A message from Sharon Graham General Secretary of Unite the Union
Picture Credit Morning Start Neil Terry
“Friends
What women know from the generations that came before us – from those who stood up and fought for the right to work, good pay and conditions – is that we don’t get what we want just because it is the right thing to do. We have to fight for it.
The Liverpool Women’s Hospital is one of those fights. A jewel in the crown of the NHS that is under attack. A lifeline for women, babies, and families across the North West. It is the sole specialist trust of its kind in the UK, delivering vital care and support.
So of course, I join you in fighting for this institution and rejecting any attempt to dilute or dismantle these services.
And we know that this fight is part of a bigger battle to save our NHS from the forces of capitalism and austerity that have been waged against it for many years.
Never forget – this is a battle we cannot afford to lose.
So be assured – Unite stands with you – everyone here rallying to protect this fantastic institution. Liverpool Women’s Hospital must remain as a beacon for women’s healthcare. We must fight to save it. We must fight to save our NHS. And we must win.
We are not stopping until we win back the full NHS, a health care system that properly values our babies and us as women. For all our mothers, daughters, friends and lovers and for every precious baby.
The latest blow to the future of Liverpool Women’s Hospital is the announcement of a joint chair with the Liverpool University Foundation Hospital trust (this is the merged Royal, Aintree and Broadgreen Hospitals). There was no mention of this at the last Liverpool Women’s Hospital Board meeting held in public, nor at the ICB meeting. Where are these decisions being made?
It is farcical that such an appointment is even considered. Women’s services must be prioritised and maternity must be led by people with deep experience in this matter. It cannot be an afterthought to a huge recently merged hospital system.
What has been and is still happening in maternity nationally can no longer be tolerated. A merger with Liverpool’s big merged hospital will not address these issues. The major reports on these issues are authoritative and powerful. The Government’s tactics are to publish and ignore the reports or issue a series of directives that are not backed by finance or staffing.
Maternity has not been given priority in the big merged hospitals, so favoured by this government. Women’s health has not been given its due importance in these merged hospitals either. We have previously quoted the mantra of the priorities for operating theatre as being Life, Limb, and Testicles.
Following Shrewsbury, the site of the first Ockendon report into unnecessary baby deaths, the NHS hospitals had to be told to have a maternity rep on each board. Maternity must not be a second-class, Cinderella service. Ockendon and other reports have shown how deeply damaged NHS maternity has become in this era of bureaucratic management. The reports describing the problems in these services are detailed, authoritative, and ignored. The Birmingham Hospital regularly hyped as the model by those who wish to merge Liverpool Women’s Hospital with the Royal/LUHFT was recently described as showing misogyny and medical patriarchy
We campaign for the restoration of the whole NHS, to get it back from the big corporations and their advocates who are damaging it. Maternity and women’s health issues need to be embedded into the whole health service, damaged as it is, and given greater, not less priority.
We campaign for Liverpool Women’s Hospital as
a women’s hospital,
a provider of services in the community,
a maternity hospital, and
a maternal medicine center,
an NHS hospital, publicly provided for everyone free at the point of need, linked to the whole national health provision,
and an excellent employer.
We have held three demonstrations, gathered more than 73,000 petition signatures, run stalls, attended meetings, gained the support of Kim Johnson the local MP, and others, had resolutions agreed upon at Liverpool City Council, gained support from local and national trade unions, met with the ICB, attended LWH board meetings for many years, run this blog and social media, attended academic and campaigning conferences, put up banners and posters and worked with many other campaign groups. All this, it seems is not enough to gain consultation.
The background to our struggle is both the damaging political reorganisations in the NHS and the consequential maternity scandals that have rocked this country. The dismantling of the NHS, transforming it into a for-profit system, and hence for the adoption of the American Accountable Care system, known here as the ICB (It is used in the US to administer second-class, state-funded healthcare). The private companies administering this get their huge profit by denying care). In the UK, it means fewer hospital beds, fewer staff, closed and merged hospitals, and money being the driving force in service provision. For more details see an earlier post here.
Despite promises both verbal and written of consultation, there was an announcement this week, without consultation with the public, that the chair of Liverpool Women’s Hospital is to be advertised as a joint position with the chair of Liverpool University Hospitals Trust. It was announced to the staff of LUHF T today and in a letter to some others.
Liverpool Women’s Hospital is the largest maternity Hospital in England. It is a maternal medicine centre and a referral hospital. It is a unique Women’s Hospital providing care for women at a time when women’s health is suffering. It provides care for some of the most vulnerable women and babies.
Like all maternity care, it has been underfunded and reorganized to fit the government’s ideology. Even when it meets the government’s staffing ratios we firmly believe that is insufficient for high-quality care.
Maternity nationally is a service struggling with cuts, poor reorganizations, staff shortages, poor working conditions, poor pay and staff attrition.
Two-thirds of England’s maternity units are dangerously substandard says the Care Quality Commission
CQC says too many mothers and babies receive care that is not good enough, with staff shortages among the reasons.
Almost two-thirds of maternity units provide dangerously substandard care that puts women and babies at risk, the NHS watchdog has said in a damning report.
The Care Quality Commission (CQC) has rated 65% of maternity services in England as either “inadequate” or “requires improvement” for the safety of care – up from 54% last year.
Services are beset by a host of problems, including serious staff shortages and internal tensions, which mean that too many mothers and their babies receive care that is not good enough.
Liverpool Women’s Hospital also had a highly critical CQC report, and this was despite the hard work of its staff. The UK does not match other developed countries in infant mortality or maternal mortality.
The board at Liverpool Women’s Hospital spoke about challenging the CQC report describing all their efforts to keep to regulations. We say in challenge to this that the regulations do not in themselves keep babies or women safe. That requires respect for women and babies, sufficient staff and good working conditions.
The CQC report on Liverpool Women’s said
“Liverpool Women’s NHS Foundation Trust is a specialist trust that specialises in the health of women, babies, and their families. It is one of only two specialist trusts in the UK and the largest women’s hospital in Europe. As a tertiary centre the hospital provides care for a significant proportion of patients with high levels of complexity and clinical risk, as well as serving a local population with significant deprivation. The hospital teams deliver around 8,000 babies and perform some 10,000 gynaecological procedures each year.
The trust is situated in an area where 44% of the population live in the lowest quintile for deprivation in England. 26% of children (0-15 years) live in poverty. The region performs significantly worse for premature cancer, cardiovascular disease (CVD) and respiratory deaths. 46% of women booking with Liverpool Women’s Hospital are from the 1st decile on the deprivation index, compared to a national average of 13%
The CQC report said
Following our inspection, we issued a warning notice requiring the trust to make significant improvements.
The trust must assess and do all that is reasonably practicable to mitigate risks to the health and safety of women, birthing people, and babies. Regulation 12 (1)(2)(a)(b) This includes but is not limited to:
Timely and effective triage of women and birthing people
The trust must ensure they deploy sufficient, suitably qualified midwifery staff across all areas of the service. Regulation 18 (1)
Assessing, documenting, and responding to ongoing risks to the safety of women, birthing people, and babies at allstages of pregnancy in line with national guidance Our findings 5 Liverpool Women’s NHS Foundation Trust Inspection report
The trust must ensure staff are up to date with mandatory training. Regulation 12 (1)(2)(c)
The trust must ensure there are sufficient numbers of suitably qualified, competent medical staff to deliver the service and reduce delays in medical review in maternity triage.. Regulation 18 (1)
The trust must ensure it operates effective systems and processes to assess, monitor and improve the quality ofservices and mitigate the risks to women, birthing people, and babies. Regulation 17 (1)(2)(a)(b) This includes but is not limited to:
The reporting and management of patient safety incidents
Receiving and acting on feedback from women, birthing people, families, and staff
Operating robust governance processes
Taking action to improve perinatal mortality rates
Taking timely and effective action to address risks and improve performance
Operating a robust risk register, with effective mitigation and controls and updated action plans
Collecting reliable data to analyze and improve performance
Operating effective audit processes
The hospital does indeed spend time keeping to regulations, juggling how and where it uses staff.
Birthrate Plus is not enough. It is though,our view that the basic government criteria are inadequate. We need more than that, especially but not exclusively in the areas of high deprivation.
Maternity needs to be able to win back some of the staff who have left, to keep the newly qualified staff, (and LWH do seem to be doing that), to be generously funded, and to be able to provide care at least as well as other advanced countries. Once we were the best health service in the world… We can be that again.
Sharon Graham from Unite the Union said at our demonstration on October 7th,
October 7th demonstration to Save Liverpool Women’s Hospital
“What women know from the generations that came before us – from those who stood up and fought for the right to work, good pay and conditions – is that we don’t get what we want just because it is the right thing to do. We have to fight for it.”
Our campaign will continue. Please join us in fighting for Women’s health, and maternity and for the restoration of the NHS as a publicly owned, publicly delivered, not-for-profit health system.
Thank you – it’s a pleasure to be here today and I would like to thank the organisers for giving me the opportunity to talk about what’s happening to our NHS.
We’re all here because we believe in the NHS as a:
comprehensive
Universal
publicly owned
and publicly delivered service
and because we know we must fight for its future.
We know that the NHS is in crisis – and it’s a crisis of the government’s own making.
Waiting lists for routine treatment recently hit record highs of 7.68 million.
And there are well over 100,000 staffing vacancies across the NHS.
Many nurses, midwives, doctors, ambulance workers and other dedicated NHS staff are over-stretched and facing burnout.
Meanwhile, the government continues to underfund the service and increase opportunities for private health companies to make profits off the back of people’s ill health.
The Tories’ undermining of the NHS is a political choice – and they are being found out.
Earlier this year, the highly respected Professor Sir Michael Marmot said:
“If you had the hypothesis that the government was seeking to destroy the National Health Service…all the data that we’re seeing are consistent with that hypothesis.”
When asked if we are stumbling or sleepwalking towards a privatised health care system, he added that government ministers are “not behaving as if they want to preserve our NHS.”
That is a damning indictment of the Tory government.
We should not be surprised, because, the truth is, the Tories have made no secret of their desire to privatise the NHS over decades.
In 1988, John Redwood and Oliver Letwin wrote a pamphlet which has been seen by many as a blueprint for the privatisation of the NHS.
Fast forward 20 years to 2008 and Jeremy Hunt, now the Chancellor of the Exchequer, co-authored a book which included the line: “Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of healthcare in Britain.”
The Tories have two tactics when it comes to destroying our NHS.
One is to legislate to open it up to greater privatisation, and the other is to starve it of funding.
One of the key measures in the 2012 Health and Social Care Act was to allow NHS Foundation Trusts to, in effect, earn 49% of their income from treating private patients.
This is wholly unacceptable.
The 2022 Health and Care Act created 42 statutory Integrated Care Boards and Integrated Care Partnerships.
The latter are able to include representatives of private companies, yet they are tasked with preparing the integrated care strategy for an area.
This integrated care strategy sets out how the assessed needs in relation to an area are to be met by the exercise of functions of the Integrated Care Board, which is the commissioning body.
This is outrageous.
There should be no private interests influencing where public money is spent on health and care.
And there should be no room for conflicts of interest.
ICSs have been designed to be vehicles for cuts.
In May, it was reported that ICSs will have to make average efficiency savings of almost 6% – the equivalent of £6 billion across England – to meet their financial requirements this year.
For Cheshire and Merseyside, the ‘efficiency’ target for this year is 5% – or £57.9 million.
How can the NHS in Cheshire and Merseyside make cuts of £57 million when waiting lists are sky-high and there are insufficient staff?
How can the needs of patients be met?
The simple answer is: they can’t be. And they can’t be because of political choice.
It doesn’t need to be this way.
If the government continues to underfund the NHS, increasing numbers of patients will be left, in pain and anxiety, without treatment.
And some will be so desperate they will pay to go private and pay for services which they are entitled to receive free of charge on the NHS.
So I want to finish with this:
Our NHS is in jeopardy.
The government is starving it of resources – and patients and staff are paying the price.
The next government must prioritise the NHS by giving it the significant increase in funding that it needs, and it must put an end to privatisation.
Without a commitment to the NHS as a well-resourced public service, our NHS will not survive.
So it’s vital we continue our fight to save our National Health Service.
I would like to thank each and every one of you for keeping the faith and keeping up the fight. Together we can – and will – save our NHS.
Mary Whitby – contribution at the SLWH rally at the Old Stone Arch, 7 October 2023
Good afternoon
I wanted to dispel some myths.
Mary describes whats happened to the NHS
The NHS is not overwhelmed because we are all using it too much or because of so-called bed blockers nor because we are an aging population – we didn’t just beam down from Mars overnight!
Nye Bevan said our ill health is not a commodity from which they should profit and yet even our our health records are up for sale.
Its not overwhelmed because we cannot afford to run a first class health service for all nor because of covid, asylum seekers or migrants nor because staff have had enough of a decade of pay cuts and have decided to take industrial action.
Mary Whitby making our case with Sharon Graham General Secretary of Unite the Union
So that’s just some of the myths.
The private sector lobbyists are funding political parties and politicians and so those parties make their policies reflect the demands of those private profiteers. Managers and politicians, including on the left, have been told the restructuring of the NHS was necessary as a response to supposedly changing needs. Labour complain its just a matter of low resources.
These myths serve to drown out the reality that the NHS has been carved up and shrunken to open up the space for the private sector to benefit.
In order to make money out of the NHS, providers take contracts to provide shrunken services at great cost to the public purse, employing fewer, less qualified staff, on lower pay hence why there are 130,000 unfilled vacancies.
When our NHS filled the space and our needs were met, we didn’t need to bother with the private sector, why would we pay again for something when we had the NHS which provided what we needed for free when we needed it?
So the private sector couldn’t get a foothold. They couldn’t compete with district general hospitals and family GPs. Successive governments of all parties have played their part in the break up of the NHS, allowing privateers to be embedded inside the NHS remodelling it
Worst of all we never voted for this
So that visual demonstration – if you shrink the NHS it stands to reason it can’t treat as many people as it did before. So even if we didn’t grow older, didn’t have any more babies then the NHS could not cope. They have closed tens of thousands of beds, closed hospitals and 125 A&Es so it is no wonder there are queueing ambulances, trolleys in corridors, people waiting 24 hours in A&E, virtual wards, people unable to get a GP appointment or a scan or 7.7m people suffering on waiting lists.
This is what we mean when we talk about the denial of care.
It is not the NHS model which can’t cope though, it’s the 42 separate American Integrated Care Systems which have caused this crisis which is set to worsen again this winter.
What does 7.7m people on waiting lists look like? If you add up all the populations of the 14 biggest cities in the country then it still doesn’t add up to 7,700,000 people! (Since writing this speech that figure has increased to 7,800,000 people)
To demonstrate how the NHS has been undermined, I have an assistant to help, he will stand over there away from the electrical equipment because I don’t want to be responsible for blowing up the mics and sending the Fans Supporting Foodbanks gazebo up in flames! – imagine there is a pint of beer in this pint glass.
What happens if you try to pour a pint of beer into a half pint glass?
Yes! It overflows because it’s a physical impossibility to fit the same amount of beer into a glass which is half the size and so it is with what’s left of our health service. There are the same amount of patients but the capacity of the NHS to meet our needs has been drastically reduced.
So all the beer overflowing from the glass represents the 7.7m people on waiting lists, it represents all the public NHS funding which never reaches frontline services or staff pay packets but is siphoned off into private pockets, its the staff leaving the NHS, it is all those people who die unnecessarily every week, it represents all those people forced to get into debt and go private to get the medical care they desperately need.
Health is a multi billion dollar commodity and our ill health will be bought and sold if we don’t fight.
In the 5th richest country in the world, we can afford a high-class NHS. In fact, we can’t afford not to have one unless we want to pay with our lives and the lives of the generations to come after us.
So we want you to join our movement to raise awareness in your friends, family, and workplaces in your union branches and communities, have those conversations, spread the word and encourage everyone to become active. As Nye Bevan said the NHS will last as long as there are people willing to fight for it.
We need more midwives, more midwives and to keep the midwives that we have now.
Rebecca Smyth spoke at the demonstration to Save Liverpool Women’s Hospital on Saturday, October 7th. We had excellent weather and a good turnout. We will be publishing all the speeches.
Hello everyone,
I worked for 35 years as a midwife, and a nurse before that. I’m also an active member of Save the Liverpool Women’s Hospital Campaign group.
I’m wanting to tell you what is happening in midwifery and maternity care. I’ve never known a time when Midwifery is under such threat. Midwifery is a profession almost entirely of women, providing care for women and here we are outside the Liverpool Women’s Hospital and all 3 are at risk; the midwives, the women AND the hospital.
Let me tell you how it is in midwifery now and about the crisis in maternity and why I believe the moving of the hospital will worsen the situation for Midwives and of course the women, babies and families that are cared for.
Now our understanding at the moment is that the hospital will move to the new Royal Hospital site…. Can you imagine that?! And we are campaigning to keep the hospital here.
To understand how catastrophic this is, I want to tell you about the crisis in maternity that we’re experiencing now.
Well in a nutshell there aren’t enough Midwives, the official figures say we are 3,500 short. If you haven’t got enough midwives then the services you provide are not safe.
Without midwives childbirth is at risk,
without midwives families are not safe,
without midwives women don’t get the care they need and deserve.
Because, how can you give safe care when they’re just aren’t enough of you?
And why aren’t there enough midwives?
Well, Midwives are leaving in their droves; and that’s because morale is at rock bottom, midwives are overworked and completely exhausted. They are working in an environment that often isn’t safe. So, many leave… either retiring early (like me), reducing their hours, changing careers completely, or leaving for no job at all.
And the reasons they are giving are insufficient staff numbers, burnout and stress.
Rebecca speaking from the Fire Brigades Union Campaign wagon
They are literally on their knees.
The consequence of this, is that there is not one maternity unit in the country that is adequately staffed. That’s every day, that’s today, that’s now.
Not a day goes by when we do not hear about a maternity unit closing its doors and women being sent to other hospitals. Did you ever imagine the day would come when you would hear that a hospital closed its doors? That is what shops do, that is how businesses are run. Yes, businesses…. There’s a thought?
I talk with midwives and they tell me they are frightened, imagine going to work and being frightened, frightened because they’re so short-staffed. They are frightened that they’re going to harm a baby so the child never reaches their true potential, never has the life they should have, and even worse the baby dies. I’m talking about avoidable deaths. And women too, the thought of harming a women you are looking after is horrendous.
Rebecca protesting for more midwives
How can we expect people to work in this way?
One midwife said to me recently “I’m leaving before my PIN is taken off me”. Your PIN is your unique number which we all are given when we qualify. So, in other words, she left because of fear of being removed from the register. She was worried that something awful would happen on her shift, not because of her own wrongdoing, but because there aren’t enough midwives. It’s just not safe.
And the staffing numbers are getting worse, year on year … for the last few years we’ve been losing around 300 midwives per year, however the latest figures (reported last year/2022) are in fact worse and shows a loss of 677 midwives in a twelve month period. We cannot lose this many!
And if you think the solution is to train more midwives it’s not as easy as that. In order to increase the size of the workforce by just one full-time midwife, we need around 30 student midwives graduating. That’s because so many of midwives are leaving. It’s the leaky pipeline effect.
Now as well as midwives leaving because of safety concerns, there’s also a problem because we’re an aging workforce – Almost a third of midwives are in their 50’s and 60’s. These by definition are the most experienced with the most expertise, but inevitably they will all be retiring soon, so we could lose a third of our workforce in the next 5years. And this is the reality….if you lose 10 midwives each of them with 30 years experience then you lose 300 years of experience. That cannot be replaced with 10 newly qualified midwives. Fabulous as they’ll be but compare 10 to 300.
Also, if you keep on increasing the student numbers (which has been done recently), as we stand there are not enough lecturers to provide the teaching, not enough clinical placements to take them, the classrooms in universities aren’t even big enough! And not enough qualified midwife mentors or assessors to teach the students in the clinical area.
It’s catastrophic what is happening now and getting worse.
Maternity care is in crisis.
And too few midwives is a political decision. But it is the clinicians that get the blame when things go wrong, it’s the clinicians who end up in court, not the government.
It’s not an easy listen I know and I’m certainly no scaremonger, but it’s now come to such a crisis that we all have to face the current situation we are in regarding the care we are able to provide pregnant women.
Remember in midwifery we have two patients, not just one.
I’m sure many of you will have heard and read about the terrible scandals in maternity. Unnecessary deaths and harm to women and their babies. The impact is heart-breaking and devastating. Recently, there have been a number of very high-profile large investigations which have included many women and their babies. What was prominent about the Reviews was the catastrophic shortage of midwives as well as obstetricians and the lack of support for junior staff (midwives and obstetricians) and delays in appropriate review of care. All to do with the shortage of staffing.
So, Midwives (and doctors) haven’t all of a sudden become unkind, haven’t all of a sudden become uncaring, or incompetent. There just aren’t enough of them.
And here is why I believe moving this hospital to what looks like the New Royal’s site will not be of benefit to women, their families or the workforce
I believe keeping the hospital on the Crown Street site is a safe and viable option. Just recently the hospital has had their Care Quality Commission investigation. This is a routine assessment for all hospitals. The Report gives no indication that women are at risk due to the hospital being on Crown Street. The report does though identify poor staffing of midwives and obstetricians. Staffing will not improve if the hospital is moved.
What the hospital needs now is more midwives, more doctors, not closing down.
And something that always always needs saying, as many people I’m sure don’t know. Black women are nearly 4 times as likely to die in childbirth than white women. Asian women nearly twice as likely. Suicide in pregnancy is escalating, maternal deaths also on the increase. This is where the discussions need to be focused, this is where the energies of the Cheshire & Mersey ICB need to be focused.
These are the issues that need addressing, not how to close and move a hospital.
Everything I’ve said has all been the result of political decision making. Not a consequence of the NHS not working, the NHS is wonderful. It’s not broken it’s BEING broken. PURPOSELY.
We can’t let this cruel, nasty, evil government destroy lives. They are literally getting away with murder.
And its complicit ‘opposition’. They too are all literally getting away with murder.
Our campaign aim is clear. No closure. No privatisation. No cuts. No merger. Fully fund our hospital. And keep it on its Crown Street Site as a hospital dedicated to Women and Babies.
Greg Dropkin was one of the speakers at the recent wonderful Save Liverpool Women’s Hospital Demonstration on October 7th 2023
This is his speech. It was first published on labournet.net
The NHS is being privatised. To illustrate how, I’ll focus on two companies: Optum and EMIS Health. The Competition and Markets Authority has just authorised their merger, with Optum buying EMIS.
Optum is owned by the biggest US health insurance corporation, UnitedHealth, with an annual turnover of $324 billion. UnitedHealth has been fined over $1.1 billion for 374 violations of US laws. Optum paid Ohio $15m for overcharging the Workers Compensation Board for generic drugs. California and Arkansas are suing Optum and other Pharmacy Benefit Managers and pharmaceutical companies for wildly inflating the price of insulin.
Here, Optum has contracts with at least 19 Integrated Care Boards, and EMIS, formerly Egton Medical, has 30.
Cheshire and Merseyside ICB pays Optum for prescribing software, and EMIS for primary care hardware and software. EMIS manages patient electronic records in GP surgeries, community and hospital pharmacies. The merger means UnitedHealth subsidiaries will be active all across England, including in medicines management.
The US parent could also gain information derived from patients’ confidential medical records.
Optum and EMIS are accredited under an NHS England scheme to fast-track firms to develop integrated care. Contracts can be dished out to pre-approved companies. Optum’s accreditations include “sharing structured medications data for uses such as population health management, medications reconciliation, and decision support”. That’s despite Optum being sued for rigging the price of insulin, and overcharging for generic drugs.
Meanwhile, the notorious management consultancy PwC with a string of fines for accounting fraud, advises Cheshire & Merseyside on how and what to cut.
In their first year, Integrated Care Boards spent at least £6.4bn on private companies. NHS Trusts funded by ICBs have their own private contracts. In our region, around 27% of the ICB budget ends up with private firms, either directly or via the Trusts. North East and South East London are even worse.
How did we get here? Back in 2014, the Coalition government appointed Simon Stevens as NHS England Chief Executive. With no mandate from Parliament, NHS England introduced Accountable Care Systems based on a US funding model promoted by health insurance firms and consultancies including UnitedHealth and PwC. In 2018 it rebranded them as Integrated Care Systems. Last year, the Health and Care Act legalised what NHS England had already done. Systems have their own budgets, set using a Payment Scheme which can vary for different areas, providers, or types of patients. Private companies are consulted on the details.
The national health service is broken into 42 pieces. By destroying the national NHS economy, this could threaten national pay, terms and conditions, or staffing levels. Before Stevens was appointed to run the NHS, he was president of UnitedHealth Europe, CEO of its $30 billion Medicare business, and president of its global health businesses.
Before working for UnitedHealth, he advised Blair.
We all want the end of this vicious Tory government. But where is Labour? From Thatcher onwards, all governments have damaged the NHS. Most PFI hospital schemes, including the Royal Liverpool, were signed off under Labour. Blair’s government changed the rules on ownership of GP surgeries, enabling UnitedHealth and later Centene to take them over.
Independent Sector Treatment Centres were paid even if no treatment was given. Some clinical services went out to tender.
Canning Street
When the banks collapsed in 2008, Gordon Brown asked the US management consultancy McKinsey how to cut NHS spending. They said massive efficiency savings, dropping certain NHS treatments, and moving services out of hospital could save £15 – 20 billion per year. When Labour enacted their plan, the NHS funding crisis began.
Labour disowned Blair for invading Iraq, but never repudiated what Blair, Brown, Milburn, Reid, and Hewitt did to the NHS.
With rare exceptions, Labour accepts or embraces the current fragmented and part-privatised landscape. But it’s a disaster, and it’s not what we want.
We want the repeal of the Health and Care Act, and the NHS restored as a national health service. We want comprehensive, universal healthcare, publicly provided, publicly accountable, fully funded through progressive taxation, free at the point of need, with decisions on treatment taken on clinical grounds without regard to ability to pay.
That’s what we want, but whether we get it depends entirely on whether patients, healthworkers, and trade unions stand up to fight for it. I hope we’re ready.
Our NHS has been sliced up into Integrated Care Boards designed to deny care, close hospitals and pump money out of health care into private companies. Even the best-intentioned workers in these organisations cannot alter this fundamental design intention. You can’t make a silk purse out of a sow’s ear.
We, as campaigners in Cheshire and Merseyside, from different organisations and different parts of the area are determined to win back a publicly owned, publicly delivered, national health service for everyone. Every time an additional person is interested or involved we get a step closer to winning back our NHS.
The first step to save the NHS is to talk about what is really happening.
Public support for our stalls
Money spent on patient care repays itself rapidly and many times over. Poor healthcare cripples us and cripples the economy.
July’s 2023 ICB meeting, The people around the table listen to reports and decide on issues. The public sit and listen!
ICBs are not integrated, they are not improving care, and are making treatment harder to access. Millions are on the waiting list.
These are some of the questions we have sent to the NHS board meeting on September 28th. There are many more we could have sent.
Questions about Liverpool Women’s Hospital Appointment of a joint chief executive with Liverpool University Hospitals NHS Foundation Trust.
The problems patients and staff see at Liverpool Women’s are down to staffing and funding
We sent an earlier question soon after the announcement of the appointment of the joint Chief executive.
Question about the decision to share a Chief Executive with Liverpool University Hospitals Foundation Trust.
“What was the timeline for this decision and what role did the ICB play in it? Why was the women’s committee of the ICB not involved, or if it was, why were we told the opposite?
Please point us to the paper trail for making this decision.
Was the person spec for the original role also applied to the joint role?
Why was this not considered through ICB papers or meetings? Why was the public not consulted?
Why were representatives of the Campaign to Save Liverpool Women’s Hospital misled at a meeting that representatives of the board invited us to?
Can you provide reassurance that the well-documented difficulties at LUHFT are now so well under control that the management can take on responsibility for the largest women’s maternity hospital in the country without detriment to Cheshire and Merseyside’s women and babies?
(Page numbers reference relevant sections of the Board papers).
Page 86 Why is the continuity of care model still being recommended after Ockendon?
Page 144. When did the Women’s Committee meet? When is its next meeting? Where do we find minutes?
Page 172 What steps are being taken to ameliorate these risks?
Page 268 Maternity. Given the severity of maternity issues locally and nationally why is this section not more detailed?
Page 280 Liverpool Women’s Hospital is in Level 3 for financial concern yet cannot afford to provide full time consultant care at the Hospital. When will the ICB address the inadequacy of NHS funding for maternity as mentioned by Ockendon and other reports?
Page 327 Partnership board “including independent healthcare providers” Who are these organisations involved with the partnership board? What will their role be? Will they have voting rights?
Question about the money for Hospitals this year.
Re the expected CIPs (plus making good non-recurrent savings from last financial year).
From which areas of expenditure are you expecting trusts to make these “cost improvements”?
Final decisions within the set budget must rest with Trusts but in your planning for these targets, you must have scoped the possibilities of savings against increased risk to patients and staff.
How have you come to the conclusion that this level of CIPs is feasible? How have you ensured this is safely achievable?
Are staff numbers protected?
Are staff wages protected?
Is staff workload protected?
Is safety-critical equipment protected?
Will the number of patients be expected to fall?
Will certain treatments be limited?
How will these cuts be risk-assessed ?
Which vacancies will be filled?
Will hospitals already experiencing Opel 3 levels of difficulty even in the summer/early autumn still be expected to make cuts? (We hear from the health service journal that LUHFT ).
Questions about big US-based health corporations’ involvement in the ICB and the privacy of our most intimate records.
Board meeting
“The ICB holds a contract with Optum, concerning prescribing. In the US, Optum has been fined millions of dollars for violating laws on pricing of medicines. California charged Optum, other Pharmacy Benefit Managers and pharmaceutical companies with collaborating to rig the prices of Insulin. Optum is owned by UnitedHealth, the largest US health corporation, and is expected to merge with EMIS Health.
a) what due diligence did the Board conduct before awarding a contract to Optum?
b) how will a merger with EMIS affect prescribing policy?
c) how will the Board prevent UnitedHealth gaining access to individualpatient medical records?”
Questions about Covid.
PIcture credit to MJHIBLENART
Hello,
I would like to put the following to the forthcoming meeting of the ICB.
How is the ICB preparing for Covid this winter?
How will hospitals make preparations
given they are expected to make large cuts(CIPS) as described in the board paperwork.
given there are so many hospitals already on Opel level 3 in summer and early Autumn.
given Staff shortages and unfilled vacancies.
and given the number of NHS staff relying on food banks, suggesting weakened responses.
I refer you to the recent enquiry hearings which showed how badly the country was prepared for the first wave, with hospital infrastructure poor. SARS-CoV-2 frequently mutates and causes waves of infection and is to some extent seasonal. It is normal for The NHS to watch levels of Flu infections in the Southern Hemisphere Winter to plan for our Northern Hemisphere Winter infections. It would seem sensible to follow Covid levels similarly. Australia had a large and extended wave in its last winter, as reported in the BMJ 2023; Covid-19: Australia’s future policies will be evidence led after “profound impact” of latest wave, says minister.
How have you taken account of the Australian experience in your preparations for this winter?
I look forward to your response,
What is public, what is private?
Another campaigner has asked
I notice that agendas of C&M ICB meetings in public do not seem to include information about any private sessions that exclude press and public, and their agenda items – although other ICBs, such as West Yorkshire ICB, routinely do so.
Please would you let me know why this is? And does C&M ICB have any plans to include private sessions and their agenda items in the Agendas for future C&M ICB meetings?
This would be in the interest of public transparency, as it shows what topics the ICB is discussing and making decisions on in private, while still retaining confidentiality/privacy regarding the topics that are the subject of these private sessions.
Are you now going to tell the people of Cheshire and Merseyside the truth about what is being done to the NHS?
Given that:
the Cheshire and Merseyside integrated care system is set to carry out £58m CIPs (Cost Improvement Plans = cuts) this year, the various NHS Trusts and Foundation Trusts plan to achieve (i.e. cut) a further £331m in CIPs, and the ICS is expected to lose £350m funding in the next few years (according to the Review of Liverpool Clinical Services commissioned by the ICB); and that:
– the impact of these cuts will be to inflict further damage on people’s lives on top of a decade of cuts in access, beds, available staff; and that:
– the forty-two integrated care systems are modelled closely on the American accountable care system and their establishment dealt a death blow to the irreplaceable and effective (before deliberate cuts, fragmentation and privatisation) NATIONAL health service; and that:
– some Board members apparently took an oath to “first do no harm” (not to “first look after the bottom line” or “follow a plan devised in Minneapolis” or “allow patients’ data into the hands of a CIA operative”); and that:
– the public do not want a privatised system:
are you now going to tell the people of Cheshire and Merseyside the truth about what is being done to the NHS?
At the start of this post, we wrote “The first step to save the NHS is to talk about what is really happening.” Well, there are some more exciting things to do too including come to ur demonsration on 7th October in Liverpool:
The ICB is the body controlling healthcare spend and policy in Merseyside and Cheshire, one of 40+ such organisations across the country.
To: Cheshire and Merseyside Integrated Care Board
We are residents of Cheshire and Merseyside, who use the NHS and are strongly in support of its founding principles as a comprehensive and universal system of healthcare, publicly provided, publicly accountable, publicly funded through taxation, free at the point of need, with decisions on treatment taken on clinical grounds without regard to ability to pay.
We note the Board’s strategy to carry out £58m CIPs (Cost Improvement Plans = cuts) this year, and for the various NHS Trusts and Foundation Trusts to achieve (i.e. cut) a further £331m in CIPs in an already crisis-ridden service. The Board’s own reports indicate how severely poverty affects health and healthcare affects poverty. Such cuts represent a danger to life and limb in our communities.
We are writing to you as members of the Integrated Care Board which has responsibility for the functioning and budgets of the NHS in our region, to raise issues of public accountability and transparency.
We call on you as a matter of urgency to:
1) rescind the plan, announced by the Chair during the 27 July Board meeting, to hold unspecified but regular meetings of the Board in private;
2) ensure, in line with the ICB Constitution (clause 7.3.1), that all meetings of the Integrated Care Board are held in public unless there is a specific resolution to “exclude the public on the grounds that it is believed to not be in the public interest”. In any such case, we call on you to publish the resolution and the reasons why the specific meeting cannot be held in public;
3) ensure that Board papers for each meeting of the Integrated Care Board are published a week in advance of the meeting so that the public has time to read them and submit questions within the deadline;
4) publish a full list of members of all committees and subcommittees of the ICB, and of all bodies receiving delegated powers from the ICB;
5) publish regular reports from all committees and subcommittees of the ICB, and of all bodies receiving delegated powers from the ICB.
We regard these as minimum standards for transparency and democracy.
This has been signed by more than one hundred people.
Good health care makes a country richer, healthier and happier. It is an excellent investment. Good healthcare gives exceptionally good returns for each pound spent, both financially and socially. Good healthcare gives babies a great start in life, saves the lives of babies and the health of their mothers, and prevents long-term damage to health.
Universal healthcare free at the point of need, run as a not-for-profit, national system, and publicly delivered is by far the most economical and cost-effective way of delivering healthcare. This is the original NHS model.
Good pay for healthcare workers helps the health system work well, helps the economy grow, protects the physical and mental health of the workers, reduces the need for means-tested welfare and reduces poverty. It also says to those workers, your work is valuable, essentialand complex requiring great skill and an abundance of care. Good pay should be a way of saying thank you to medical and healthcare workers.
Good healthcare grows the economy, helps sustainability. It is not a drain on the economy.
Market-based healthcare, as seen in the USA and as being sneaked into our NHS, makes corporations wealthier and happier and damages our health, our society, our communities and the economy.
“NHS will be just a memory!” one young woman said as she signed our petition.
Why is the health service starved of funds? Why is money haemorrhaging out of it into private companies?
There are intertwined issues making up the background to the threats to Liverpool Women’s Hospital. This list does not imply an order of priority; each issue is important in itself:
1. The chronic neglect of women’s health issues for many years, as well described in many reports, culminating in the Government’s Women’s Health Strategy which says:
The Women’s Health Strategy promises to address the poor experiences and worse health outcomes that women endure. The underlying cause of these issues is that the health system has historically been built by men for men. Consequently, women are often not listened to or believed by the health and care system. So, the crucial question is, will this strategy change the culture in the NHS of women not being listened to about their health and wellbeing?
2. The acute underfunding of healthcare which leaves hospitals struggling and their management focussed on balancing the books.
3. The Maternity Crisis. The experience of giving birth is deteriorating as cuts bite. Our Midwives and other maternity staff strain every sinew to provide good maternity care but there are too few midwives, too few obstetricians and gynaecologists. They are overworked and underpaid. The country is short of midwives “Midwives are being driven out of the NHS by understaffing and fears they can’t deliver safe care to women in the current system, according to a new survey of its members by the Royal College of Midwives (RCM)”. Maternity is underfunded. The maternity tariff (the money the government allocates to maternity) is inadequate.
Even this week there were further reports of problems in maternity care “Leaders of two maternity services have been told to take urgent action, after inspectors found understaffing and declining levels of care, despite safety warnings from midwives.
Maternity services at University Hospital North Durham and Darlington Memorial Hospital have been downgraded from “good” to “inadequate” in Care Quality Commission reports, published today. The CQC noted a “concerning deterioration” in the care the two services provided, despite midwives telling managers they felt the service was unsafe.”
We can see the terrible maternity scandals. Our love and sympathies to all the babies, mothers, fathers and families involved and all the staff who did their best to challenge the situation. We honour you in our fight for a better health service and better care for maternity and women’s health.
4. The pattern of concentrating resources in big hospitals which, until the Ockendon Report did not even have to have a Maternity Champion on their Trust board. A big hospital does not cause the deaths, nor does that model prevent these tragedies. Respecting women, respecting the working classpeople, respecting ethnic minorities, respecting patients and the public all would help prevent these deaths, and we see precious little of that in the situation in Liverpool, Cheshire and Merseyside.
5. Money. Maternity care is nationally underfunded but no other hospital has such a large part of its income dependent on the maternity tariff so this affects particularly Liverpool Women’s Hospital.
6 Staffing problems, caused by poor pay, underfunding, using vacancies as a way of saving money and by staff leaving maternity nationally because of unmanageable work pressures and poor pay.
7. The cost of the Foundation Trust administration requirements.
8. Underfunding which denies the Liverpool Women’s Hospital the full range of intensive care services, requiring about eight women a year to be transferred one mile away to Liverpool Royal for intensive care. Many women are transferred into Liverpool Women’s Hospital as well. Transfers between hospitals are routine but complicated by the internal market in the NHS and of course years of underfunding.
9. The difficulties in cooperation between hospitals as imposed on the NHS by the 2012 Health and Care Act where hospitals were supposed to act like competing companies in a market, rather than components of an integrated and cooperative national service.
10. The huge waiting lists for treatment.
The British Medical Association (BMA) says “…around 7.68 million people waiting for treatment, an increase from the previous month; nearly 3.18 million of these patients waiting over 18 weeks; around 390,000 of these patients waiting over a year for treatment – which is around 308 times as many as in July 2019, before the pandemic began”. This is the equivalent of the whole population of the North West of England. There is also a hidden waiting list caused by non-referrals or difficulties in getting to see a GP.
“Harold Pedley, known as Derek, attended his GP surgery during the late afternoon on 21.12.22 and after spending most of that day feeling unwell with symptoms including abdominal pain and vomiting. He was appropriately referred to the hospital and travelled there with his Friend after his GP had discussed his case with doctors. Due to a lack of available beds in the assessment unit, Derek needed to remain in the emergency department. Following his arrival at 20.07 hours, doctors were not notified of his attendance. He remained in the emergency department waiting area for almost two hours during which time due to significant pressures faced by the department he was not assessed or spoken to by a medical professional. At 21.59 hours a triage nurse called for him. By then, Derek had been unresponsive for some time and had died, his death confirmed at 22.26 hours. A subsequent post mortem examination revealed he died from the effects of non-survivable extensive small bowel ischaemia caused by a significantly narrowed mesenteric artery. His death was contributed to by heart disease.
“At the time Derek arrived, as the Hospital Trust’s own internal review of this death explained, such were the pressures on the hospital Trust posed by patient numbers that it was operating at OPEL [Operations Pressure Escalation Level] 4. This is a method used by the NHS to measure the stress, demands, and pressure a hospital is under. OPEL 4 represents the highest level, when a hospital is “unable to deliver comprehensive care, and patient safety is at risk”. This is not a ‘one off’ event, and such pressures are becoming ever more common.
Liverpool Women’s Hospital reports that;
The urgent and emergency care (UEC) system continues to experience significant pressure across the whole of NHS Cheshire & Merseyside, with the majority of trusts across C&M consistently reporting at OPEL 3 in 2023 to date. The system has been escalated overall at OPEL 3, which is defined as ‘the local health and social care system is experiencing major pressures compromising patient flow‘. And this is in Summer.
12. Women are again faring badly on waiting lists. Health Watch reports that
Women are 28% more likely to wait over four months for NHS treatment than men (54% vs 42%).
More women are also likely to experience adverse impacts of long waits compared to men.
Most strikingly, women are 50% more likely to say that long waits impacted their ability to socialise than men (41% vs 28%).
Thirty-eight percent of respondents who identified as female said that waiting for treatment impacted on their ability to work, compared to male respondents (29%).
“Women face extreme pain, heavy bleeding, and poor mental health as waiting lists reach record numbers” (From the Royal College ofObstetricians and Gynaecologists. April 2022).
Poorer people and people from ethnic minorities also suffered worse than average. Women, poorer people, ethnic minorities and disabled people are part of the demographic of Liverpool and Liverpool Women’s Hospital, so this should be a factor in decision making.
13. Treatments, like dentistry, opticians, hearing aids, where now we must pay individually or do without.
14.Misogyny in the NHS. Seventy-seven per cent of the NHS workforce is female, but still there is a gender pay gap and men overall are paid more than women and are more likely to be in senior roles. The women in the NHS are amongst the most educated and dedicated in the county and yet are still subjected to sexual assault, bullying and discrimination.
15. Disrespect towards Liverpool’s pattern of specialist hospitals, a pattern which is based on the history of the city and its role as one of the core cities of the region, and beyond. We have some wonderful specialist hospitals in Liverpool Including the Liverpool Women’s Hospital, the Heart and Chest Hospital, the Walton Centre for Neurology and Alder Hey Children’s Hospital. The Liverpool Echo reported on the threats to them here and we reported this in our posts about the Carnall Farrar report.
17. Staff shortages and staff pay. Staff have been on strike over pay and over working conditions and about restoring the NHS. We must heed their warnings about the state of the NHS. Consultants and Junior doctors are about to strike again. Industrial action has cost the government far more than if they had met the pay claims. This government is ideologically anti-union and anti-NHS.
18. And above all the long-term drive to privatisation, the introduction of the American model of Accountable Care which envisages less care in hospitals, denying certain services, for example, breast reduction, which the NHS declared to be of no clinical worth(!)and outsourcing many other services to private companies. This culminated in the imposition of the Integrated Care System. In our view the ICS is not integrated, is not taking Care, breaks the national system, hands vast sums of money to the private sector, and makes huge cuts in finances. We listed local examples here.)
19. The austerity politics of healthcare. Political parties that support Austerity pretend that the country cannot afford healthcare. We say, as do many economists, that money spent on healthcare (if that money gets to patient care and to staffing), makes the country richer because it keeps workers working and makes recovery quicker. It happens to help more babies live as well. Deaths caused by Austerity rarely get a mention in NHS papers but it is referred to in the House of Lords Library, where it says “approximately 335,000 additional deaths had occurred between 2012 and 2019 compared with what had been previously been predicted. It also said the change in these trends was greater for people living in the 20% most deprived areas in England, Scotland and Wales.” Of the deliberately limited spend on health care since Austerity started, far too much of our tax pound goes to private companies and private medicine.
20. The impact of the privatisation lobby has been enormous, penetrating the thinking of political parties and even some who work in healthcare. Our Lobby for the NHS, for treatment free at the point of need, publicly delivered, publicly owned has got to be larger and louder., has to get deep into the unions, workplaces and communities.
Credit to the National Health Action Party
This blog is written from the standpoint of the campaigns in Cheshire and Merseyside but we love working with other campaigns for the NHS.
Please do sign our petition and please come on our demonstration
We didn’t say it would be easy to do so but it’s definitely possible if people keep coming forward to help.
This is a report on the immediate situation. Another blog will look in detail at the background factors
The board of Liverpool Women’s Hospital and, we presume the ICB, have agreed on the appointment of a joint Chief Executive Officer with Liverpool University Hospitals NHS Foundation Trust. We believe this appointment is a first step towards a merger and the dispersal of services. It is normal for a merger to follow such an appointment.
The original job advertisement for the new CEO of Liverpool Women’s Hospital said this and included the graphics shown here.
“Liverpool Women’s NHS Foundation Trust delivers the highest standards of care for women, babies, and families. 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.“
We have some of the leading experts in their field, which has been showcased on national TV and news, making our teams famous across the world for professionalism, skill & compassion.”
“…..the only specialist trust for women and babies in the UK and the largest standalone women’s hospital of its kind”
We want to keep this hospital, for all our mothers, daughters, sisters, friends, lovers, and every baby born there.
Among the person specifications for the CEO role was:
“Demonstrable and detailed understanding of current women’s health issues, national policy and standards, as well as best practice locally, nationally and internationally.”
We would love to know how the board considered that the CEO of Liverpool University Hospital Foundation Trust met these criteria. Maternity at his previous hospital Mid Cheshire Hospitals NHS Foundation Trust was evaluated by CQC as “requires improvement” though this may have happened before he got there. Over a number of years, there were eleven temporary closures of the Maternity Unit at Mid Cheshire. One woman in labour was turned away from the hospital due to a lack of beds. This is not reassuring. He might have dramatically improved maternity and women’s services there but we have not been able to find evidence of this.
Join us on the 7th of October in our demonstration. Act before the NHS is merely a memory.
More than seventy-three thousand people have signed our petition to Save Liverpool Women’s Hospital and to repair and restore the NHS. The petition is online here and on paper at our stalls. We get great support on the streets for our campaign. Our campaign, and similar campaigns across the country continue. We need to reach more and more people and organize people to speak up.
Even as the NHS is being stripped away, much great work is still being done, day after day, in our hospitals, clinics, and GP practices thanks to our healthcare workers. Our NHS workers have kept the ship afloat throughout the years of cuts.
Recent local developments in the battle for the NHS, for safety in maternity, and for women’s and babies’ health. On the 14th of October, the Liverpool Women’s Hospital Board met. Members of the public attending heard of some great work, and of many problems.
The board considered developments in the role of Maternal Medicine Centres, a new development. Liverpool Women’s Hospital is one of three Maternal Medicine Centres in the Northwest.
“The Maternal Medicine Centres will provide a regional service including pre-pregnancy, antenatal and postnatal care for women who have either pre-existing significant medical problems or medical problems arising in or shortly after pregnancy. The MMCs will also provide advice and care for the most complex and highest risk women including those with respiratory, haematological, renal and cardiac problems and women diagnosed with cancer. “
The board also heard a patient’s story which has helped develop innovations in menopause care, including having some joint menopause and mental health clinics. The attention now being paid to menopause is a great step forward and is disclosing years when treatments were simply not available leading to women’s long-term ill health. The patient’s story showed how women staff, nurses and doctors, can work together and push through real change. Surely this cooperation and mutual respect is much easier in a women’s hospital rather than in a huge four-site hospital. Will the new CEO prioritize the forty-odd people waiting in A and E for a bed at the Royal site, or agree to these innovative clinics?
Delays in Induction of labour. The meeting also discussed problems at the hospital with women kept waiting for Induction of Labour. This was both a staffing and a space issue. Induction of Labour is used for safety reasons so delays are potentially dangerous.”Delay in the induction of labour (IOL) process is associated with poor patient experience and adverse perinatal outcome.” Studies have shown this happens more in planned Induction of Labour rather than when the induction is an emergency
The board also received a brief report from the Letby case but could not discuss it in detail, because of ongoing police investigations.
As members of the public, some of our campaigners have attended board meetings for many years. We cannot contribute at these meetings but we can ask questions at the end of the meeting. On September 14th there was the first board meeting since the announcement of the intention to install a shared CEO between Liverpool University Hospital Foundation Trust and Liverpool Women’s Hospital. This issue of a shared CEO had not been raised in the previous Board papers. The author asked if campaigners had missed some paperwork about this and we were told no, we had not. At the previous meeting, the discussion was about putting an advertisement out for a new CEO.
Announcing a shared CEO is a fundamental change. We had been assured of public consultation on the future of the hospital but this critical decision happened without consultation and without being mentioned at previous board meetings. It happened after we were told in multiple meetings that decisions about the future of Liverpool Women’s Hospital were to be made via the Women’s Committee of the ICS.
It seems, from the board meeting, that the advertising and recruitment were managed by the Remuneration Committee at Liverpool Women’s Hospital, for which minutes are not published. According to the Chair of the Board, in a verbal answer, they had approached the ICB and system partners about the possibility of a joint CEO some time previously. (Again, we cannot find this in the public papers). They had been told that the time was not right so had gone on with the advertising for a new Chief Executive. Then they were told (It is not clear by whom) that the time for this joint CEO was now right, so they ceased the advertising process, closed the vacancy, and agreed to the joint appointment. Did the board, staff, and concerned patients at LUHFT know about this before it happened?
Who is making these decisions? Where is the clarity? Where is the candour? Where are the impact assessments? How can the public follow this?
We were told that the report from the chair of the Women’s Committee of the ICB had arrived too late for the Board papers but it has been on the ICB website since the beginning of the month. How moving to a shared CEO matches with this report from the chair of the ICB Women’s Committee beats me. The report says, “This committee will oversee the development of a safe and sustainable future model for women’s health services in Liverpool” Did it oversee the idea of a joint CEO? If so, why were we specifically told otherwise?
There are serious money troubles at both Liverpool Women’s Hospital and Liverpool University Hospital Foundation Trust. In the minutes of the previous meeting,there was this statement
“It was asserted that wider system support would be required to find solutions for the structural deficit that underpinned the Trust’s financial challenges”.
This “wider system support” means that more money from the local ICB and the system of hospitals it controls will be needed.
At the board, the severe financial pressures of the hospital were partly discussed in the “in public” section of the meeting and were due to be discussed in depth in the afternoon private session. The financial problems of Liverpool Women’s and Liverpool University Foundation Hospitals Trust are severe yet they are expected to make more than five per cent CIPs (cuts) plus making good non-recurrent savings made last year. There are money problems also in Mersey Care, and the Countess of Chester. This is not spendthrift hospitals but structural underfunding and a government bent on cuts.
Finances at the Women’s
The core issues specific to Liverpool Women’s Hospital are.
Nationally inadequate NHS Funding.
Inadequate funding for maternity through the maternity tariff. This affects all maternity providers but the scale of maternity at LWH makes it a far greater problem.
The cost of running a Foundation Trust
The Insurance system which is based on market models and which nationally carries more claims from maternity than any other service.
The inclusion of nonrecurrent items in balancing last year’s books. The government has insisted this is made good across the country.
Making between five and six per cent CIPs(cuts).
Cuts in spending inevitably impact staff pay and recruitment because that is where most of the budget is spent
Winter is coming.
Each doctor or nurse with whom I have informally discussed this situation, says that the situation this coming winter fills them with fear. We must demand better funding, money directed exclusively to staff and patients, not to privatization.
Our local hospitals are already under pressure in summer and early autumn. Most local hospitals even in the summer were reporting that they were on Opel 3. This is reported on page 23 of the board papers. What does this mean? The NHS says
At OPEL 1, there is a low level of pressure on NHS services, and the system is functioning normally.
At OPEL 2, there is moderate pressure, and healthcare facilities may need to take additional steps to manage demand and capacity.
At OPEL 3, there is a high level of pressure, and the system may need to implement additional measures such as canceling elective surgeries or diverting patients to other facilities.
At OPEL 4, there is severe pressure, and the system is at risk of breaking down.
At OPEL 5, there is a critical level of pressure, and the system is unable to deliver comprehensive care.
We need action for the health service now and not one penny must be diverted from patient care, staff costs, and building and estate safety before the winter sets in.
In summary, we want to keep Liverpool Women’s Hospital as a standalone Hospital, cooperating and working in a mutually respectful system across the whole NHS. We want to keep our specialist hospitals too. As our petition says “Save the Liverpool Women’s Hospital. No closure. No privatization. No cuts. No merger. Reorganise the funding structures, not the hospital. Our babies and mothers our sick women deserve the very best”.
Liverpool Women’s Hospital is much valued by the people of Liverpool. For many years now its future has been under threat. Nationally many hospitals are also under threat and many have closed. There is no evidence that closing swathes of hospitals improves healthcare. Our health has been declining in this time of closures. There is no evidence that huge reorganizations are more effective. Necessary reorganisations are damaged if implemented without resources. Everything we face at Liverpool Women’s is reflected in the rest of the country.
We must fight to save our healthcare. Fight for our rights, for our lives.
Every worthwhile right that we have ever won, had to be won, first, in the minds of the people. This includes the vote, equal pay, maternity leave, free and universal education, abortion rights, race equality, effective sewers, trade union rights, and some level of environmental protection. LGBT rights, ending slavery, all of them. The idea of healthcare, universal, free at the point of need, as a public service, funded by the government was first won in the minds of the public, by working-class women and trade unionists (and, back in those days, the Labour Party), before the post-war Labour government introduced it 75 years ago.
The people of Cheshire and Merseyside and beyond, the women and families in, the UK are entitled to world-class healthcare. Our communities have paid for the NHS for 75 years, and we continue to pay our taxes and our National Insurance, contributing far more as a percentage of our income than the rich do), but the government does not release the money or diverts it to the private sector.
We must protect what’s left of our healthcare, we support our healthcare workers, and demand the return of what has been taken from us to fill the coffers of big corporations.
The Government is implementing fundamental change to the NHS, change that no one voted for, change that was in no party’s manifesto, but change that makes the corporations and some of the ultra-rich even richer. This change is obscured by a smokescreen of propaganda coordinated by a lobby group that makes the tobacco and Oil lobbies look like amateurs. They seem to have their tentacles into parts of the Labour Party too. These changes are costing lives and pain for ordinary people.
Leading trade unionists are showing their support
We are entitled to know what is happening to our healthcare. Who is making what decision? Where are they making these decisions? What is the reasoning behind decisions being made? What impact assessments have been done? How and when is the public allowed a say? Where is the candour??
For all our sisters,mothers, daughters and babies.
Save Liverpool Women's Hospital 