have written much about this in other posts.  Just this week there was a report about delayed induction of labour across the country (and this also has been seen in Liverpool Women’s Hospital). The Care Quality Commission reported “The quality of maternity, mental health and ambulance services has seen a “notable decline” over the last year, which is contributing to “unfair care” and worsening health inequalities,”

The Neonatal Unit at Liverpool Women’s Hospital

The Health Service Journal  also reported that

“families whose babies died and whose mothers were harmed – in some cases dying – in the East Kent maternity scandal were still having to prove legal liability to get any compensation. This is despite Bill Kirkup’s report, published around 18 months ago, having already looked at their cases in detail and reached conclusions on whether better care could have led to different outcomes.

But NHS Resolution, which handles the NHS’s clinical negligence claims, says causation and a breach of duty of care will need to be proved in each case. This may mean families have to engage not just lawyers but also experts in midwifery, obstetrics, and neonatal care.”

In such a national maternity crisis we must protect the services we have in the area. We say women and babies will be harmed if the Liverpool Women’s Hospital is forced into a merger with the huge general hospital. The focus on women and babies will be lost. The great maternity scandals of our age have happened where there was no real focus on women and babies.

The government and the NHS bureaucracy have wanted to close one hospital in Liverpool since 2015. Liverpool Women’s Hospital was chosen. This is to do with saving money not patient care.

Liverpool Women’s Hospital sits on a great site on Crown Street. The official opening was on 7th November 1995 and the building is in good condition. A £20million pound neonatal unit was recently added to the hospital. It does not need a rebuild.

Liverpool Women’s Hospital does need more staff and additional resources like a proper blood service, an improved emergency medicine service, a 24/7 consultant obstetric presence. It needs to tackle the long waiting list for Gynaecology treatment,  and improved intensive care. All of this requires funding and support from the national health service and government funding but without that funding our babies and mothers will suffer. The money must be provided.

Our Saturday stall n Bold Street

All hospitals should be run in a cooperative system with other hospitals but specialisms should be protected.

Liverpool Women’s Hospital, along with the whole of the UK, needs to improve infant mortality, maternal mortality and injuries to women and babies and to tackle gross inequalities.

Serious damage has been done to our health care. We see it in the terrible waiting times in Accident and Emergency, in the 14,000 preventable deaths caused by those A and E problems, we see it in dentistry, in the GP service, in mental health and in maternity. We see it in the eight million people on waiting lists. We see it in the exhausted staff.

The experience women have giving birth is getting worse because of these underlying, national problems and the day-to-day stress this brings into the hospital.

Liverpool Women’s Hospital is damaged too by the business model imposed on the hospitals. The drive to privatise and to move away from a service model in the NHS has caused problems all this century.

The new Chief Executive (James Sumner) and Chair of Liverpool Women’s Hospital (David Flory) are also the Chief Executive and Chair of the Royal, Aintree and Broadgreen Hospitals (Liverpool University  Hospitals Foundation Trust). Neither man is a specialist in maternal or infant health. The Health Service Journal has said these joint appointments are likely to lead to a merger of Liverpool Women’s with the big hospital. We say no to a merger, and a big yes to cooperation between all the hospitals in the area. Such cooperation is anathema to the privatisers. We need continued support from the people of Liverpool to win this fight and we need to link up with other maternity campaigners.

Please help Save Liverpool Women’s Hospital. Sign the petition, talk to friends family and workplaces about this, join the discussion, and help with leafleting and social media.

Invite us to speak to your organisation.

 Send us a donation.

 For all our mothers, sisters, daughters, friends, and lovers and for every baby

The Future of Liverpool Women’s Hospital, Spring 2024

Save Liverpool Women’s Hospital.

The future of Liverpool Women’s Hospital has been under threat for nine years now. The petition which is at the heart of the Save Liverpool Women’s Hospital Campaign says “No closure. No privatisation. No cuts. No merger. Reorganise the funding structures not the hospital. Our babies and mothers our sick women deserve the very best.

In the Liverpool Women’s Hospital Board papers 11.04. 2024, it was announced that “An indicative programme plan had been developed and this reflected the unlikelihood that a new hospital building, co-located with an adult acute site, would be built within a five-to-ten-year timescale.

( In plain English this means they will not get a new Hospital)

 And that

 “… discussions were held on alternative solutions for citywide women’s healthcare.

Our opponents promised the public that a new smaller hospital on the Royal site would improve services. We always said that such a plan was magical thinking and that even if they got the money for a new building the existing problems would still be there. We said moving the Liverpool Women’s Hospital from the Crown Street site would be bad for women and babies.

Now we are in the horrible position that the bribe of a new hospital has evaporated but the core financial and organisational problems remain. We well remember the Panorama programme many years ago when it was announced that they wanted to close one hospital in Liverpool, and that clearly was Liverpool Women’s Hospital.

There are serious problems for Liverpool Women’s Hospital not to do with the Hospital site.

The Board of Liverpool Women’s Hospital has made it clear that safe services require extra funding. We demand that this money be provided.

Liverpool Women’s Hospital has a grave shortage of funds for crucial services. The fault for this lies with the last four governments but especially the current government who are very much aware of the damage they are doing to maternity care. There have been numerous high-profile reports on this, not least of these reports, being the work of Donna Ockendon. Donna Ockendon is now working on another maternity report, this time from Nottingham.

There are five reasons this national problem impacts on Liverpool Women’s Hospital

  1. Healthcare in the UK is badly funded and badly organised, wasting money and resources on privatisation.
  2. Eighty per cent of Liverpool Women’s Hospital’s budget comes through maternity funding, mainly the Maternity Tariff. The maternity tariff nationally is inadequate. No other hospital relies quite as much on maternity funding as the Liverpool Women’s Hospital does.
  3. The costs of the Clinical Negligence Scheme weigh particularly hard on this, the largest maternity hospital. The Government scandalously spends more on compensation than it does for the whole maternity service.
  4. The hospital is a Foundation Trust, which is an expensive management model for a small hospital.
  5. The model of healthcare from this, and some earlier governments, saw hospitals as competing businesses rather than a cooperating system. A small hospital could not thrive in such a scenario. This model is changing but the new ICB model also poses serious problems. We call for a return to the original Bevan model of the NHS, where a fully funded national, publicly owned and delivered health system based on cooperation not competition, sees ongoing improvement in maternity services.

Liverpool Women’s Hospital lacks crucial services because of these funding issues.

Our petition, now with more than 40,000 signatures online and more than 20,000 on paper, says “Save the Liverpool Women’s Hospital. No closure. No privatisation. No cuts. No merger. Reorganise the funding structures not the hospital. Our babies and mothers our sick women deserve the very best.”

Our campaign wants to improve the whole maternity journey for women and babies, every aspect of it, safety, respect and celebration of birth. We campaign for maternity everywhere in the UK. It is not possible to solve the fundamental problems of Liverpool Women’s Hospital without solving national funding and staffing issues but we can stop projects that make things worse. There are many and detailed reports about how the experience of maternity has worsened in recent years.

Our campaign wants midwives, nurses, obstetricians, CSWs and other staff to feel safe, and respected at work, free from undue stress, with access to ongoing education and training and with the opportunity to eat well, go to the toilet and have proper breaks at work, both day and night.

Our campaign wants to see maternity well-funded and protected from privatisation and protected from trendy, untried innovations.

We want those running maternity services to remember that as medics they have a duty of candour, to tell the truth about funding and staffing issues.

Since 2010 there has been damage done to all maternity and women’s health services nationally, and Liverpool Women’s Hospital has not escaped that damage. Underfunding, understaffing, and lack of key equipment and services have all had an effect.

We campaign for the whole of the NHS, not just maternity

Why do we want a women’s hospital?

We want excellent healthcare for women and babies. Our babies, our mothers, deserve the best. It is that simple.

However, that is not what this and previous governments have provided. We want to keep the focus on the needs of women and their babies. The scale and depth of the maternity scandals in other big multi-site, multi-specialism hospitals is a testament to how important this is. There have been many prestigious reports published about how bad the damage has been to Maternity and to women’s health. One in seven maternity units have closed during the period of cuts and this wave of closures has not stopped.

Cuts in NHS funding are part of the Austerity project. Austerity cuts have hit women and children and the working class very badly whilst the rich get ever richer. In this situation, we must protect what we have and not let it go. Maternity in England has suffered grievously under austerity. Maternal deaths are the highest in 20 years.

Ockendon’s reports have painted a grim picture of the failings of the system. Our campaign has fought hard for national as well as local funding and held two conferences on this matter. None of these hospitals involved in the big maternity scandals were standalone  Women’s Hospitals like Liverpool Women’s Hospital and their failings were not blamed on being a standalone Women’s Hospital. Yet the standalone character of Liverpool Women’s Hospital was what all the case for change was based on.

When Donna Ockendon did her first report on the Shrewsbury baby deaths it was revealed that many hospitals providing maternity care did not even have a member of their board charged with Maternity care, so board papers could go with nary a mention of maternity. Bad Care Quality reports were not given due consideration by the Shrewsbury board.

  • “The Trust board did not have oversight or a full understanding of issues and concerns within the maternity service, resulting in neither strategic direction and effective change, nor the development of accountable implementation plans.“

Most of Liverpool’s babies are delivered at Liverpool Women’s Hospital. The hospital delivers roughly 8,000 births per year. The Hospital also provides maternity care from a wider region for complex pregnancies and very premature or very sick newborn babies. It is a Maternal Medicine Centre, one of three within the Northwest Maternal Medicine Network. The Hospital also provides Gynaecological treatments,  Fertility services, Genetics services, Cancer care and termination of pregnancy, when that requires surgical intervention. The hospital also has a reputation as being a safe and caring place for women (though that has faltered a little in recent years). For all these reasons,  Liverpool Women’s Hospital is considered to be especially important by the people of Liverpool and beyond, but not considered so important by the Government or NHS England. For the last nine years, the future of Liverpool Women’s Hospital has been under ongoing threat.

We ask the people of Liverpool to continue to support our campaign for a fully funded, fully staffed, fully equipped hospital on the Liverpool Women’s Hospital Crown Street Site and for a fully funded, fully staffed, publicly owned and delivered national health service.

The NHS. Back to the Future.

by Deborah Harrington

I am sure you will all have seen the NHS described as not fit for purpose because it is ‘a 1948 structure trying to deal with 21st-century problems’. Politicians say it, health ‘think tanks’ like the King’s Fund say it, the IEA and health ministers say it. Even NHS campaign groups say it!!

I would say that we don’t HAVE a 1948-style NHS anymore and haven’t for a long while, so whether or not it is or would be ‘fit for purpose’ is a moot point.

The 1948 NHS had a clear set of principles. It had a basic organisational structure designed to put those principles into action. Hospitals were very haphazardly located pre-1948 according to local charity or local authority available funds and inclination. Rich areas had more hospitals than poor ones, although the distribution of illness meant poor areas should have had more. Many hospitals were completely unfit for purpose.

The public service NHS set about doing something that no other health service did or does. It started a 20+ year programme of redistributing and modernising hospitals to try to provide the same easy access to high-quality care for everyone, regardless of issues of rurality or urban deprivation. The private, voluntary and even local government sectors don’t have the power to do that kind of national planning.

It never reached its optimal distribution because after 24 years of gradual change and development to meet its ambition, it ran into major political opposition in the 1970s (up til then both Labour and Conservative governments carried on the programme, after the mid-70s neither did).

GPs were also badly distributed and although they originally all (well, 96% of them) signed up to the NHS immediately and continued in their own locales, a more equal (although again never quite equitable) distribution was achieved by the 1960s. This was partly as a result of Enoch Powell importing a lot of Indian and Pakistani doctors in the early 60s (all already GMC registered) to put into the under-doctored poorer areas where white middle class doctors couldn’t be persuaded to work.

Universities were linked with major teaching hospitals and the NHS and British Universities were at the forefront of cutting edge medical technology and healthcare innovation.

In the 1970s, for lots of reasons, the political climate changed and the very principle of a planned health service which was fully publicly funded was no longer flavour of the month.

And we have had nearly 5 decades of a slow assault on both the founding principles and the structures designed to provide them as a result.

In addition we have to a large extent dismantled the welfare state which was designed to support and promote good health in the population.

The NHS is now run along entirely different lines. In the ‘paradox of productivity’ although it is run on commercial imperatives with finance in the driving seat this produces worse outcomes for more money. We have closed down entirely, or downgraded, District General Hospitals particularly in poorer and more remote locations on the grounds of ‘financial sustainability’ leading to decreasing life expectancy. We have removed essential social support and exhort the poor to take better care of themselves instead. We pretend that the problem is too many over-qualified staff (our staffing ratio is poor in international comparisons) and use ‘different skills mixes’ which saves money but not lives. We have driven GPs out of the service by making their working lives untenable.

And we no longer have 1 NHS. We have 42 Integrated Care Systems built along US Medicare lines run by boards which are staffed by McKinsey clones and US health insurance ex-executives or private healthcare representatives. The intention of NHS England is to shift our NHS model of a whole population risk pool assumed by the government to a risk-and-reward sharing system where the ICS will be given a fixed, non-negotiable, capitated payment from which they will bear the profit or loss themselves.

Absolutely not the 1948 system. Nothing like it.

( Deborah has asked us to change the title as she does not want people to “make instant assumptions about starched sheets and matrons! (And they will….) So now this post is called Back to the Future,

Deborah is co-director of Public Matters, a policy partnership which has provided the secretariat for an APPG ( all Parliamentary Group)and produces articles, videos and briefings on public policy, particularly the NHS.

Next, listen to Maxine Peake on the damage to our NHS

Maxine Peake laments the damage to the NHS in her own special way.

Go back to Bevan

The National Theatre is showing Nye, a play about the founder of the NHS, seventy-five years ago. The play is being live-streamed to many cinemas. So it’s appropriate for us to republish a local leaflet written advocating a return to the system of healthcare designed by Nye Bevan.

We face a Healthcare Disaster.

Take back the NHS. Go back to Bevan.

We cannot wait as the damage in healthcare escalates still further.

Nye Bevan, in the post-war Labour Government, set up a world-beating healthcare system that served us well for decades.

It was a national service – not a business. It was publicly provided by the nationally owned service – it responded to need not profit.

It provided all the treatments when we needed them – including GPs, mental health, elder care and dentistry. No to waiting lists! No to profits for private providers. It was a Health Service open to every human in the country – no migrant charges. The Health Secretary then was legally obliged to provide health care but no longer. It was free at the point of need – no charging.

Bevan’s system had capacity; it did not run at a panic level like today.

The Bevan Model of Universal Public Health care is cheaper, more cost-effective and more equitable than the vandalised service we now have. The for-profit business model costs more and delivers less.

We need immediate action on maternity, mental health, the GP service and dentistry. Action in hospitals, sort out budgets. More beds in the NHS not fewer. Invest, do not cut.

Restore the Public Health System. Plan effectively for epidemics and natural disasters

Address Women’s Healthcare needs. When the NHS started, women’s health improved; now under the semi-private system, it is declining. Even Maternity is unsafe.

Everyone working in health should be employed by the NHS on proper terms and conditions – no outsourcing, no commissioning. Demand good pay for all NHS staff – an immediate pay rise. Respect the staff. End bullying and lying to them. Win back staff who have left in disgust. Plan the workforce training.

We do not want and cannot afford the big corporations’ involvement in our NHS. Abolish the so-called Integrated Care System where all sectors are incentivised to cut and deny care. Bring back national, publicly owned and provided, comprehensive healthcare, free at the point of need.

Beware the corporate health lobby groups in all the political parties. Human needs should dictate our level of care, not Big Business and its failed ideology. The NHS privatisers are like vandals smashing and grabbing profit, albeit hidden behind a veil of lies and public relations gobbledegook.

End all privatisations: outsourcing, commissioning, reliance on private companies’ reports, staffing agencies, population health management, the rationing and denying of services, running down services, and using charities as substitutes for real NHS capacity.

Power concedes nothing without a demand. The NHS was a great social victory won by the generation that defeated Hitler. Let us make our demands as loud and long as those of our grandparents. No one else will save the NHS. It must be a mass campaign.

If the reader wants to read more about Bevan please read, a chapter from Nye Bevan’s book.

Organise in each ICS area to challenge the cuts, challenge the syphoning-off of our healthcare finances by private companies. Mobilise the unions and the communities. Demand world-class publicly owned and provided social care. Renationalise the NHS! Lobby all MPs and Councillors

This leaflet was produced by Cheshire and Merseyside Coordinated  Healthcare Campaign, which involves local Trades Councils, Union branches, Health Campaign Groups, including Save Liverpool Women’s Hospital, Defend our NHS, Keep our NHS Public, (both Merseyside and Cheshire) and individuals. We work with many other campaigns nationally.