Category: Uncategorized

Getting Rid of the Virus Public Meeting

Our speakers were

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

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

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

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

Part 2:

Comfort Etim:

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

Philomène Uwamaliya:

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

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

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

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

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

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

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

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

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

We don’t remember Polio, you and me.

Public meeting Wednesday 17th February 2021

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

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

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

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

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

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

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

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

Let’s get rid of Covid.

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

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

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

Please respond to this reorganisation of the NHS

Act to save our NHS

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

The deadline for the response is 8th January, and the link to the consultation is

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

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

Integrating Care: Why NHS England is getting it wrong

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

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

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

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

We also attach background papers from Keep Our NHS Public:

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

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

     * KONP’s response to the legislative proposals

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

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

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

To reiterate, the deadline for the response is 8th January, and the link to the consultation is

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

Respond even if it is late.

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

Dear —

Integrating Care: Why NHS England is getting it wrong

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

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

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

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

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

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

     * KONP’s response to the legislative proposals

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

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

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

To reiterate, the deadline for the response is 8th January, and the link to the consultation is

In solidarity,

Keep Our NHS Public

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

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

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

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

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

Restructuring of the NHS in England .

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

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

The mergers inevitably result in larger bodies, more remote from the needs and concerns of any local community, and therefore a loss of local accountability. This point has been powerfully argued by the all-party Local Government Association (LGA), which represents the leaders of 335 of England’s 339 local authorities. Their response states: “We are concerned that the changes may result in a delegation of functions within a tight framework determined at the national level, where ICSs effectively bypass or replace existing accountable, place-based partnerships for health and wellbeing…. 1 2

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Changes are being made to the NHS, without publicity.

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

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

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

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

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

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

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

Not sufficient at all

Hello fellow midwives,

Have any of you seen the message to RCM members by CEO Gill Walton. Here is the link for you if need:

I find it hard to put into words how this makes me feel, but utterly disgusted and outraged by the attitude of GW is a start.

Where is the support from our union? Other unions including the BMA and Unison are asking their members to let them know about COVID related issues in the workplace – PPE for example. These discussions need to be had out loud in the public arena not stifled by our union or our hospitals with fear of reprisal. Let’s speak out. Together we are strong. Let’s support those staff members that do.

If any of you want to tell me anything in confidence please private message me. Some know me already and I hope trust me, others who don’t please message and talk with me.

We need to do this to protect each other, our families, the women and patients we look after.



If midwives wish to contact R we will forward your message

Issues from the maternity services front line. Protect maternity in the virus crisis

Since we posted our last blog we have been hearing from people directly involved with maternity care locally. Merseyside camapigners for good maternity care are not alone in sharing concerns about how maternity should be treated during the crisis. The Royal College of Midwives has published its concerns, saying “Help us deliver safe care for Pregnant Women.

This is the link to Liverpool Women’s Hospital public information as on 31st March 2020

Even without the crisis, too many babies nationally die at birth or shortly afterwards or sustain brain injury. It is right that we raise concerns at a time when staff are under great pressure.

Here are some of the issues raised locally during this crisis which is still in its early stages. We have raised these issues directly through questions to the board of the Liverpool Women’s Hospital. The Board is not meeting in public but we have submitted questions.

  1. Discharging babies

Delivery suite are needing to discharge women as soon as ossible after birth, for obvious reasons. However, each baby is required to have an Examination of the New-born prior to discharge. Pre the COVID-19 outbreak this was always performed in the community but that is now not possible, therefore it is now the responsibility of delivery suite midwives. However, most midwives are not trained in this. Delivery suite midwives are also needing to complete all the discharge paperwork. It would help the situation if staff who were trained in the Examination of the New-born were allocated to the delivery suite to do all the discharge work. Questions are being asked as to how can delivery suite (d/s) midwives be supported with this extra workload? For mums discharged home before having their baby examination completed they are bringing their babies back to LWH clinic to do this examination, but more staff are needed to do this.

2. Infants who would usually go to SCBU/NICU; because they need 3 hourly feeds / true blood glucose checks are now staying on the delivery suite and therefore the responsibility of the staff there. However, there is not the workforce on the delivery suite to do.

3. COVID-19 / COVID-19 suspected women are cared for on the delivery suite and looked after by the 1 clinician, this ensures social distancing as much as possible. Staff are to care for the women in 4hrly intervals but in reality, staff are working their full 12.5hr shifts with no break/relief. This ensures as few clinicians as possible are coming into contact with the women, however, this way of working is not sustainable long-term.

4 Personal Protective Equipment (PPE) is needed for staff looking after COVID-19 / COVID-19 suspected women. At present only flimsy plastic aprons, paper face marks and the usual plastic gloves are being provided. Staff are to remove all ‘PPE’ when they come out of a clinical room and return with a fresh lot of on. However there is not enough stock, particularly the paper masks, so the same face masks are being re-used when re-entering rooms and used for hours on end. Staff are not getting measured up for the proper COVID-19 protected masks, at present only for theatre staff where a woman/patient is COVID-19 positive are wearing them.

5. On Delivery at present, there is only 1 COVID-19 designated/converted room, a second one is getting sorted. It is important to know how many is the hospital planning on converting? Staff need to know how many pregnant COVID-19 women are they expecting over the next coming months based on Public Health England data.

6. The Clinical staff need to know how many babies are contracting COVID-19 from their mothers in the immediate post-natal period? What are the UK / local stats?

7. For women undergoing a general anaesthetic for a caesarean section when COVID-19 positive – what additional care is provided? Will it always be a consultant who anaesthetises the woman? Are consultant anaesthetists required to be on-site out of hours throughout the pandemic?

8. Staff until recently went home in their ‘dirty’ uniforms. Now this being stopped (thankfully) but not adequate changing room space/showers are available at LWH. There is 1 small locker room (far away from the delivery suite entrance) that staff are required to use, which means they have to walk the full length of the delivery suite in their ‘clean’ outdoor clothes to access the room. Only 1 shower is available, so staff cannot shower before leaving work. Also, the room is far too small for 13 or so members of staff to change all at once. More locker/changing room space needs to be provided for clinical staff.

9. Are Trust cleaning staff available to deep clean the clinical area/consultations rooms after a suspected/confirmed COVID-19 pregnant woman has attended? This is particularly problematic in clinic situations as the cleaning staff only usually attend after hours. Midwives at one Trust have been instructed to leave these rooms free for 20 minutes ‘let the dust die down’ (!), then perform 20 minutes of cleaning, then allow 20 minutes for the room to dry, other Trusts are instructing staff to leave rooms vacant for 4 hours.

Has there been any increase in cleaning staff and what training regarding the cleaning of clinical areas have Sodexo staff had re COVID-19? Particularly, given the long period that the virus is thought to remain active on plastics/wood/cloth. What are the procedures in place to reassure the public this is happening?

10. We hear that LWH is planning on suspending the home birth team, This would mean more women will be coming into the hospital, which is not a good move in this climate. Additionally, ambulances are under pressure but we are also hearing of other maternity units in the northwest being closed and the premises given over to Corvid treatment. Where possible home births should continue.  

11. Staff  are not clear who is eligible for COVID-19 testing – is it all staff or only those in contact with a confirmed COVID-19 patient? When will staff testing begin? And in what order of staff? Will it include ancillary staff?

12. At present, 60 staff (midwives/doctors)  are off – mostly related to COVID. Last week it was 42.

13. Regarding staff; what are LWH numbers of COVID-19 confirmed cases, suspected cases, staff returned to work cases, self-isolating because of a high-risk group, and come into contact with COVID-19 person?  

14. For patients what are numbers of confirmed/suspected cases?

15. How is patient crockery/cutlery being dealt with for COVID-19 patients?  There need to be disposable versions used. Midwives are taking responsibility for the cleaning of this.

16. Student midwives are remaining in clinical practice: Why?

a. There is mounting evidence that the clinical area is not a safe place i.e. not the required standard PPE for all staff or the optimum (even by pre-COVID-19 standards) staff: patient ratio, already the workforce is down / out of practice (self-isolating).

b. Medical students have been pulled from practice, why not student midwives (& nurses)

c. How is the Trust dealing with mentoring/ supporting students? We are hearing from the students that they are not getting adequately supported/mentored in practice, even already.  It has always been the case that students are taken out of clinical areas where this is happening. Why is this now not happening? The situation will worsen regarding supervision/mentorship. We are not yet at the peak of the crisis

d. Most midwives find mentoring students an extra responsibility. Is this necessary now? Is it not possible to pause all clinical learning and focus on theory only, this would be a far better option than putting students in an at-risk environment. Universities could front-load their learning with theory. Have the Trust considered this? In particular to ‘save’ the future workforce

17. Birth partners are essential for patients emotional and mental health support for every mum in labour. We know from the MBRRACE Report and our BAME community that given the raised risk for BME women the presence of support is essential. Yes, partners too might carry COVID-19. This is another reason to make maternity a key area for staff, patient (and partner) testing. It’s not a reason to leave a woman on her own giving birth in this high-stress time. The RCM supports birth partners being present. However severely restricting other visitors seems semsible and appropriate to keep everyone safe.

18.  Children seem  to be less susceptible to the coronavirus than older people There  is a detailed article on this here,  It is interesting that this work is being led in Liverpool.

There is only one chance at birth. Each birth involves two human lives. Defend maternity services, defend maternity staff, defend all our mothers, sisters, daughters, friends, and lovers during this crisis.

One chance at birth. Protect maternity services in the crisis.

Maternity care and women’s health require an excellent response to the Coronavirus outbreak. Virus or no virus, there is only one chance of birth. Two human lives are involved in each birth. There should be no short cuts during this crisis. Services for women and babies were already in trouble before the virus. The Royal College of Midwives has called on NHS leaders to ”protect the safety of pregnant women by ring fencing maternity services in the current crisis

While other areas of the health service can postpone and cancel procedures, there is still an ongoing need for maternity services. Women are still pregnant, still having babies, and they need the care and support of properly resourced maternity services. We have to ensure that midwives and maternity support workers are ringfenced from any redeployment to ensure that women continue to receive safe care.

Over a fifth (22 per cent) of survey respondents also reported that local midwife-led maternity units had been closed, with more than a third (36 per cent) of areas also either stopping (32 per cent) or restricting (four per cent) homebirths. In 11 cases the midwife-led unit has been closed to provide facilities to assess or care for coronavirus patients.

We need careful professional responses, careful supervision of new and inexperienced staff, and good supplies of personal protective equipment and good supplies of ventilators and we need testing of staff and patients for the virus. We need meticulous recordkeeping so long term effects can be traced

The response of NHS front line staff, of volunteers and returnees to the professions has been outstanding. They are saving thousands of lives by their response. It is right that the nation clapped them on Thursday!

NHS staff kept the NHS afloat through years of cuts. Staff worked a million hours per week of unpaid overtime. Their last pay deal was such a disaster that the RCN apologised for advising staff to accept it. More than a million volunteers also helped out in the NHS even before the recent call-out

Even before the virus there was a dire shortage of midwives. The Guardian is reporting that the midwife shortage has doubled as NHS staff are diverted to tend to Corvid patients.

Reports have come in of the first deaths from the virus working surgeons in the NHS. The NHS staff are putting themselves on the line for all of us. We must protect them too, by demanding better equipment and more testing.

Sadly, the main organisation of the NHS, in contrast to the workforce, has been found seriously wanting. “When this is all over, the NHS England board should resign in their entirety.Lancet  The culture of doublespeak and the use of soundbites has not changed. Staff still fear to disagree with management, whistleblowing procedures are poor. Annual surveys show staff unsure of their managements. In some hospitals, we hear of bullying by management happening even as the virus rages

The most up to date advice for pregnant women found whilst writing this article for pregnant women and pregnant NHS professionals are found here for professionals and here for parents. “ Our advice remains that if you feel your symptoms are worsening or if you are not getting better you should contact your maternity care team or use the NHS 111 online service / NHS 24 for further information and advice.”

The Lancet voice has a useful podcast on Corvid Virus and pregnancy. In this podcast doctors dealing with pregnant women and new babies speak from the virus outbreaks in China, Italy, Spain and other counties sharing their experiences.

In Italy, Spain and France numbers of the dead are growing and medics are amongst the dead. We send our solidarity and sympathy but know we are not far behind if the virus continues in the same way here.

Current research shows that Pregnant women are not more severely affected by the virus. There is no evidence of vertical transmission from other to baby, so far. Mothers in labour are still advised to bring a birth partner but only one. Visiting has been restricted to reduce the amount of virus coming into the hospital Advice from Liverpool Women’s hospital is to be found here

Pregnant women over 28 weeks are advised to self-isolate

Save Liverpool Women’s Hospital is a campaigning organisation trying to save Liverpool Women’s Hospital, to campaign for better health care for women and babies and to defend and win back the NHS. We have been campaigning for five years and learned a lot about how the NHS works now, how it used to work before 2012 Act, how the NHS was originally designed to work, and how it has been damaged.

At the last local CCG meeting, one of our campaigners tried to persuade them to take more time to plan the Corona Virus crisis but was unable to do so. They discussed the reorganisation of the CCG instead. When our campaigner raised the issue of migrant access, she was told there was no problem with people being afraid of charging. She then raised the example of the three mums dead from fear of migrant charges. Still, no action was suggested. You can hear a detailed report in the second part of this podcast here

The role of CCGs seems to change quickly. All commissioning for the crisis was taken off the last week but now some claim to be trying to source PPE. And some are gaining praise for their efforts. What is happening?

Fundamental changes in the CCG network have been underway with mergers and changes to adapt to the new STP/ Integrated Care networks 44 areas of the NHS. A summary of changes can be found here

A huge amount of money is allocated each year to the NHS. That pipeline of money is siphoned off by business and financial consultants who are restructuring the NHS on US models The process of making the NHS reflect the US model is well underway and must be reversed. Infant and maternal mortality in the USA is dreadful

Testing, Testing, Testing .In this crisis, we need testing for mothers and staff. A gaping hole in the UK response is the lack of testing, mapping, tracking and isolation.Maternity is the largest reason for healthy people to use hospital facilities, yet neither staff nor patients are tested for the virus. Personal protective equipment is as short in maternity hospitals as anywhere else. It is impossible to know who carries the virus in the non-testing environment.

The experience of giving birth safely and happily is a human right and one our campaign will always defend.

Different parts of the country are experiencing different levels of infection. The most up to date figures are here Liverpool is still not a leader in the infection but the Northwest is a growing hotspot behind London and the West Midlands. The public good, not private profit must drive this response.

Public good and public service is the best way to provide health care. It is more efficient and efficacious than for-profit companies. PFI was and is a disaster.  It is important to remind people of Carillion’s nonsense, remind people how campaigners fought to prevent the PFI and the contract being given to Carillion. Liverpool faces this crisis with a broken half-built hospital because those who run the local NHS allowed PFI and then let contractors work unchecked. Remember all the outsourcing nonsense? Carillion, Interserve etc.? All the reduced wages and reduced service levels, reduced sick pay rights? Remember companies who took on services they failed to effectively deliver, remember the cut wages and sick pay?  Remember the companies like Carillion who either went bankrupt or restructured their debt

An Interserve Executive is being given the task of organising mass testing for Corvid 19, the Corona Virus. Interserve! Not public health, not even the NHS, Interserve. In this current Corona Crisis, who would you want to administer widespread testing when it finally is ready? Would you give it to a skilled, well educated public health service, or would you give it to an outsourcing company recently in dire financial trouble

We welcome any increase in testing but it has to be conducted well under rigorous conditions. The CV of the woman chosen, comes from Interserve? Really? Not a professor of public health? Not a public health practitioner? Not an epidemiologist?

 Women are at the heart of this crisis in the communities.

Women are at the heart of the social crisis around this virus. Most key workers are women, many of whom have young children and are many single parents. Many have caring responsibilities for older family members too. Contact out in the community is going to increase the key workers viral loading as they meet more people. Only the most obviously ill patients are being treated in hospital, so most of the virus is in the community, including in care homes and mental health facilities.

 Most of the additional informal care at home is falling to women in the community. With one in five workers expected to get sick, the pressure on women will be immense. Domestic violence  is increasing under the lockdown internationally. Pregnancy sadly is a peak time for domestic violence, All services must be aware of this and the government should intervene as the Spanish government has done. Disgustingly a UK boxer even filmed a tutorial telling men how  to hit their girlfriends during the lockdown

The Coronavirus is an equal opportunity killer but men are slightly more likely to die from Corona. Most people who have died are older rather than younger and most have other illnesses. Multiple illnesses amongst older people are itself a result of poverty and inadequate health care. People who live in poor areas have 19 years more ill-health than those in poorer areas and this is reflected in maternity outcomes too

The building sites across the country who are still working, not respecting safe distancing, are not going to help the figures for male illnesses. These men by and large will go home taking their acquired virus load with them.

Our concerns around the virus extend to babies and young children. Babies and young children seem to resist the virus better than older people but many children are already weakened by poverty. Liverpool has far too many underweight babies born reflecting the poverty of the area. Child poverty in Liverpool is a scandal but one that will get worse in this crisis Far too many babies in Liverpool are dying under one year old with at least one in three directly attributable to poverty

Mothers and babies in the UK have not had the best possible service from the NHS and life expectancy and healthy life expectancy for women have been falling

The worsening of Infant mortality over the last number of years is spelt out, in detail, by Danny Dorling

These developments mean that the UK as a whole now has one of the worst IMRs in Western Europe, falling behind the EU average of 3.6 per 1000, and ranking 25th of the 42 countries with available data for 2017.16 This is a marked change since 1990 when the UK had the seventh best neonatal mortality record in Europe and was even better, relatively, before that.17

Women are at the heart of the  family money issues in this crisis.

 “Making the household budget stretch even further when there is less money and more mouths to feed more hours of the day”

Many women are caught in low pay in the economy at large and in the low paid end of self-employment.  Women comprise 34% of self-employed workers, most of them on the low paid end of the pay structures and will be dealing with all the complications of this.

We heard (Shock! Horror!) that in Italy, such is the extent of the epidemic that patients are being treated in corridors. We were in this situation even before Corona fully hit us. A situation caused by policies like closing beds and hospitals, like diverting much-needed funds to for-profit companies, like not training enough doctors, nurses, and midwives and making the burn out rate soar in the NHS.

The NHS was woefully underprepared for this crisis. All the years of cuts, understaffing, burnt-out staff, bed closures and post-2012 reorganisations were bad enough.

The lack of preparation for a pandemic was even more unacceptable The Lancet, the doctors’ paper agrees with us “The NHS could have prevented “chaos and panic” had the system not been left “wholly unprepared for this pandemic”, the editor of a British medical journal has said.

The shortage of materials for NHS staff is directly down to political and financial decisions the Guardian reported here.

The NHS used to have a national procurement body but it was outsourced and run in some way by DHL, who has since lost the contract despite the boasts in this posting. Jobs the national health service could do, the private sector failed. A new supply chain body was set up in April 2018, making grand claims of new efficiencies but somehow its got this crisis all wrong.

The NHS was woefully short of beds and staff

The Kings Fund reports that

The total number of NHS hospital beds in England, including general and acute, mental illness, learning disability, maternity and day-only beds, has more than halved over the past 30 years, from around 299,000 in 1987/88 to 141,000 in 2018/9, while the number of patients treated has increased significantly.

We need old fashioned public health services. Dr. John Ashton, a Liverpool based  public health expert has gained publicity for his challenge to the government over this crisis. He  wrote in 2016 ” The state of public health services in England – why hospital physicians should be worried”

In this Coronavirus Crisis, we urgently need (but are being denied) old fashioned public health measures deliver by skilled experts. Much of public health has been decimated by local government cuts in this era of Austerity.  In 2017 John Middleton wrote” There is a high burden of preventable disease and unacceptable inequalities in England” Across the world, and for two centuries it has been recognised that humans living in close proximity to each other, need well organised public health services.

In Liverpool, we rightly commemorate the work of Kitty Wilkinson who set up the first wash house during the 1832 Cholera epidemic in the city. Similar solidarity action today, across the area, is providing formal and informal support within our communities in the crisis of hunger and poverty and this new  virus crisis. If Kitty could intervene all those years ago should not pandemic precautions have been in place today?

Picture from Liverpool Express

Our campaign calls for testing in the population. We agree with the WHO. The World Health Organisation, (WHO) say “Test, Test, Test”. Using the WHO recommendations, some countries have defeated the virus at least in its early presentation. What happens when the virus crops up again we still do not know, we do not know how long immunity to the virus will last or how the virus will react in different seasons. But for now, China, South Korea and Singapore appear to have defeated the virus .unlike the UK and Europe.

Maternity services need widespread coordinated public testing as much if not more than any other section of the NHS. Public testing could dramatically reduce the number of infected cases and let staff know when they are dealing with someone with the virus, even if they are  symptom-free. Testing and isolating reduces the number of infections

Aggregating across all individuals and under the optimistic assumption that all the contact tracing can be performed rapidly, we expect contact tracing to reduce the basic reproductive ratio from 3.11 to 0.21—enabling the outbreak to be contained,” they write. “Rapid and effective contact tracing can, therefore, be highly effective in the early control of covid-19, but places substantial demands on the local public health authorities.”

Professor Allyson Pollock quotes this in this article where she argues for widespread testing

Universal healthcare for all .As well as calling for testing we call for universal access to healthcare. For the NHS to be safe for all it needs to be available to all.

Think of the three mums who, thinking they could not afford NHS treatment for maternity, died last year from lack of care. Even today across Merseyside hospitals posters warn patients they might not be eligible for free NHS treatment

Will everyone who fears the virus dare to go for treatment? Mum and baby and everyone they meet are at risk, unless healthcare is universal.

The Government have said all Covid treatment has to be available to all

This means, as, for any other infectious disease in Schedule 1, there can be no charge made to an overseas visitor for the diagnosis, or, if positive, treatment, of this coronavirus.

  • No charge applies to a diagnostic test even if the result is negative. No charge can apply to any treatment provided for suspected COVID-19 up to the point that it is negatively diagnosed. t is very important, for public health protection, that overseas visitors are not deterred from seeking treatment for COVID-19. Please ensure that overseas visitors are not charged, or informed that charges may apply, for the diagnosis or treatment of the coronavirus
  • : patients that are known to be undergoing testing and treatment for coronavirus only are not subject to Home Office status checks

Portugal has offered to treat all migrants as residents during the crisis. The UK should do the same

Can we keep maternity hospitals free of the virus?

In Italy, doctors have described key tasks for the hospitals

Over the last fortnight, Italian hospitals rapidly restructured to achieve complete segregation of covid-19 positive and negative patients. Using designated “clean” and “contaminated” areas, this flow is maintained from presentation to discharge.

It is hard to see how this Italian model can work in maternity without testing of staff and patients. The assumption is that the maternity hospital is a “clean” area and the Corvid will be kept out as much as possible, but while Corvid in the population, corvid is in the maternity wards.

The nation clapped the NHS workers who are struggling to prevent both huge numbers of deaths and to stop the NHS being overwhelmed. The NHS is, just about weathering the storm of Corona (as this is written) but at a dire cost Crucial life-improving, pain-relieving, surgery, like that for endometriosis, and in some cases even cancer treatment are being postponed or cancelled to allow the NHS to manage a pandemic, that was well predicted and whose numbers could have been far better managed..

This pandemic was not a bolt from the blue. Serious scientists, who should have been heeded, predicted it. The literature showing that the pandemic was predicted and that proposals to address it were prepared is extensive but this is a useful summary This also gives detail on international discussions

Nor is this pandemic non-political. It was political choices that landed us in this situation. We had six weeks lost in preparation thanks to this inept government. Testing, mapping, tracing and an earlier lockdown of the population could have saved many lives.

The issue of understaffing in maternity and other areas of the NHS had caused political uproar. Many different enquiries in to maternal and infant deaths have been held See our detailed article here. It is good that more NHS staff were beginning to be recruited even before the crisis and great that that thousands of doctors and nurses have come back to the NHS to help.

The NHS met this pandemic under-funded, understaffed and under-equipped Basic commissioning of equipment and services has failed in the current NHS structure

Personal Protective Equipment is lacking so our NHS staff are at risk from, and present a risk to, patients Personal protective equipment should have been both stockpiled and immediately recommissioned once the WHO warning came out 6 weeks ago. There are small clothes making factories even in Merseyside who could have been commissioned to produce materials

Midwives too have reported shortages of PPE. One report was of midwives being told at what stage of Labour they are to use PPE. The nursing and midwifery council have added their voices calling for PPE for nurses and midwives.

The futile palaver over the shortage of ventilators, over losing an email offering EU cooperation, and getting newly designed ones created from Dyson is more public schoolboys playing games. There is an existing model. Reproduce that at scale or make minor improvements if necessary.

The decision not to buy in advance, not to stockpile was political. It was a political decision coming out of a political context of shaping the NHS as a commercial operation designed for the well being of big corporations.

Each huge accountancy and consultancy organisation in the UK “advised” the NHS and was well paid to do so in the run-up to the car crash that is pandemic preparedness. Breaking the NHS into 44 areas, into local CCG areas has all contributed to the mess.

Reports from China showed no enhanced risk to pregnant women or their babies from the virus, though there were slightly more premature births. There are some reports from the US  who are now reporting larger numbers of virus sufferers, of women giving birth in unusual rooms and of inductions to free up space.

Those with existing family responsibilities are more likely to have exposure to the virus. Women present in the hospital to have babies as the largest cohort of healthy people to use the NHS.

Personal distancing between staff and delivering mum is not possible in the Labour Ward or the delivery suite. All the virus that staff carry can be transferred to the mum, all that the mum carries to the staff. In normal times no one wants a midwife dressed as a spaceman with huge PPE but right now PPE is needed.

Staff and patients in maternity should be tested for the virus, and records should be kept.

Student midwives in their final year are being brought into hospitals to help with staffing levels. The shortage of midwives, of course, predates this crisis and will remain after it. Our campaign has long called for, full bursaries, and full pay whilst training, more training place for midwives. We want no reduction in the quality or quantity of midwife training and education, but a steady ramping up of provision. Student midwives and inexperienced midwives need supervision as they practice, as they work with the mums. That is how the skills are honed. We need too to retain the young obstetricians and gynaecologists. Up to 40% of young doctors were “taking a break at the end of foundation training”

It will be tough for everyone coping through this virus.

Let’s build an NHS without the privatisation, without the financial consultants, one fit for all our babies. One where what NHS administrators say is not from a spin-doctor but from reality,  An NHS without bullying. An NHS were young and old midwives are happy to work, one where young doctors feel valued and well cared for.

For all our mothers, daughters friends and lovers and for every baby. Let’s build the NHS afresh from this crisis.

Campaigning for Women’s Rights.International Women’s Day 2020

Fighting for excellent healthcare for all our mothers, sisters, daughters, friends and lovers and for each and every baby

Women need healthcare at every stage of our lives. Too many babies die at birth, too many babies in Liverpool are dying before they are one year old. Still mothers die giving birth, or shortly afterwards. Many more Black mothers and babies die.

Too many older women have complex health issues. Mental health support for women and men is stripped to the bone. Every mother in the UK must get access to free maternity care in the UK! Stop the migrant charges that killed three women last year. Stop all migrant charges. The Windrush scandal killed people through denial of care.

Women’s illnesses are not adequately researched, nor treated. Life expectancy, and healthy life expectancy are falling, especially for poor women. Our right to control our fertility is still under threat from the right.

The NHS is starved of resources. Only the efforts of its staff keep it afloat. We need many more midwives, and more doctors specialising in women’s health. The NHS must be fully funded, and the private companies dismissed. Bursaries and grants must come back. The NHS must become an excellent employer for women, with workload and pay improved. The NHS must be funded sufficiently to be able to respond well to crises; no more corridor treatment! No more rationing! Stop cutting public health programs that helps keep us from falling ill.


 We call for the right to live free from rape and to organise against rape and sexual assault.

Rape prosecutions are at their lowest in a decade, yet more rapes are being reported. Together we can change this. We must organise on the streets and in the communities to eradicate violence against women. But don’t think it will be easy.

We need fully funded health care support for sexual crisis. Women need fully funded support for those who wish to leave abusive relationships.

Whatever we wear, wherever we go, yes means yes, and no means no!

Women must speak out against rape culture. Men must stop it.

The right to control our own fertility and the right to abortion are at risk across the world. Those who oppose abortion don’t have to have one, but the decision must always be that of the mother. Liverpool Women’s Hospital provides both safe terminations and fertility treatments in a women friendly environment. Both these services need to be protected. LWH provides support to Gay and Trans people’s fertility and sexual health in very practical ways.

The NHS publications frequently places the blame for ill health on the patient rather on the causes of ill health in society. We are all for taking care of ourselves, but the issues are much bigger than the individual.

You can make a difference by joining our campaigns. Power never conceded anything without a demand. We demand great healthcare for all. Healthy people make the country wealthier and happier. Ill health make us all poorer. Invest in health!

International Women’s Day in Liverpool 2020

The right to breathe clean air and to live in a viable climate

Good health requires air we can breathe, food that is free from contamination, and a planet with a viable future, for all humanity.


The right to clean air for all is essential for good health. Liverpool youngsters have been out on the streets asking us to take notice and to save the planet. Climate and environmental health are all essential to women’s health.Save Liverpool Women’s Hospital Campaign calls for Liverpool Women’s hospital to remain on its green site on Crown Street away from the heavy traffic of the Prescott Street site by the Liverpool Royal Hospital. Babies in the womb are very susceptible to damage from traffic fumes. We should not be sending babies into heavily polluted areas. Liverpool already has an issue with lung diseases like asthma in young children. Thousands of babies every year are born at Liverpool

Join the Save Liverpool Women’s Hospital Campaign, and fighting the NHS free at the  point of need, fully funded and not for profit, nationally provided and planned, and available to everyone. We have fought for five years to Save Liverpool Women’s Hospital so the hospital is still there – but it’s not safe yet. It is a tough fight to win back a decent NHS, but one that must be won. Each extra campaigner helps. Sign our petition on line Follow us on facebook or come to our meetings and get involved

The coronavirus means we need the NHS still more. The NHS has been cut to the bone by Government policy. Big companies have made fortunes from the NHS, while staff go short. We all need our NHS staff. Let’s roll up our sleeves, wash our hands, and fight for the NHS, for Liverpool Women’s Hospital, for excellent maternity care, and for vast improvements in women’s health!

Fighting internationally for women’s rights at work and for health care.

Across the globe, women are fighting for our rights at work. Good health requires good living and working conditions, decent wages, and decent housing.

The right to decent wages, secure employment in safe conditions, and trade union rights are important to improving the health of women and children across the globe.

  • We support the right to welfare support where women (or men) need to care for children or other people.
  • We demand the right to support in raising all our children and excellent affordable childcare. We demand the right to decent pension at 60 years old.
  • We demand an end to austerity and deliberately created poverty. Kick out Universal Credit. End the third child block on benefits. Give us our rights!
  • Women need control over their own reproductive rights and the right to their own income.
  • The right to access support for their children from the community at large is crucial. It takes a village to raise a child.
  • Poverty wages must go both in the UK and across the globe.
  • Global supply chains should mean global rights for women workers.

The Fedration of Home Based workers of Pakistan send greetings each year to Liverpool’s International Women’s Day.

This year they faced threats to their right to match but marched anyhow.

International women’s day was founded as a day when working class women fought for their rights, demanding Bread (meaning decent wages to pay for food and necessities) and Roses (meaning the good things in life) too. Bread and Roses is now an anthem of workingclass women That fight has spread across the world.

 Paying women well makes healthier women. Poverty must end. Girl babies must be cherished, girls must be educated.. Women workers across of the world should support each other. Fight femicide! Fight for education for all girls! End patriarchy . Young women today can change the world

The Fedration of Home Based workers of Pakistan send greetings each year to Liverpool’s International Women’s Day.
Our two new women MPs Kim Johnson and Paula Barker speaking at IWD really in Liverpool 2020 speaking

Twenty-Five years old.

Lets celebrate one victory in the fight to save our NHS. Twenty five years since Liverpool Women’s hospital opened, five years since the threat of closure first reared its ugly head, and the hospital is still here. It is still not fully safe from closure, or relocation and dispersal but we celebrate where we are today.

If we fight for something sometimes we do win.

We wish Many Happy Returns to Liverpool Women’s Hospital! The new building is 25 years old. In February 1995 the first baby was born in the new purpose-built Crown Street site of the Liverpool Women’s Hospital. Since then about 200 thousand babies have been born there at a rate of 8,000 babies per year.

We thank all the staff for their work at this hospital, whatever their role.

Many women, many babies, and a few men and boys, have been treated there for many conditions other than childbirth. The genetics specialism is just one of the innovations Liverpool Women’s Hospital has developed for the area.

The old Liverpool Women’s Hospital on Catherine Street and two Victorian maternity hospital buildings, Oxford Street and Mill Road, merged at the new location. Local historian Mike Royden wrote a history of the old hospitals.

History of the old Hospitals written by local historian Mike Royden.

It was not until later that Fazackerly Maternity Unit also moved to the new site.

Liverpool Women’s serves not just Liverpool but the wider region and is a centre of expertise meaning it treats some of the most complex patients.

The hospital was built on land owned by Liverpool people, built by the skill of Liverpool builders, and staffed by workers from Liverpool and across the world. It is, like the NHS, the property of the people. The Crown Street site is low rise on a site set back from the road but walkable from the city centre and the Royal Hospital. It is one mile from the main acute hospital, Liverpool Royal, down a straight road. Despite this it is repeatedly described as “isolated” by those who wish to close it. Its not isolated at all.

The site for building the new hospital was provided by the city council. There had been council housing previously on the land. In that estate a young disabled man, David Moore was run down and killed by a police vehicle. The police were driving vehicles directly at protesting youth in the 1980s “riots” but David was just going into a family house. For more details of the causes of the riots see Loosen the Shackles First Report of the Liverpool 8 Inquiry Into Race Relations in Liverpool.

Unions and local activists were determined there would be no colour bar, no discrimination in the building of the site, determined that local black workers would be part of the project. It linked to Project Rosemary to make good the wrongs done to the area. Unions were successful in involving local labour in the construction. It is now a place were local Black and Asian women tell campaigners that they feel safe.

The hospital had state of the art buildings and equipment. It pleased patients with beautiful rooms, layout and equipment, It was a real contrast with the Victorian buildings it replaced.

More importantly, it was respectful of and celebrated the women and babies treated there. The staff were pioneers in developing respectful caring treatments. Old ladies, expert carers themselves, loved the atmosphere at the new Women’s Hospital. Women in Liverpool who needed care at that hospital received the best available care in the world.

Thousands of staff have been trained there and thousands work there; Staff were proud to be part of what became a world-class women’s hospital.

Liverpool Women’s Hospital was built without a PFI, so does not have that debt hung around its neck. It was built before the madness of the internal markets, PFI mortgages on hospitals and massive outsourcing of staff.

The new neo natal unit opens this year.

Despite the overwhelmingly positive outcomes from the hospital, there have been some problems at the hospital since it opened. It is not fairyland. Most of these problems, in common in the whole NHS, are caused by financial cuts and underfunding, by the internal market,( introduced by New Labour) cuts in the number of beds, outsourcing of ancillary staff,  poor management decisions and more. There were some low points. One was a terrible case of a surgeon whose work caused dreadful harm to many women who suffer to this day. At one point there were not sufficient midwives employed. By 2015 Monitor, the NHS quality body at the time published this which basically gave the women’s a fresh start.

Liverpool Women’s Hospital remains a treasured possession for Liverpool women, and for nearly as many dads. As Julie Taylor from Merseyside Pensioners put it “In these troubled times, what we have we hold!” Campaigners  want much more investment, much higher staffing ratios, better pay and conditions and more respect for the staff, better imaging and diagnostics,  more research into many aspects of women and babies health, (all of which are described elsewhere in this blog) but we will not see Liverpool Women’s Hospital closed!

5 years ago a Panorama programme revealed plans to close one Liverpool Hospital, and our campaign to save this hospital started. The Liverpool Echo reported it with the headline “Exclusive Liverpool Women’s Hospital could close, city’s top NHS boss admits”  andFuture of Liverpool Women’s Hospital uncertain after reports deem it “financially unviable” In 2017 the proposals were reported by the BBC and the Echo twice. It was also reported on labour net here.

The management of the NHS in Liverpool has been pushing for the end of the Crown Street site. They even produced documents listing PFI as an option. Fortunately, the scandal of PFI was crystal clear before they got the go-ahead. Most recently they have asked for a rebuild on the benighted Prescott Street site of the Royal, so badly built by Carillion.

The option for using a PFI is in this document.

We call for the existing site of Liverpool Women’s Hospital to be upgraded, and for the hospital to continue to work on the garden site. We want a Women’s Hospital as we have had in Liverpool for more than 100 years.

The disastrous Conservative health care “reforms”, were well underway by the time of the first announcement of the threats to Liverpool Women’s Hospital. There have been many closures and attempted closures of maternity units across the country since then, but so far we have saved Liverpool Women’s Hospital.

Liverpool Women’s Hospital is important as a specialist hospital for women’s health. Women endure many years of ill health, In the UK the average life expectancy in good health is only 62 years old. There is not enough appropriate research as to how this can be prevented. Women’s health matters and we need specialist women’s health care.

The crowd gathered for out last big demonstration.

Chronic ill-health conditions also plague many young women. Endometriosis is just one example of a chronic debilitating illness that required major research to improve current treatment and let us live our lives in good health.

Heart disease in women is a major killer. The British Heart Foundation writes;

Heart disease kills more than twice as many women as breast cancer in the UK every year and is the single biggest killer of women worldwide. Despite this, it’s often considered a man’s disease.”

Heart disease is a significant factor in maternal deaths in childbirth. All of this means that we need a women’s hospital to focus on our health issues.

Save Liverpool Women’s Hospital Campaign calls for major investment on the Crown Street Site, including in blood, labs and imaging, and longer term intensive care if that is truly needed. The completion of the neonatal unit is a good step in protecting the future of this hospital.

This is a hospital at the heart of Liverpool. Paul McCartney has added his voice to the thousands of people who have signed petitions and joined marches to save this hospital and will continue to fight for it. We have been part and parcel of the national fight for the NHS, for maternity rights, for better chances for babies, and for women’s health. As Nye Bevan said of the NHS, it will survive as long as there are people prepared to fight for it and so it is with Liverpool women’s Hospital.

Make the UK the safest place to have a baby!

Why is the UK still not in the top ten countries for infant mortality and for maternal deaths? Why? We are a rich country. We have an established high-quality health service. Healthcare is supposed to be accessible to all. How come babies and mothers die or are badly hurt at birth? How come Black and Ethnic minority babies suffer most? Why do poor areas have worse outcomes than wealthy areas? Why is infant mortality rising? (The infant mortality rate is the number of children that die under one year of age in a given year, per 1,000 live births. The neonatal mortality rate is the number of children that die under 28 days of age in a given year, per 1,000 live births. These are both common measures of health care quality, but they are also influenced by social, economic and environmental factors). Are there fundamental problems with core policy documents like the maternity review “Better births”? These are painful questions.

Our campaign wants real improvements for mothers and babies. This posting is not intended as a clinical paper, it is a discussion amongst activists and concerned citizens about where the problems lie. A key set of participants in this discussion are mothers who have given birth, including those who have lost babies, grandmothers and other birth partners, and women who could not conceive.

Our campaign published our Maternity Manifesto during the election but though well shared on Facebook, it did not get into any party’s manifesto.

We also called a national meeting on issues in maternity care.

What then are the factors that result in UK outcomes at birth worse than other advanced countries?

The answers include shortage of NHS funding, staffing shortages, poor management in some hospitals, staff in fear of speaking out, some policies and procedures, disrespect towards the women carrying the baby, and, as cited in the East Kent enquiry, a lack of practical understanding by staff and by mums of the need to “count the kicks” in the latter part of pregnancy. The introduction of charges for migrant women has also caused deaths. NHS material seems to centre the cause on mothers who smoke, or who are overweight. (Now smoking in pregnancy is plain stupid, it really is, and most mums would not do so if they were not addicted. Don’t do it!). However, other countries, Greece for example, who smoke more, have better outcomes in pregnancy than does the UK. Wider problems like obesity and diabetes, and even women giving birth older, are mentioned in the literature about this. Again, the age of the mother as a factor, but this is only partly true. Giving birth older is often safer than giving birth too young. Globally it is most often young girls who die in childbirth.

Answers may lie in the financially and emotionally vulnerable place that pregnant women occupy in our society, including poverty, violence and stress. Poverty and inequality are factors in infant mortality; “The sustained and unprecedented rise in infant mortality in England from 2014 to 2017 was not experienced evenly across the population. In the most deprived local authorities, the previously declining trend in infant mortality reversed and mortality rose, leading to an additional 24 infant deaths per 100 000 live births per year (95% CI 6 to 42), relative to the previous trend. There was no significant change from the pre-existing trend in the most affluent local authorities. As a result, inequalities in infant mortality increased, with the gap between the most and the least deprived local authority areas widening by 52 deaths per 100 000 births (95% CI 36 to 68). Overall from 2014 to 2017, there were a total of 572 excess infant deaths (95% CI 200 to 944) compared with what would have been expected based on historical trends. We estimated that each 1% increase in child poverty was significantly associated with an extra 5.8 infant deaths per 100 000 live births (95% CI 2.4 to 9.2). The findings suggest that about a third of the increases in infant mortality between 2014 and 2017 can be attributed to rising child poverty (172 deaths, 95% CI 74 to 266).” (Our bold for emphasis).

The UK is a rich advanced country, with a long history of universal healthcare but we have rising infant mortality. “Rising infant mortality is unusual in high-income countries, and international data show that infant mortality has continued to decline in most rich countries in recent years” and “In the most deprived local authorities, the previously declining trend in infant mortality reversed and mortality rose, leading to an additional 24 infant deaths per 100,000 live births per year, relative to the previous trend“.

Poverty is not the sole cause of high Infant Mortality though, Cuba has good outcomes equal to the UK for infant mortality. Cuba is very poor indeed and the UK is one of the wealthiest economies (sadly Cuba does less well on maternal deaths).  

Research shows out of 700,000 births a year in England and Wales, around 5,000 babies are stillborn or die before they are a month old”. 5,000 babies each year. There have been major news stories about baby deaths in many hospitals, notably in ShropshireEast Kent and Morecombe Bay.

Maternal deaths. The UK is not in the top ten countries with the lowest infant mortality rate, neither is it the safest place to give birth. In 2015-17“209 women died during or up to six weeks after pregnancy, from causes associated with their pregnancy, among 2,280,451 women giving birth in the UK. 9.2 women per 100,000 died during pregnancy or up to six weeks after childbirth or the end of pregnancy.” In 2016 The UK ranked 24th in the world in Save the Children’s Mothers’ Index and Country Ranking Norway, Finland, Iceland, Denmark, Sweden, Netherlands, Spain, Germany, Australia, Belgium, Austria, Italy, Switzerland, Singapore, Slovenia, Portugal, New Zealand, Israel, Greece, Canada, Luxembourg, Ireland, and France, all did better than the UK. The situation in some other countries is massively worse than here but that is no excuse. But these baby and mothers’ deaths must stop. We cannot sit back and let these deaths continue.

Let’s be clear, the situation for women in pregnancy and childbirth is massively better than before the NHS, and is head and shoulders better than in the USA today. But maternal mortality is an issue here in the UK, and a huge issue in poorer countries, especially where women give birth without a trained professional being in attendance. Quite rightly professionals and campaigners in the UK participate in international endeavours to improve this situation. The NHS should be training and sending midwives to those countries, instead, it is recruiting midwives from poorer countries. In Europe we have cuts in healthcare through Austerity; in the global south, the same concept of cutting public services to the bone is called Restructuring.

Why is the UK, a rich country with (almost) universal health care not doing better by its mothers and babies? Look at just this case and see the problems in the provision of maternity care;

Archie Batten

Archie Batten died on 1 September 2019, shortly after birth.

When his mother called the hospital to say she was in labour, she was told the QEQM maternity unit was closed and she should drive herself to the trust’s other hospital, the William Harvey in Ashford, about 38 miles away.

This was not feasible and midwives were sent to her home but struggled to deliver the baby and she was transferred by ambulance to QEQM where her son died. Archie’s inquest is scheduled for March. (BBC).

We know that temporarily “closing” maternity units because they are full is a common occurrence. Women then have to go to a different hospital. Induction of labour can be halted because the unit is full. It is not a pleasant situation for mothers. Some maternity units have closed permanently, meaning mothers have to travel further for treatment, at a time when the ambulance service is under great strain (though being in labour is not considered an emergency for the ambulance service!).

Shortage of Midwives and consequent overwork for the existing staff. The UK has a shortage of three thousand five hundred midwives. The midwife workforce is skewed towards older midwives who will retire soon.

Gill Walton, general secretary and chief executive of the Royal College of Midwives said “We know trusts are facing huge pressures to save money demanded by the government, but this cannot be at the expense of safety. We remain 3,500 midwives short in England and if some maternity units regularly have to close their doors it suggests there is an underlying problem around capacity staffing levels.

Training midwives is not just about recruiting new starters to university courses. There need to be sufficient training places in the Hospitals who are already working flat out, leaving little time for mentoring of students, as well as places in the Universities. Alison Edwards, senior lecturer in midwifery at Birmingham City University, who says: ‘It isn’t as simple as recruiting thousands more students as this requires the infrastructure to support it.

‘You need more tutors, more on-site resources and, perhaps more importantly, more mentors and capacity in placement areas – which is currently under immense strain.’ 

One student midwife wrote about her experiences in this letter, where she described very hard work without either pay or good quality mentoring.

The government and the NHS call for Continuity Care from Midwives. This means the same midwife or small team of midwives cares for the mother through her pregnancy, birth and postnatal period. We too believe this would be wonderful if it were possible. It is however impossible with the existing ratio of midwives to mothers. Providing continuity of care to the most vulnerable mothers is a good step. NICE have reduced this to the idea of each woman having a named midwife. One to One a private midwife company claimed to provide this but was unable to continue trading, and went bust leaving the NHS to pick up the pieces.

Nationally the NHS is underfunded and looks set to continue so. Much of the problem comes from a long period of underfunding. We spend less than 9.8 per cent of GDP on health. Switzerland, Germany, France, Sweden, Japan, Canada, Denmark. Belgium Austria Norway and the Netherlands all spend more. That places the UK 13th in the list of high spenders on health care. The US spends 16.9 %. (although a lot of that money is diverted from patient care to the big corporations and insurance companies). The NHS was the most cost-efficient health care service in the world.

Underfunding causes staff shortages. Some errors at birth come from staff being overworked and making mistakes.

Some, our campaign believes, flow from fundamental flaws in government policy such as in the Maternity Review, where the pressure is on staff not to intervene in labour.

 Listen to the Mother. Some of the deaths are from women not being heeded in pregnancy and childbirth. This is backed up in reports from mothers, including some quoted in the big reviews mentioned above. However, overworked and tired staff who know labour like the back of their hand can easily stop heeding an inexperienced mother.

maternity-picturePoverty kills mothers and babies. As we said above, some deaths, poor baby health, and injuries come from growing maternal poverty and ill-health. Low-income families find it hard to afford good food. Food poverty affects a staggering number of children. The charity UNICEF estimates that “2.5m British children, or 19%, now live in food-insecure households. This means that there are times when their family doesn’t have enough money to acquire enough food, or they cannot buy the full variety of foods needed for a healthy diet. In addition, 10% of these children are also classified as living in severe food insecurity (the European average is 4%) and as a result, are set to experience adverse health.”

Studies show that;

The Independent inquiry into inequalities in health (Acheson 1998) found that a child’s long term health was related to the nutrition and physique of his/her mother. Infants whose mothers were obese had a greater risk of subsequent coronary heart disease. Low birth weight (under 2500 g) was associated with increased risk of death in infancy and with increased risk of coronary heart disease, diabetes and hypertension in later life. Accordingly, the Inquiry recommended, ‘improving the health and nutrition of women of childbearing age and their children, with priority given to the elimination of food poverty and the reduction of obesity’. (NICE

mental healthA significant number of deaths of new mothers come from mental health issues that spiral out of control. Some of these will be newly developed conditions and some existing conditions made worse by pregnancy and childbirth. Mothers family and professionals must all be on the alert and intervene early. There are good ways to treat mental health in pregnancy.

Reducing the social and economic stresses around pregnancy would also help reduce the deaths and suffering

When Birth goes wrong it can be a dreadful experience for everyone involved. In most cases, the panic button brings in a well-drilled team of experts who can solve nearly every problem and do it calmly. At other times, it is dreadful, as described in the coverage of the birth and death of baby Harry Richford. Harry Richford was born at the Queen Elizabeth the Queen Mother Hospital in Margate in 2017 but died a week later.

count the kicks poster

Sands, the baby death charity explains that there are many causes of babies dying before birth. Crucially important is that mothers are heeded when they are concerned and that everyone Counts the Kicks

Maternity is not the only area of the NHS that suffers. There have been serious mistakes in NHS planning including closing far too many beds. The NHS closed 17,000 beds and now is working beyond safe bed occupancy. There are 100,000 staff vacancies. Waiting times in A and E are dreadful, as are waiting times for cancer treatment. NHS managers and the Government have taken the NHS far from the Bevan model of healthcare (for history read this).

Press coverage. How does the press cover the NHS, and baby deaths? There are very real problems in the NHS and maternity care but the coverage in the press of these problems seems to switch on and off in strange ways, often to suit Conservative Party political requirements. The NHS and the Government are masters of propaganda and news manipulation. The public needs to learn to judge the news and to look both for actual problems and look out for bullshit and manipulation. Why was news of the arrest of the nurse from the Countess of Chester hospital headlines on the 70th Anniversary of the NHS? Why was the news of the understaffing there not given similar nationwide publicity? Why have we heard little or nothing since?

If the government can switch the blame to the professionals in the NHS (but not their mates the high admin of the NHS), then they seem to be happy to publicise the problems. In other cases, problems are swept under the carpet.

Professionals expect to (and do) take responsibility for their own actions. Mistakes will be made. It is impossible to go through life without some mistakes. When we are dealing with life and death mistakes can be catastrophic, even where there is no ill intent.

Malicious action is rare.   There are the terrible cases of serial murderer Harold Shipman, and the convicted surgeon Ian Paterson who falsely told women, they had breast cancer and operated on them unnecessarily. The hierarchical system in the NHS and the lack of regulation in private hospital, which was described as “dysfunctional at almost every level” allowed that harmWe have not found such a case in maternity.

Unintentional bad practice, however, has also harmed babies. No one went to work intending to harm in the events publicised in the Morecombe Bay Enquiry into the deaths of 11 babies and one mother. It was said that “The prime responsibility for ensuring the safety of clinical services rests with the clinicians who provide them, and those associated with the unit failed to discharge this duty over a prolonged period. The prime responsibility for ensuring that they provide safe services and that the warning signs of departure from standards are picked up and acted upon lies with the Trust, the body statutorily responsible for those services.”

The Enquiry described what happens like this “In the maternity services at Furness General Hospital, this ‘drift’ involved a particularly dangerous combination of declining clinical skills and knowledge, a drive to achieve normal childbirth ‘whatever the cost’ and a reckless approach to detecting and managing mothers and babies at higher risk.”

The Furness General Hospital was pushing for Foundation Trust status at the time and was not exercising the necessary supervision.

“Maternity care is almost unique amongst NHS services: the majority of those using it are not ill but going through a sequence of normal physiological changes that usually culminate in two healthy individuals. In consequence, the safety of maternity care depends crucially on maintaining vigilance for early warning of any departure from normality and on taking the right, timely action when it is detected. The corollary is that, if those standards are not met, it may be some time before one or more adverse events occur; given their relative scarcity in maternity care, it is vital that every such occurrence is examined to see why it happened.

So, many factors come into play in such incidents of harm to mother and baby. Professionals too can be emotionally wrecked by tragedy.

Huge personal and professional lessons can be learned from a detailed review of cases where mistakes are made. There is a whole literature about learning from mistakes. The worst such incidents are referred to as Never Events. This is just one article about such errors but there is a whole field of research devoted to it. Serious Mistake Reviews often happen at the end of shifts, and in the worst cases, may lead to long public enquiries.

NHS as a research organisation One of the great virtues of the NHS is the research base it offers professionals. What happens in the NHS which covers 62 million people is studied, evaluated, and researched. This is invaluable to staff and above all to patients. Sadly this research is also of interest to big business especially to those who sell health insurance and to the big corporations who have their ‘snouts’ in the NHS ‘trough’. Research for the common good is clearly different from research to make money. We see that regularly in big pharma. Cheap effective medicines do not make money for the companies. Yet the government is giving away our medical data to companies to make a profit.

There are also “errors” that happen when everyone is following accepted procedures and protocols; “untoward events, complications, and mishaps that resulted from acceptable diagnostic or therapeutic practice”. Procedures within the NHS can be robust and well researched, and problems still occur.


Research matters. Only by studying outcomes can these errors be revealed. A classic example is the once customary practice of episiotomy, cutting a woman to prevent tears to the perineal skin in childbirth, which is now no longer used except in an emergency. Research both formal and informal changed that practice. As another example of such research, Liverpool Women’s hospital has been involved in research about the benefits of leaving the baby attached by the cord if they are born unwell. NHS staff and other health professionals, academics and pressure groups are working hard to improve outcomes for mothers and babies. Each mothers death is reviewed in the MBRRACE-UK report


Never again. The tragedy of the death of a mother and or baby is felt by that whole extended family. Most families want to know it will never happen again. Cover-ups and lies mean it will happen again, so brutal honesty is needed.

The aftermath of medical treatment or neglect which causes real harm is complex. Whether the outcome is death, life long impairment, or long term physical and mental health issues, these are very significant events for all concerned.

Campaigners in Liverpool campaign for SEN funding to be returned. 2019

If a baby is born with life-changing impairments, the baby is left facing catastrophic difficulties and the mother and family can face major heartbreak and hardship. The huge love we have for our kids (may it long continue), whatever their issues, does not prevent the financial, housing and employment issues families with disabled children face. Nor does it guarantee the best educational opportunities, SEN is being battered by cuts. but parents and teachers are fighting back.

The cost of financial “compensation” from an injury to a newborn is huge because it is life long. The cost of this “compensation” used to be carried by the government but the system changed to make hospitals “buy” insurance from a government body which is set up like an insurance company. The cost to the hospital is charged on the basis or earlier claims, like car insurance. Obstetrics make the highest claims of any section of the NHS.

Liverpool Women’s Hospital had a huge case (not about babies) some years ago, arising from a surgeon who left many women damaged after incontinence operations. Their total bill, over 5 years, according to the Echo, was £58.8 million. “The NHS trust has been forced to pay out £58.8m in the last five years for both recent and historic negligence cases.

The limited work we do, as a campaign, in holding the hospital to account, leads us to believe lessons have been learned by the hospital. However, in every hospital, there are pressures which could lead to problems. These pressures include financial and organisational, problems of management ethos, and the potential for bullying, the distrust by the staff of their management, and disrespect for whistleblowers.

The NHS has gone through years of reorganisation after reorganisation. In that time the financial and government pressure has been to complete the re-organisation, or face catastrophic consequences so very many hours of admin and senior doctor time has been wasted on this process. That time could have been focussing on saving babies

its their NHS we fight forAt STP and national level, there are other problems. The NHS is intensely political. There are deep structural problems. (We believe the NHS should return to the Bevan Model of health care)

The NHS is not only deprived of adequate funding, but it has also been forced to implement many market-based changes, including the internal market, outsourcing and commissions of services to for-profit companies. These market-based structures are expensive.

The NHS has also seen dire staff shortages resulting from stupid decisions like removing bursaries, not training enough doctors and the hostile environment to migrant staff.

There are moral and financial issues in all cases of such errors. The hurt to the babies is our priority.

Baby deaths and severe injury at birth have complex roots. Though what happens in the hospital is crucial, it is not just what happens in the hospitals that matter. The stress, poverty and anxiety many mothers endure during pregnancy do sometimes affect the outcomes for the child. Many women are still sacked for being pregnant but families can rarely cope with just one wage (do fight back against sacking pregnant women!). See Maternity Action for details. Both mums and midwives can call Maternity Action for advice.

Low pay or the dreaded universal credit can make food heating and rent all too expensive. This can lead to food poverty. Women do not yet have real equal pay but mothers have the worst pay of all  Benefits are no longer allowed for a third child. even though most claimants are working. Whether parents are working or not, every child has a right to food and shelter, be they first or 10th child. The child gets no choice!

Not every pregnant woman is in a stable caring relationship. Housing, especially private renting, becomes more difficult when women are pregnant. Who can forget the story of the homeless woman giving birth to twins in the street? Pregnancy is often the time when domestic violence is inflicted on a woman but it is the time when women are least able to walk away. Poverty kills babies too.

Please join us in campaigning for better outcomes for all mothers and babies in the NHS and across the globe. We want this to start a discussion, so please send us your views. and information