Greg Dropkin, a retired NHS administration worker and long term warrior and researcher for the NHS campaigns spoke at our zoom meeting about the impact of the proposed legisaltion as foreshadowed in the NHS White Paper. These are his notes
Every trade unionist should be interested
“I will be talking about the implications for staff, which should ring alarm bells for all unions organising in the NHS. But let’s start with the Health Systems Support Framework, an NHS England scheme to accredit companies to support the development of Integrated Care Systems.
The HSSF already involves 200 companies including 30 US firms involved in the health market, providing health insurance or supplying services to insurers. IBM, Optum – owned by UnitedHealth, Cerner, Centene, Palantir. The Bill is expected to allow them onto ICS Boards and Committees, with pivotal roles in setting up digital and data systems. Already in Bristol, Virgin is on the ICS Board. It is accredited for 6 topics under the Framework:
1) Shared or Integrated Care Records (Implementation Support); 2) Development of Service Change and reconfiguration proposals; 3) Transformation project and programme management (expertise and capacity); 4) Organisational redesign, governance, payment and contract reform; 5) Workforce and leadership development; 6) Patient pathway optimisation and care model design
This isn’t about Virgin getting a contract to run a service designed by the NHS, it’s Virgin and other transnationals lined up to tell the NHS how it should redesign and govern itself with new payment systems and contract models, and develop the workforce to deliver new models of care.
The Bill will be based on a White Paper which adopted proposals from NHS England.
I’ll talk about 3 issues for staff: national agreements, flexible working, and deregulation.
Currently, NHS staff are covered by national agreements on wages, terms and conditions. The agreement covering all healthcare staff apart from doctors and dentists, is called Agenda for Change.
Neither the White Paper, nor the Consultation which NHS England ran over Xmas, nor the Workforce Strategy for Cheshire & Merseyside, mentions Agenda for Change or wages, terms and conditions. If you search for “pay” in the Workforce Strategy, the only thing that comes up is: “…we must improve the experience of our people. At every level we need to pay much greater attention to why many of them leave the NHS” (!)
Breaking up the NHS into 42 separate ICSs each with their own budget, threatens the national agreements, because each ICS will be trying to cut the costs in their own area, and staffing is the biggest item because healthcare is still labour intensive, although of course they want to change that.
Back in 2012, employers in the South West tried to break from Agenda for Change. It was known as the South West Pay Cartel, and all the unions including the RCN fought it off. Here’s what NHS South of England said at the time:
“We are aware that some employers are considering working more collaboratively in order to ensure that their pay frameworks represent best value for money… the Strategic Health Authority continues to work with employers and trades unions in applying national terms and conditions where employers do not have the freedom to develop their own.”
Now the ICS will give employers that freedom. Before Xmas, an NHS England consultation on reform of the payment system stated:
The blended payment model would involve: •a fixed payment based on the costs of delivering a level of activity conforming to the ICS system plan •The fixed payment would be based on consideration of costs, rather than prices. •The value of the fixed payment would be determined locally. •Fixed payments would be expected to include funding for new ways of delivering services – for example where there are service design changes
Now a locally determined fixed payment based on consideration of costs means that there is no guarantee that staff costs will be tied to a national agreement on wages, terms and conditions.
The latest guidance from NHS England, issued this month, includes a commitment to protect terms and conditions for CCG staff being directly transferred into the ICS body, but says nothing about the other 1 million NHS employees.
The latest NHS England guidance, like the earlier consultation, highlights flexible working.
To support local and national people priorities for the one workforce in the system,
the ICS NHS body should work with organisations across the ICS to:
Develop new ways of working and delivering care that optimise staff skills, technology and wider innovation to meet population health needs and to create flexible and rewarding career pathways for those working in the system. This should be enabled by inclusive employment models, workforce sharing arrangements and passporting or accreditation systems.
This will allow continual redeployment as and when deemed necessary.
It will interfere with union organisation, demoralise staff, reduce continuity of care, undermine local knowledge and team working, and require more travelling, which is bad for the environment as well as staff.
Also, inclusive employment could allow redeployment into private sector partners.
Later on in the document, NHS England say NHS bodies are expected to
“adopting a simplified cloud-first infrastructure that provides agility and frictionless cross-site working experience for the workforce.”
This poorly written phrase suggests that as long as the computer system is set up for it, all other problems with continual redeployment are irrelevant.
A) Non-nurses in nursing roles.
On 9 June, the Guardian reported the RCN warning that NHS trusts are recruiting people without the right qualifications to act as registered nurses, despite the risk to patients. One trust advertised for a matron – a managerial role usually filled by a senior nurse – to work in acute medicine but said that a qualification in nursing was not necessary. Another trust sought to recruit a matron who would be responsible for older people’s mental health and learning disability services, but did not specify that the successful applicant had to be registered with the Nursing and Midwifery Council, which regulates both professions. Another advert for a nursing role stressed that the recruit could be a staff nurse, nursing associate – a new role being expanded to help plug the shortfall of registered nurses – or healthcare assistant.
B) The White Paper would give power to the Secretary of State to remove individual professions from regulation in future. “over time and with changing technology the risk profile of a given profession may change and while regulation may be necessary now to protect the public, this may not be the case in the future.” But technology means taking decisions by algorithms and apps instead of clinical judgement. If the healthworker lacks skills, training and experience, they won’t even be able to tell their manager they think the computer is wrong, either because of a glitch or a badly written programme. This is a risk to patients and also threatens professional development.
C) The Bill will remove the NHS from the scope of the Public Contract Regulations 2015. This is being promoted as an end to privatisation, but it actually means an unregulated market, without the protections in the PCR 2015 under which “contracting authorities may consider incorporating social, ethical and environmental aspects into specifications, contract conditions and award criteria. In addition specific rules have been included for handling abnormally low tenders, and on the exclusion of suppliers who have violated certain social, labour and environmental laws.” Those protections will vanish.
Over the last year, Government spent £37 billion on a Corporate Test & Trace which failed – even as the Delta variant emerged, when case numbers were low and the timing was ideal for it to work. The government threw billions more at private sector crony contracts, like those in the latest revelation from the Good Law project:
*Uniserve Limited* is a logistics firm controlled by Iain Liddell
Prior to the pandemic the firm had no experience in supplying PPE, yet the firm landed a staggering £300m+ in PPE contracts from the DHSC and an eye watering £572m
(This video starts with some noise distortion but settles quickly)
We have an excellent healthcare system in the NHS. Its battered and bruised but still worth its weight in gold.Our campaign is for a fully funded public service providing all the treatments and to everyone The NHS is not only in the middle of a pandemic, in the middle of delivering millions of vaccines and in the midst of major staff shortages, it is also facing a fundamental political reorganisation by this government. This reorganisation is spelled out in the NHS Whitepaper, a reorganisation which will ration services, ramp up profit for private companies. and pay the corporations to cut our services. It has significant implications too for NHS staff. The NHS is being split into 42 very different areas Ours is Merseyside and Cheshire.
As ordinary people we have to do our best to spread the word of what is happenning and give people the chance both to be informed and to take action. We were delighted to be joined in a zoom meeting by two local MPS. Margaret Greenwood MP and Ian Byrne, and by John McDonnell MP
Our June 22nd 2021 meeting started with an introduction to our local campaign. Our campaign is for a fully funded public national health service providing all the treatments for everyone. Nothing less.
Report to public meeting from Cheshire & Merseyside Campaign 22 June 2021
To date, we have written to hundreds of council candidates in Wirral and in West Lancashire before the local elections in May asking if they were prepared to oppose Integrated Care Systems.
In the last 3 weeks, we have written to every councillor in the footprint of the Cheshire & Merseyside ICS, that’s 9 councils comprising 579 councillors from all parties. The headline under which we have written to them is “Not on Your Watch”. We sent them detailed briefings explaining ICS and the implications of the white paper. We have offered to provide more information, to speak at council meetings or party groupings and to work with any council or councillor and any party willing to engage with us. We have had some replies but not many considering the number of emails sent. The replies we did receive range from automated replies, to replies saying that they are not responsible and directing us to some other councillor, to saying they are planning a meeting to discuss the meaning of ICS, to saying they do not understand, to disclaiming responsibility for waving through this remodelling and claiming they are trying to mitigate the effects, to some who are supporting our campaign and want more information.
In particular the green party group in Wirral council are interested in learning from us and have invited us to meet with them.
Cheshire West had invited Felicity, on behalf of the local trades council, to speak but have now postponed that meeting until the Bill is published when they will have very little time to oppose it if the rumours are true that it will be rushed to a second reading by the end of July.
The ICS restructuring is made to sound complicated, using misleading vocabulary, ignoring traditional boundaries and local historical arrangements. The chief officer of the Lancs & Sth Cumbria ICS was one of those in Davos with Simon Stevens when McKinsey drew up their plans for the NHS. L&SC was one of the early vanguard ICS and so has been grappling with the restructuring and new ways of thinking for some years. In January 2020, Amanda Doyle also took over as chief officer at West Lancashire CCG (she was already chief officer of two other CCGs) and the tension in the room was palpable. Previously CCG meetings had been fairly relaxed affairs, the former chief officer sat off to the side, was mostly quiet throughout and was softly spoken when he did contribute. However, under the new regime it was clear the boss had entered the room, she sat centre stage and took control. She does the same at ICS level and often reminds committee members that they are straying into the old ways of thinking and they need to forget boundaries and CCGs borders. They talk about getting the “right people around the table” especially from local authorities because they have “difficult decisions to make” – one difficult decision is how to make £300m of cuts across the ICS, £ 200m of it in one year was their original aim. They have spent a fortune on bringing in consultancy firms to re-educate NHS staff and others to think in the ICS way and to persuade the public to change our way of thinking about what the NHS is for and what we should expect from it, e.g., our GP-patient relationships are being broken down. They talk about “winning hearts and minds” and admitted in one meeting that they are “not quite there yet” in persuading clinicians. So, it is no surprise that councillors and the public find the concept difficult to understand. We have access to speakers from our collective campaign and also from other organisations and we will return as many times as necessary to speak to groups until they have grasped the ICS model and its implications. We really want to keep the dialogue open.
Some councillors have claimed they are mitigating the worst excesses of the bill and claim to have reached an agreement in C&M whereby each of the 9 councils will have one councillor on the ICS board. However, the recent government guidance is that there will be one councillor from the ICS footprint and that councillor will not represent their local government sector. Who or how will the 9 councils decide which councillor is the chosen one or is it the ICS chief who can bestow such gifts?
We are not looking for mitigation or amelioration, to quote our very own Dr Alex Scott-Samuel that is just rearranging the deckchairs on the Titanic. What we are calling for from councillors is wholehearted, loud, and vocal, public opposition to ICSs particularly labour councillors just like the uproar we heard from football fans in the 48 hours it took them to turn around the involvement of US corporations and the European Super league. If we do not want US global giants like United Health and Centene running our football, we certainly do not want them running our NHS.
We will be following up our letters to councillors reminding them that this wholesale destruction of the NHS is happening on their watch, and it will go down in the history books as the biggest theft perpetrated against an entire population.
Another campaign action over the last 3 weeks was the distribution of 5000 leaflets to NHS staff at their shift changeover mainly at 7am. Our campaigners were outside The Royal, Aintree, Liverpool Women’s, Arrowe Park, Alder Hey, Southport and also at a picket with striking Biomedical Scientists at Burnley General Hospital. Greg will speak more about the industrial action in Burnley. We handed out the KONP leaflet aimed at NHS staff, and it was very well received by them. We could see them reading it before their shifts, as they came off shift and during their breaks. For the last month, campaigners have been holding stalls in West Kirby, Wallasey, Ellesmere Port, Crewe and Chester with a good reception and causing merriment by handing out leaflets via fishing nets to ensure social distancing! These stalls will continue, and we are planning stalls across Sefton, Knowsley, South Liverpool and also in Blackburn over the next few weeks. Please get in touch if you can do a stall in your location, the idea is to have them all over the footprint and beyond. We can supply you with leaflets and posters or alternatively let us know if you want to join us on a stall. Everyone is most welcome. Bring your fishing net! For over a year we have been producing our own artwork for posters, having them printed and laminated and putting them up in prominent locations around the C&M footprint but mainly across Merseyside. For example posters were put on railings in Sefton Park, Otterspool Prom, County Road, Walton Vale, Ellesmere Port and many more places like parks, shopping areas,and in shop and café windows. Members have also encouraged the public to take the posters home and to put them in a window. We have electronic posters in distinctive vivid blue and yellow which we use for social media posts and for banners to create a recognisable colour scheme and message. Our posters are being used by other campaign groups. Let us know if you would like a poster for your window.
Other work we have undertaken is to speak at as many meetings as we can with organisations, campaign groups, political party meetings, union branches, Trades councils, Area Activists meetings, North West health committees and privately with a wide range of union officials and MPs and supporters. This is getting the message out, building the body of people who understand what the whitepaper threatens and who can in turn speak to colleagues at work and at home to spread awareness, and aids us in getting the ICS motion passed and pushed through the layers of parties and unions. Our aim is to bring people on board with our campaign and it has spurred some on to start their own campaigns. We have learned lots of new skills, made new friends and built up relationships and it has to be said we have also ruffled a few feathers which is exactly the aim of our campaign. We need people to feel uncomfortable about what they are waving through. Zoom has enabled us to reach audiences we may never have reached before. We want all unions and all sectors talking about this attack on the NHS not just health unions and health branches. These plans put patients at risk, risk jobs and leave staff at risk particularly when being expected to work beyond their competencies. We all need the NHS and we need properly trained and properly paid NHS staff.
Our efforts are gaining momentum and as we speak to each group, they are horrified to learn what has happened to the NHS and the way it has been restructured without any political mandate nor any statutory authority to do so. Our campaigners also attend CCG, ICS, Trust Board meetings, council O&S and Health and Wellbeing meetings. We raise Freedom of Information requests and hold them to account where we can.
We are building a movement – anyone who can help with any of these actions, who can write letters, use social media, write articles, use technology etc is urged to get in touch. We need any skills you can bring to the campaign.
Our campaigning against the NHS restructuring did not just start this year, it has been going for years including resisting the closure of the Liverpool Women’s Hospital as part of the ICS restructuring which is an ongoing battle. Two years ago, we mounted a mass campaign over the course of 2 weeks against the MyChoice NHS price list at Warrington Hospital Trust, giving out 5000 leaflets, getting signatures on petitions, lobbying MPs, getting articles in the Daily Mirror and The Echo and forcing Simon Stevens to have to speak about it in a House of Commons committee meeting. We got that pricelist paused but it is part of the restructuring of the NHS so it will come back on the agenda and indeed it was forced through in other parts of the country. But the point is, we CAN do this if we build enough pressure from the ground up so that those in positions of power cannot ignore us. They have to take notice. Just like people did in the poll tax campaign. It just needs us all to do our bit however small.
If you have children under 13, you need to fill in this form [PDF] and e-mail or post it back to NHS Digital – this form works for both you and your children.
If you have an adult dependant for whom you have legal responsibility, you must use this form [PDF] and send it back to NHS Digital on their behalf.
There is no deadline for step 2, the National Data Opt-out (i.e. your non-GP data), but the sooner you do it, the sooner it takes effect. The National Data Opt-out will not stop your GP data being extracted by the new GP data collection.
N.B. If you opted out of care.data in 2014, then you shouldn’t need to do anything now. As most people did both a ‘Type 1’ opt-out and what is now a National Data Opt-out, you can check your NHS Digital opt-out status online at NHS Digital. Your GP opt-out status will probably match the opt-out status shown there; although if you’re not sure, giving a a ‘Type 1’ form to your GP Practice now doesn’t have any risk.
If you don’t have access to a working printer, you can ask the NHS Digital Contact Centre to post you the forms you need. Their phone number is 0300 303 5678 and they are open Monday to Friday, 9am to 5pm (excluding bank holidays).
Or, if you prefer, you can e-mail printer@medConfidential.org with your postal address and we will post you copies of the paper forms, for free, no questions asked. If you don’t have e-mail, you can text your address to us on 07980 210 746. If you can afford to make a small donation to support us in offering this service to others, we have a donation page. We will, of course, only use your details to send you the forms you want and will delete them as soon as we have done that. (medConfidential is registered with the ICO to process personal data in this way.)
As new information or actions that you can take become available, we inform people via our mailing list: Join our mailing list We will not share your details with anyone else.
GP data: As your ‘front door’ to the NHS, your GP holds the lifetime history of your GP care; all of your prescriptions, your diagnoses, your ailments, your tests and referrals – and the context for them all as well. You have the choice whether information from your GP record is copied outside of your GP practice for purposes other than your direct medical care. (This choice was created in 2010, and is between you and your GP only.) Your GP treats you; other parts of the NHS tend to treat ‘a condition’.
Other data: The National Data Opt-out is intended to cover your data being copied from all other care providers, and NHS Digital, for purposes beyond your direct care. This choice will in time cover all hospitals, etc. but can at present only be set via NHS Digital, the option to do so via your GP having been withdrawn in 2018. (N.B. The National Data Opt-out does also cover your data leaving bodies such as Public Health England, which used to run the database of every patient who has ever had cancer, as well as other databases.)
Opting out: While in 2014 you could opt out of secondary uses (i.e. non-care uses) of your NHS data with a single form, now you must use at least two different processes – three, if you have children or dependents.
Re-use of your records beyond your direct medical care: Choices not available to you
Exercising the opt-out choices linked above will protect you from some risks – certainly more risks than if you do not express those choices. Both opt-outs do precisely what the Department of Health claims they do, but they do not protect you as they could.
These choices do not, for example, currently:
Prevent the sale of your hospital history to companies;
Prevent the non-clinical body NHS England insisting that you opt out all over again if it decides to create a new project…
As of 2021, some NHS bodies’ actions are still not compliant with the 2018 Data Protection Act, which implemented the General Data Protection Regulation (GDPR) into UK law. And several of the important safeguards promised in 2014 are still entirely missing:
The commercial re-use loophole remains open;
No ‘single-strike’ penalties are in place;
No significant contractual sanctions have been applied, despite serious breaches;
No Regulations have been laid to guide the Confidentiality Advisory Group;
NHS Digital is still releasing huge volumes of linked, individual-level patient histories rather than using safe settings;
The best way to have confidence in how your wishes will be respected, and in how your data will be used next month, is to see how your data was used last month. This, for all the reasons we list above, remains impossible.
(A leaflet from Defend our NHS Wirral given out at their stall this weekend. The details will differ in different areas but the issues are the same.)
Who’s running our NHS? The wrong people. For the wrong reasons.
What do you want from the NHS?
Free health care for everyone, everywhere—or being forced to ‘go private’?
Seeing your GP — or questions on a screen?
Experienced professionals — or an ‘app’? or a call centre?
A walk-in centre and hospital services near home—or not even in Wirral?
Treatment decisions by medical staff on medical grounds—or an accountant in the USA?
Well, the people below want you to have the second choice in every case. They call it ‘efficiency’. Or ‘patient choice’ . We call it putting profits before people, with lucrative opportunities for the private sector.
What’s happening? Our precious NHS will disappear next April, replaced (here and in 41 other regions) by a so-called ‘integrated care system’ (ICS).
Already in the driving seat (yes, in Wirral as well as nationally) are giant corporations, many of them American. You know the nightmare of American ‘healthcare’; it’s here.
We have to stop the ICS. Why? In each of them:
a “single pot” budget will cover all the people in one area (instead of paying for
individual treatments, like now). So waiting lists will lengthen and there will be rationing. Cash-strapped hospitals will depend on treating ever more private patients.
there will be two boards, one of which could appoint private companies to sit on it. Companies on boards will be awarding each other contracts, and many of them will be American. Contracts will be handed out without a tendering process (like the cro nyism during the pandemic but on an even bigger scale).
NHS staff face an uncertain future. They will be required to work with more “flexibility”. “Cheaper” staff will be expected to take on work without professional qualifications or regulation.
Who’s running our NHS? McKinsey of New York, United Health and Optum of Minneap- olis, Centene and Operose of St Louis, Cerner of Kansas City….
We think we should be running our NHS—for PEOPLE NOT PROFIT. JOIN US TO STOP THE ICS!
We respond here to the terrible news that babies of black mothers are twice as likely to suffer a stillbirth.
This article represents an immediate response to recent news. We need to find out what the situation is at Liverpool Women’s Hospital and will report back. We do know that the hospital is aware of the issues and has interventions in place.
It would be wrong to scare mums who are pregnant. The figures are still low, it is still a rare occurance, but any preventable baby deaths are too many. The heartbreak lasts forever.
Infant Mortality: These countries are better than UK in delivering live babies. Japan,1.9 deaths per 1,000 births Sweden, Finland, Austria, Spain, Italy, Ireland, Germany, Portugal, Greece, Netherlands, Denmark, Belgium, France. We have 3.9 baby deaths per 1000 live births. Sadly for our US sisters, we are much better than the USA who have 5.8. In both US and UK, black babies are more likely to die.
Our midwives are not to blame for this. The staffing levels for midwifery are not good enough, even when hospitals meet them. We need more midwives, more antenatal visits, more post-natal care. Our babies are worth it.
Train more midwives and obstetricians. Treat them well. Stop burnout. Stop maternal Poverty. Improve ante natal care. For all our mothers, sisters, daughters, friends, and lovers and for our precious babies. #SaveOurNHS #NHSResistance Source Lancet and LSE COMMISSION on the NHS
Our provisional data show that the number of stillbirths continued a long-term downward trend in 2020. There were 1,835 stillbirths in the first three quarters (Jan to Sept) of 2020, 130 fewer than in the first three quarters of 2019. As a result, the stillbirth rate declined from 4.0 stillbirths per 1,000 total births in 2019 to 3.9 in 2020 so far.
As in earlier reports ethnic origin continues to have a significant impact on mortality rates:
Stillbirth rates for Black and Black British babies were over twice those for White babies, whilst neonatal death rates were 45% higher.
For babies of Asian and Asian British ethnicity, stillbirth and neonatal death rates were both around 60% higher than for babies of White ethnicity.
The stillbirth rate was 1 in 295 for White babies; 1 in 188 for Asian babies and 1 in 136 for Black babies.
‘These results suggest that a more targeted approach may be required to benefit the Black and Black British and Asian populations’ says Professor Draper. ‘In the New Year we will be starting an MBRRACE-UK confidential enquiry into the deaths of babies born to Black and Black British mothers to investigate the quality of care provided for these mothers to identify whether there are any particular issues.’
The results continue to show that women living in the most deprived areas had an 80% higher risk of stillbirth and neonatal death compared to women living in the least deprived areas. The rate of stillbirth was 1 in 383 for women living in the least deprived areas, compared with 1 in 214 for women living in the most deprived areas.
Liverpool Women’s Hospital is in a deprived area, serves a deprived city and a multi-racial population, so this very much matters to us.
Our response is that we will campaign. This campaign will include pressure on the government and on MPs and NHS England to:
Drive out racism, in all its forms. Every baby counts.
Mourn the babies and commit to reduce Still Births.
Significantly Increase Funding for Midwifery Services and Obstetrics.
Increase Funding for Hospitals and Universities for Midwife training; training midwives requires sufficent staff in the universities and in the labour wards and maternity services to provide excellent education for students. The NHS needs an effective plan to train many more midwives to world-class standards.
No reduction in professional standards, no subsitution of less well qualified staff, no asking staff to act up beyond their qualifiications.
Maternity needs a more humane, cooperative, and respectful management structure. It needs improved relationships between obstetricians and midwives right from the first training, and all maternity units require 24 hour consultant cover.
Reduce workload and where it can’t be reduced, provide real staff welfare. Good food on site, including some to take home if people are too tired to cook when they get home, free parking, excellent admin support and of course better pay. Support #NHSPay15. See this to help NHSPAY 15.
The pace of work in maternity units must be more humane, and that means more staff, which means changing the recommended staffing ratios. Better working conditions will improve staff retention.
By improving outcomes for Black babies we improve them for all because this will take interventions and improvements that cannot help but improve them for all.
Stop migrant charges. Full stop! These charges are fundamentally wrong and affect black and asian women most of all. The law must change. The charges deter women from seeking timely maternity care and this has caused deaths.
Increase antenatal checks; research has shown that additional antenatal checkups save babies.
Listen to the mums, heed their concerns. Midwives and obstetricans of course spend their lives listening to pregnant women and women in labour but we must find ways to improve that communication. Maternity needs to heed to the mothers, during pregnancy and in labour. Health education needs to to offer much better school and popular education about pregnancy and childbirth.
The NHS must consult the midwives and obstetricians and the communities, openly and democratically, on how to improve the experience of BAME Mums.
Have working parties of BAME staff to research how to drive down the numbers where the cause is medical rather than social.
The removal of bursaries shut out recruitment from many less well off and mature students. Bring back full bursaries. No-one should pay to train as a midwife. There is currently no shortage of people wanting to be midwives. We just have to find the werewithal to train them initally and to provide ongoing professional education, and to persuade those in service to stay.
Austerity was a policy introduced after the financial crash, a decade ago.It not only cut the money spent on healthcare in real terms, it was accompanied by a rise in racism and in racist rhetoric becoming normalised. This rhetoric seeps into people’s thinking unconsciously and has to be challenged. Austerity resulted in contempt and disregard for poor communities.
The Kings Fund reports that “During the period of austerity that followed the 2008 economic crash, the Department of Health and Social Care budget continued to grow but at a slower pace than in previous years. Budgets rose by 1.4 per cent each year on average (adjusting for inflation) in the 10 years between 2009/10 to 2018/19, compared to the 3.7 per cent average rises since the NHS was established.
However during this funding drought the services the NHS was required to deliver increased. In the current White paper the Government said
NHS activity has grown every year since records began (at an average of 3.3% a year) (This while funding increased by 1.4% Our comment)
Most countries have been reducing still birth, but the rate of improvemnt in the UK is grindingly slow.
Maternity Units have been closed in numbers only equalled by the closures in A and E. Staffing numbers were not protected. Our lives did not matter to the government
Poverty as well as race increases the liklihood of still birth. Some still births are to women not living in stress and poverty and we mourn with them too.
In this Austerity time poverty for women grew, Women’s poverty passes on to babies and children. We all need to shout from the rooftops that poverty is bad for mums, bad for babies. The wages and welfare systems have to provide for all. Child Poverty Action group described how families are falling deeper and deeper into poverty.
“The latest annual report by the Social Metrics Commission found that nearly half of Black African Caribbean households were in poverty, compared with just under one in five white families, while BAME families as a whole were between two and three times as likely to be in persistent poverty than white households.“
Whilst our communities grew poor the rich became much richer.”Since the Great Recession hit in 2008, the 1% has only grown richer while the rest find life increasingly tough. The gap between the haves and the have-nots has turned into a chasm. While the rich have found new ways of protecting their wealth, everyone else has suffered the penalties of austerity.“
A huge chunk of our kids live in poverty. This is not personal misfortune, or bad management, it’s policy and it must change. This is a very wealthy country. The UK are part of the G7 group of wealthiest nations. Poverty is bad policy.
We also ask, did the years of focusing on natural childbirth affect the training of midwives? Our campaign supports women in choosing their style of birth but the dangers seem to occur in the most complex cases. We have seen the Ockendon, report into baby deaths in Shropshire and Morecombe Bay, and other scandals. Responding with Continuity of Carer as the answer is contradicted by a shortage of midwives. “Although maternity providers across the UK are striving towards providing full CoC to women, this level of continuity can be hard to maintain in a system with staff shortages and an often depleting workforce, combined with the need to be on-call for births.
The Continuity of Carer system could work if we had excellent staffing, but we do not.
Do we need greater medical emphasis in training?
Do we need to ensure that doctors in training all do obstetrics early in their training? Do we need to look at the professional and working relationships between obstetricians and midwives?
We cannot accept the concept of population funding as described in the White Paper in the context of far too many still births and maternal deaths in childbirth, There has to be flexibility of funding to respond quickly. Health care on the cheap is not health care at all. maternity needs funding and that responsibility rests squarely with the government. The US companies to whom this government is turning to run our NHS has nothing at all to teach us about reducing Still Births. Indeed they are a danger to us.
From 1994 onwards, the United States has consistently had the highest rate, with 5.6 infant deaths per 1,000 live births in 2016. In contrast, Finland had the lowest rate of 1.9. In 2016, the UK had the fourth highest infant mortality rate of the comparator countries, but the highest of comparable European countries.
Chase the US companies out of our NHS, demand full NHS funding with an increase year on year of 5%
Save Liverpool Women’s Hospital Campaign will be one of the sponsors of a national meeting in the autumn on defending and improving maternity.
Please do get in touch to tell us your views as a mum, a family member, or a midwife
All of this shows how we need a fully funded universal health care publicly provided, and an absolute end to austerity. That is why we are joining in the Cheshire and Merseyside camapign for a fully funded NHS and to say no the white paper.
For all our mothers, sisters, daughters, friends, and lovers and for the precious babies
World class healthcare for all. That is how the NHS was founded, and we want that back. “What we have we hold”! We will not give up the NHS.
“They would not dare privatise our NHS”
We are writing this to say, YES, they are doing just that, but under a smoke screen. We are saying that privatisation puts private profit way ahead of public good and leads to pain, suffering and denial of medical care.
Repair the NHS – reject the government’s “Integration & Innovation” White Paper
This whitepaper is a deep threat to the NHS as we know it. We are calling for a big campaign to explain the threat to as many people as possible, to build a popular campaign to defend the NHS and resist this White Paper.
If you want to know more about the White Paper please see other articles on this blog, and we recommend this article from calderdaleandkirklees999callforthenhs.wordpress.com
Deborah Harrington has written this briefing for MPs, Keep our NHS Public has mountains of information and there are dozens of campaigns around the country.
The structure of the system which the government and NHS England have already implemented, and which will be made legal by the legislation if it passes, is like this;
The NHS is split into 42 areas.
2. They claim to unify health and social care, but social care is privatised means tested and a mess
They will cash limit the health services on offer in each area and make councils and NHS keep to certain targets. To meet the targets, treatments will be restricted and rationed rather than be offered according to the medical need of the patients. They will open the door to more private providers and not content with that, they will allow private organisations to sit on the boards governing these areas making decisions about what limits will be placed on the health services offered, who will be given the contracts and which of us will be lucky enough to be allowed to access those much-reduced services.
All trade unionists in the NHS need to be very aware of the HSSF which allows companies to be allocated NHS work without going through contractual scrutiny This includes employing staff. We all know what outsourcing has done to wages and conditions.
As NHS campaigners, so often people say to us “They wouldn’t privatise the NHS, they really would not dare”, but the government ARE doing it behind closed doors. They are doing it behind a smoke screen using the Covid pandemic to cover up their actions, but this privatisation was going on long before Covid hit.
Rationing and Charging
Two years ago, Warrington Hospital published their “MY CHOICE” price list for operations on the NHS. They planned to charge patients for operations which they previously would have had free on NHS e.g. new knees, hips and cataracts. However, the government has raised the bar for qualifying for such operations meaning many people are denied the operation and told it would not be clinically beneficial to them. However, in the next breath Warrington NHS hospital was willing to do that apparently “unnecessary” operation, using NHS staff, on NHS wards and in NHS theatres, PROVIDED patients could pay e.g., £7000 for one new hip or £1800 for a cataract operation This shows how charging for mainstream treatments will come in unless we stop them and how paying patients will be prioritised in NHS hospitals over non-paying patients, in other words a two tier system where people who can pay will be get better treatment and those who cannot pay will either get into debt to pay for it, or be left to suffer.
We demand a full repair and reinstatement
We are a coalition of NHS defence campaign groups in Cheshire and Merseyside starting a fresh campaign to bring this to people’s attention including;
Save Liverpool Women’s Hospital Campaign
Keep our NHS Public both in Merseyside and in Cheshire
Defend our NHS Wirral
Liverpool City region Socialist Health Association
Provide healthcare for every single person funded by the government from tax, free at the point of need. This was a wonder when it was first created in 1948, it transformed the lives of the post-war population and successive generations and still would be a wonder in many areas of the world.
be a public service and not for profit. This now is being eroded. Matt Hancock said recently that those who oppose private sector involvement did so for purely ideological reasons. Well, that’s us, because we believe ordinary people should have excellent health care, free at the point of need.
provide all the treatments for all the people and avoid a two-tier system
employ professionally qualified staff at decent national wages, in decent conditions
improve the health of all the population by eradicating diseases. We can thank the NHS for making TB an unusual disease rather than a rampant one, for getting rid of polio and for making giving birth so very much safer. The creation of the NHS removed the fear every family felt at the thought of getting sick or having an accident which meant they could not work and support their family. The workhouse was a looming, ever present threat.
We are forever in the debt of the NHS staff for the work they did on the frontline during the pandemic, and we know they are tired out after it. We owe them! The government owes them and should pay them the 15% pay rise they deserve.
It will take a while before we must pay for all treatment but restricting the availability of some treatments is already happening. Clearing ear wax is a well-known one, now costing £60 at Specsavers. The Patients Association, when interviewed about proposals to restrict still more treatments, said in the Guardian
“Putting “barriers” in the way of people expecting to have so many previously commonplace tests and treatments would lead to “harm and distress”, said Rachel Power, the association’s chief executive.
“Patients have seen the range of treatments offered by the NHS cut back over recent years, and the NHS has been upfront about this being to save cash. Often there are good reasons for not using these ‘low value’ treatments as a first choice, but they are appropriate for some patients.
“This is of a piece with the restrictions on prescribing over the counter medicines [which NHS England brought in last year], and patients have told us of the harm and distress this broad programme of restrictions has caused them,” she added.
“As a result of this rationing, we know that patients who can afford to pay privately are doing so, while those who can’t are going without and suffering. This is exactly what having an NHS is supposed to prevent.”
There are many of the world’s largest for-profit health care corporations already active in the NHS. This is their own webpage. You can see a list here.
More than that we know profit always comes first in “for profit” organisations. Look at the Volkswagen diesel scandal. They risked the planet’s climate for a few euros profit. Look at the lies that the tobacco industry pushed out, and how the sugar industry lied to us.
Government funding for health care is a very secure source of income for big multi-national health care corporations. If they can get their hands on the big pot of public money set aside for “NHS” healthcare, on the false claim that they are more efficient, that is a better way of making money than collecting Insurance from millions of people, chasing unpaid medical bills and having to constantly look for business on the open market.
In the US system personal insurance policies, employer’s insurance policies, the veteran’s insurance, Medicare and Medicaid and other schemes all stream the money to the big health care corporations. Even with insurance some US patients can be refused care or given enormous bills. They employ people to refuse treatment on all kinds of grounds and then there is the Co Pay system not to mention the huge administration costs of collecting in payments and chasing debts.
Steadily increasing private sector involvement, restricting the treatments available and pushing the private hospital sector is happening now!
During the pandemic we saw the private sector run rampant making huge profits whilst our hospital staff went short of PPE, and we saw the private health sector rescued from financial difficulties
We cannot discuss the NHS without discussing the risk of a third wave of Covid 19 infections. We demand that the Government act to stop a third wave of Corona Virus infections!
The process of infesting the NHS with private companies has been going on for years, but the white paper takes it much further.
They will privatise, they are doing it now, all cloaked in deceit and false publicity.
The NHS represents a huge prize for the big international corporations that want to privatise it. They want the NHS as a cash cow, we want it to keep our people healthy, to provide timely treatment when we need it.
“If it was true that they were privatising it people would be up in arms and out on the streets”.
Well, we are sounding the alarm organising the resistance, calling you out onto the streets now!
It is true and we are up in arms about it!
We are happy to speak to people anywhere invite us to speak at your community centre, your church, your playgroup, your workplace or any other organisation you are part of.
Ian Byrne MP supports NHS Staff and against government reorganisation plans
I pay tribute to all my constituents in Liverpool, West Derby who work in the NHS and social care; I send my solidarity and thanks to them. My speech will focus on defending these workers and on defending our NHS against the Government’s plan for major reorganisation—words that should terrify every citizen in this country who values this wonderful model of socialism. These worrying plans come at the same time as 5 million people are waiting for NHS treatment, and at the same time that NHS staff are exhausted and those same staff are facing a proposed real-terms pay cut.
Last month, I held a meeting with Royal College of Nursing members. They were visibly exhausted, and I came away genuinely worried for their wellbeing. How can this be? I urge the Minister to listen to the concerns of the Save Liverpool Women’s Hospital campaign, Doctors in Unite, EveryDoctor, Keep Our NHS Public, We Own It and many others who are calling for the reorganisation to be halted and for a full public consultation.
The Government’s proposals for the NHS, as set out in their White Paper, could, as my hon. Friend the Member for Wirral West (Margaret Greenwood) has said, open up privatisation, deregulation and cronyism. They could open up opportunities for private companies to be represented on ICS boards, have a say in what healthcare gets delivered in an area and then provide that service. They could allow for the deregulation of professionals, which would threaten patient safety and have serious implications for the pay, terms and conditions of NHS workers. It is unthinkable that the Government are pushing ahead with these plans after the events of the past year. A person more cynical than me would maybe think that the exhausted state of both the NHS and the nation have created an environment that the Government find ideal for pushing through these changes, which will imperil the public ownership of our NHS even more.
In closing, I ask that this Government find the same values that they discovered earlier in the month, when greedy billionaire capitalists tried to destroy our football heritage, putting profit ahead of the interests of football fans, and the Government reacted. Well, now they are back, but this time it is our NHS that they wish to destroy. I ask the Government to act with equal urgency to protect the greatest jewel in our heritage—to halt these plans for the reorganisation of the NHS and a roll-out of integrated care systems and, instead of pushing ahead with privatisation and threatening the rights of our NHS workers, to give our health service the resources it needs and give our NHS workers a 15% pay rise. They deserve no less.
Margaret Greenwood MP
” instead of addressing these issues, the Government have come forward with a damaging White Paper that says very little on care but proposes a major reorganisation of the national health service.”
“A recovery plan for the NHS and social care is urgently needed. Almost 5 million people in England are waiting for NHS treatment, and a quarter of people with mental health problems are having to wait months to get help. NHS staff are exhausted from battling coronavirus, and there are nearly 90,000 vacancies across the NHS in England. Social care is in crisis following over a decade of savage cuts by the Conservatives, and 1.5 million older people are not receiving the social care support that they need. Care workers, many of them paid below the real living wage, have been working in extremely difficult circumstances.
However, instead of addressing these issues, the Government have come forward with a damaging White Paper that says very little on care but proposes a major reorganisation of the national health service. To do so at a time when staff are exhausted and millions are waiting for treatment is reckless and irresponsible. It is not acceptable that the Government have not carried out a consultation on their White Paper, and Ministers have failed to communicate the impact that the changes would have on patients and staff.Toggle showing location ofColumn 772
It beggars belief that the Secretary of State said on Monday that his proposed reforms would help to deal with the backlog. Nothing could be further from the truth. Sir David Nicholson, former chief executive of NHS England, has warned that the Government’s impending shake-up of the NHS could prompt a lot of staff already exhausted by covid to quit.
The Government’s damaging plans to put 42 integrated care systems across England on a statutory footing, with each ICS setting its own plan for health and social care, would embed a postcode lottery, with the health and social care services that people could access varying depending on where they live. The plans would open up the opportunity for private companies to have a say in what health and social care services are provided in an area, and the very same private companies could potentially then provide those services, representing an opportunity for huge conflicts of interest. The plans would also give the Government the power to remove a profession from regulation, with potentially serious implications for patient safety and for the employment status and terms and conditions of workers.
Professor Kailash Chand, honorary vice-president of the British Medical Association, said:
“The core thrust of the new reforms is to deprofessionalise and downskill the practice of medicine in this country, so as to make staff more interchangeable, easier to fire, more biddable, and, above all, cheaper.”
The plans would also allow the discharge of vulnerable patients from hospital before they have been assessed for continuing healthcare, leaving patients at risk and families to pick up the pieces. The Government’s plans would create immense uncertainty for NHS staff and open the door to widespread cronyism and increased privatisation.
On Monday, the Secretary of State told me that my party’s Front Benchers welcome the reforms. He is wrong. Labour’s Front Benchers have not welcomed these reforms. He really should get his facts straight. I call on the Government to pause the whole process of their reorganisation of the national health service until after all covid restrictions have been lifted and they have carried out a full public consultation, so that patients, NHS staff, care workers and unpaid carers can have their say on the proposals.”
Please join our campaign to repair and reinstate a fully funded world class NHS, with well paid staff, and all the necessary treatments, without the privateers and cuts. Email SaveLWH@outlook.com
We put out this call to all who care about the NHS, to all who campaign for the NHS, all who work in the NHS. Our grandparents and parents had to fight to create the health service in the first place, free at the point of need, provided as a public service and providing all the treatments required. We are echoing their call, more than 70 years later. The NHS cannot be run for profit. Give us back the NHS. End the cuts for cash scandal. We will try to get this message out across this city, across the whole of Cheshire and Merseyside region. We will work with the national campaigns too. Please help us.
There are major problems in midwifery, in deaths of babies under one, and in women’s health, We will continue to campaign on these issues Look out for our Autumn National Meeting Maternity Matters. We are all too aware that maternity has its own grave problems. We can, and do win short term gains but longer-term funding and staffing maternity can only be solved in a renewed and repaired National Health Service.
Meanwhile we must protect every service we still have. Not one more bed closed, not one more service removed, not one more member of staff outsourced, not one more service given to the private sector.
Money spent on health care gives one of the best returns on investment in the world. It gives good money returns but much more important it makes people healthier and happier. We are worth it and as the 6th richest economy in the world, we can well afford it.
The decisions to slash the number of beds, to under recruit and under train staff numbers, to fail to stockpile equipment against a pandemic, to give sweet making companies core NHS contracts were all wrong and cost us dearly in lives lost and staff exhaustion. Reducing staff terms and conditions was morally wrong and damaged the service
Our NHS staff are worth every penny and more.
The NHS model of healthcare is much more cost efficient, more effective in health terms and much more fair than the US model.
The original NHS model gave the world’s most cost effective and the best treatment worldwide according to Commonwealth fund
We are going to campaign for a return of
A fully funded NHS, funded by the government
All treatment free at the point of need
Comprehensive treatment, all the treatment and medicines required
A national service, not a post code lottery. Keep the national in the NHS to share the risks more equitably.
Universal health care, no one excluded
A health service built on treating the whole patient not just specific ailments.
A health service built on cooperation not competition
Reduce the bureaucracy and expensive and damaging financial consultants
A service delivered by public service, not by profit making companies
A researched based institution
Well-regulated and well-educated professions in the NHS
Good wages and conditions of work for all staff
A mass five-year recruitment, retention and return drive for midwives, nurses and other professions
No student loans in the NHS
Sufficient beds to provide for all in fair reach of home
Re nationalised mental health care and beds
No more hospital closures
A new Independent Living Service distinct from the NHS
NHS workers to be employed by the NHS on national conditions of service
Full rights for all migrant health workers including full access to NHS health services for them and their families and an end to migrant charges
A democratic management structure and management style
Public health to be nationally funded and locally delivered
Staff to be employed in patient care not in jumping through deliberately difficult financial loops
A comprehensive audit of NHS land and buildings including reports on disrepair, wear and tear and recommendations for short, medium and long-term repairs, reinstatement and improvements
The NHS White Paper finalises changes already implemented changes, made without legal status, They are very damaging and will see much more private ownership and control, much more involvement of US health corporations and their subsidiaries in health service in the UK. Lesley Mahmood from our campaign said “
“Councillors, trade unions and elected representatives need to realise the ICS express train is about to crash through any idea of one National Health Service very soon as the government proposals look likely to be in the Queen’s Speech in May.
This is not just another NHS reorganisation, bad as they have been. Previous privatisations have been about the Virgins, Sercos, Carillions and other privateers stealing cakes from the NHS bakery. The White paper on ICS is about splitting the NHS bakery into 42 parts and handing them over to the privateers. These multinationals will be sitting on the decision-making bodies, 83 major corporations, 22 from the US are already heavily involved in developing ICSs. Councils will find themselves lucky to have one seat at the table from half a dozen or more councils and no powers of scrutiny over closure of hospitals and services.
While ‘integration’ sounds appealing, ICSs are about dismantling the NHS, ICSs are based on a US insurance-based model aiming to spend less on health & care. Fixed annual budgets won’t be based on need, resulting in more rationing and postcode inequality, fewer services, down skilling & outsourcing of jobs, local pay and further cuts on top of the 10 years of austerity in the NHS.
We challenge the use of deceptive language in the Conservative Government plans for the NHS. They talk of accountable care, but that does not mean that they are answerable for that care but that the accountants can measure it
They talk of Population funding, sounding like improvements for the whole population but it means cash limits for different regions and financial incentives to restrict access to healthcare, “cuts for cash”
They talk of “integrated care” but far from integrating with social care it will disperse NHS funds to private social care companies
This government said at the election that they would never privatise the NHS but are busy bringing private companies in, even to the major decision-making bodies of the NHS nationally regionally and locally
You can move this resolution from keep our NHS Public at your Trade union branch. We will face lies and obfuscation, our arguments will be dismissed as scaremongering, but a victory will save many lives and avoid much misery. If you value it, fight for it. Otherwise, we will be looking back at the time we had a proper health service and wondering how it slipped between our fingers, how it went the way that dentistry free at the point of need, mental health provided by the NHS and elder care went, how the hospitals could close, how once we had student grants and bursaries for nurse training.
They have produced a list of companies called HSSF that can be given NHS work without tender, including the employment of staff
We will campaign to show that population funding, integrated care and accountable care will inevitably lead to charging, as we saw in the My Choice plan from Warrington Hospital
Our campaign helped save Liverpool women’s Hospital because of the popular campaign. Such campaigns will have less power as local authorities will have less influence.
This is not going to be an easy campaign.
Look out for details of our campaign and please do get involved.
For all our mothers, sisters, daughters, friends and lovers and for the precious children, reclaim and restore our NHS.
A meeting with Sisters Uncut, Sistah Space, Women’s Lives Matter Yorkshire, Women Against Pit Closures, Save Liverpool Women’s Hospital, The Anti-Fracking Nanas, Kate Hudson Secretary of CND, Sandra Daniels representing the struggles of disabled women, Black Lives Matter Oxford, and contributions on the struggles of asylum seekers and the need to oppose the White Paper for the NHS, demanding that the NHS is not controlled by private companies but returns to the model the NHS was founded on.
The meeting is captioned and with BSL interpretation.
Certain themes unite us: Gender based violence in the home, in the workplace and education settings and in the street, the coming legislation on Police Powers, the NHS White Paper, the crazy intention to increase nuclear weapons, the need to address the climate catastrophe, the ongoing damage of Austerity which loaded more than 80% of the damage on to women, the damage done to Domestic Violence Services and the threat of endemic Covid, the discriminatory benefits system and the damage done to our communities and especially children by growing poverty.
We recognise the anger and pain that all who call that Black Lives matters during the trial for the murder of George Floyd
We mourn the dead of the pandemic.
Our campaign says the NHS must be free at the point of need, for all people not for profit, providing a comprehensive service, fully funded by the government. and not for profit The blood sucking big corporations must be dismissed from the NHS. WE demand a huge increase in funding for maternity and women’s health over 5 years to make our services the best in the world. We challenge the deaths o black women and babies in child birth
We demand better pay for NHS staff, and consistent recruitment and in service training for all NHS staff, over a five year period to tackle staff shortages and over work
Every gain we have made in two centuries have been through campaigning, protest and demonstration. That right is at risk. We oppose the policing bill and demand the right to protest
We raise the watch word Liberty
We will we will we will be free
For all our sisters,mothers, daughters and babies.