Ockendon Report and Safer Maternity Care

It is with great sadness that we read the findings from The Ockenden Review and we add our thanks to the families who fought so hard to bring their experiences to public attention. As midwives and campaigners for safe and compassionate maternity care we have a duty to reflect on the findings of this report and our thoughts are with the women, their families and staff working at The Shrewsbury and Telford Hospital NHS Trust. The Lancet commented that;

The report found that around 200 babies and nine mothers would or might have survived if the trust had provided better care. The Royal College of Obstetricians and Gynaecologists (RCOG) called it a “dark day”. Criminal charges might still be brought against the Trust and individuals.”

BBC Photograph

Donna Ockendon gave great credit to the parents whose campaigning instigated the report;

The work contained in this final report and the first report of the Independent Review of Maternity Services at the Shrewsbury and Telford Hospital NHS Trust, came about from the exceptional efforts of parents Rhiannon Davies, Richard Stanton, and Kayleigh and Colin Griffiths, whose daughters died as a result of the care they received at the Trust.
The deaths of Rhiannon and Richard’s daughter Kate in 2009, and Kayleigh and Colin’s daughter Pippa in 2016 were both avoidable. Owing to their unshakeable commitment to ensure the precious lives of their babies were not lost in vain, this review has implementation of meaningful change, not only in maternity services at The Shrewsbury and Telford Hospital NHS Trust – but also across England. As we publish this final report, we want to acknowledge and pay tribute to Rhiannon, Richard, Kayleigh and Colin.

Shrewsbury is not alone. There have been other maternity scandals in Morecombe Bay, Essex and Nottingham.

The crisis in maternity staffing in 2022 is worse than the period covered by this report. Many hospitals did manage against the odds to avoid some of the damage done in Shrewsbury. Shewsbury’s managers and senior clinicians have serious questions to answer. The context does not excuse their actions but it is crucial to understanding what was happening.

Understanding and appreciating the context in which these failures happened is a vital step in working towards any type of prevention. What is prominent throughout the review is the catastrophic shortages of midwives, medical staff and other maternity healthcare workers and the impact these shortages have had on care. For many years we have known of these critical shortages and the tragic damage this would cause. Now, sadly, we are seeing it.

With this shortage comes poor supervision and training of staff, in particular preceptorship programmes for newly qualified midwives (NQM). Without enough qualified midwives, it is impossible to provide supernumerary status with protected learning time for NQMs. This is crucial if we want to grow a competent and confident workforce.

Donna Ockendon says;

It is absolutely clear that there is an urgent need for a robust and funded maternity-wide workforce plan, starting right now, without delay and continuing over multiple years. This has already been highlighted on a number of occasions but is essential to address the present and future requirements for midwives, obstetricians, anaesthetists, neonatal teams and associated staff working in and around maternity services. Without this maternity services cannot provide safe and effective care for women and babies. In addition, this workforce plan must also focus on significantly reducing the attrition of midwives and doctors since increases in workforce numbers are of limited use if those already within the maternity workforce continue to leave. Only with a robustly funded, well-staffed and trained workforce will we be able to ensure delivery of safe, and compassionate, maternity care locally and across England.

Yet, how can a maternity service be safe and compassionate if there aren’t enough staff? How can staff give women their time, time to sit and talk, time to listen. It is impossible. It cannot be done. As a consequence, women will not be provided with the safe and compassionate care they so justly deserve, not because staff don’t care, but because there simply aren’t enough of them.

In July 2021 the report on the Safety of Maternity Services from the Parliamentary cross-party Health and Social Care Committee said;

With 8 out of 10 midwives reporting that they did not have enough staff on their shift to provide a safe service, it is clear that urgent action is needed to address staffing shortfalls in maternity services. Evidence submitted to our inquiry estimates that as a minimum, there need to be 496 more obstetricians and 1,932 more midwives. While we welcome the recent increase in funding for the maternity workforce, when the staffing requirements of the wider maternity team are taken into account–including anaesthetists to provide timely pain relief which is a key component of safe and personalised care – a further funding commitment from NHS England and Improvement and the Department will be required to deliver the safe staffing levels expectant mothers should receive.” 

We recommend that the budget for maternity services be increased by £200–350m per annum with immediate effect. This funding increase should be kept under close review as more precise modelling is carried out on the obstetric workforce and as Trusts continue to undertake regular safe staffing reviews of midwifery workforce levels.“.

Despite this recommended additional funding for maternity, the government produced only half of what the committee said was needed. The Government did not even respect a parliamentary committee.

A whole year has been lost that could have stopped the current situation from developing. That funding has still not been provided.

Donna Ockendon reported on maternal deaths, baby deaths and the injury to some of the babies. She wrote this of the Cerebral Palsy cases;

All of the families in this group self-reported to the review. The diagnosis of cerebral palsy was often made some years following their maternity episode. On reviewing the medical records, where it was found that the neonatologists at the Trust had recorded a diagnosis of HIE [(hypoxic-ischaemic encephalopathy] in the early neonatal period, a small proportion of families were subsequently transferred to the HIE incident category. From the remaining cases of cerebral palsy, more than 40 per cent were identified to have significant or major concerns in maternity care which might have resulted in a different outcome.”

Mistakes will be made in any field of medicine, though few with such catastrophic results as mistakes, or carelessness, in maternity care. Lessons must be learned from every incident and changes implemented quickly. This failed disastrously in Shrewsbury and the fault is not with the midwives (though significant mistakes were made ), but with the hospital management.

The government has made and is still making appalling decisions in funding and managing the NHS and particularly in maternity. A quick check on MumsNet today found a mother refused an induction despite her concern about her near term baby’s reduced movements. We are told to Count the kicks yet even today after Ockendon has reported, women are not always heeded.

The bureaucracy of the NHS also bears responsibility, if only for failing to describe publicly the damages from Government policies including; the shortages of funds for the NHS, bad workforce planning, the closure of beds and maternity units, not calling out the disaster of the “internal market” and for “managing” the news around incidents. We saw a pretence that all was well, whilst embarking on expensive new initiatives, like Continuity of Carer, without adequate funding and thereby driving out still more midwives. A background of bullying and silencing staff is also important. The number of midwives quitting because they do not feel that the system is safe surely should have been a warning to all.

Donna Ockendon notes

The key themes identified requiring improvement within maternity services at the Trust were:
• The poor quality of incident investigations
• Poor complaints handling
• Local concerns with statutory supervision of midwifery investigations
• Concerns with clinical guidelines and clinical audit

…the review team has identified the following concerns regarding governance in
maternity services at the Trust:
a) Incidents that should have triggered a Serious Incident investigation were inappropriately
downgraded to a local investigation methodology known as a High Risk Case Review (HRCR),
apparently to avoid external scrutiny.
b) When serious incident investigations were conducted many were of poor quality.

c) There was a lack of learning and missed opportunities to improve safety.
d) There was a lack of oversight of serious incidents by the Trust’s commissioners.
e) There were repeated persistent failings in some incident investigations as late as 2018-2019.

4.8 The review team has found a concerning and repeated culture at the Trust of not declaring adverse
outcomes as an SI in line with the national framewor
k. Instead, they were inappropriately downgraded
and investigated by what the Trust termed a High Risk Case Review (HRCR). This method of investigating
incidents, created by the Trust, was less robust, varied considerably in quality and lacked the rigour and
transparency of an SI investigation. Notably, HRCRs were not reported to NHS England, the Clinical
Commissioning Groups (CCGs) or the Trust Board, and therefore avoided external scrutiny.

The Review also importantly recognises the damming consequence of Cumberlege’s National Maternity Review and the Midwifery Continuity of Carer model. With such poor staffing, such a programme not only cannot but should not have been implemented. We welcome The Reviews Essential Action for the suspension of this provision unless Trusts can demonstrate safe staffing levels on all shifts. The Review acknowledges the unprecedented pressures that the model places on services, services already under significant strain and the impact of which compromised the safety of pregnant women and their babies. We support the need for robust evidence to assess if it is a model fit for future maternity care. Currently, that evidence does not exist.

What is evident from The Review is the harm mothers and babies suffered from what appears to be withholding the use of caesarean sections. We will watch with caution the end of total caesarean section percentages as a metric for maternity services, as potentially we could see rates escalate and we urge continued careful monitoring.  

Apparent in The Review, is the fear staff had to speak out about their concerns. There can be no transparency, and no openness to change if free speech is not allowed.

Save Liverpool Women’s Hospital Campaign has been working since 2016 to

  1. Expose the flaws in the funding and structure of maternity provision and

2. To support all who continue to work in maternity despite the odds.

3. To demand excellent maternity care for all, (including migrant women, who face dreadful charges for maternity care).

4. To fight for women’s healthcare.

5. To protect our hospital, Liverpool Women’s Hospital, on its Crown Street site.

6. To campaign for the NHS to remain free at the point of need, funded by the government, providing universal and comprehensive care, publicly owned and publicly delivered.

A publicly provided, well funded, universal maternity service, free at the point of need is essential. There is no solution to the problems the NHS faces to be found in privatising it. Cuts, shortages, coverups of shortages, and bullying, cannot keep our mothers, sisters, daughters, friends and lovers and every precious baby, safe.

The figures for maternal deaths in the US privatised model quoted by The Commonwealth Fund, prove this:

Key Findings: The U.S. has the highest maternal mortality rate among developed countries. Obstetrician-gynecologists (ob-gyns) are overrepresented in its maternity care workforce relative to midwives, and there is an overall shortage of maternity care providers (both ob-gyns and midwives) relative to births. In most other countries, midwives outnumber ob-gyns by severalfold, and primary care plays a central role in the health system. Although a large share of its maternal deaths occur postbirth, the U.S. is the only country not to guarantee access to provider home visits or paid parental leave in the postpartum period.

Conclusion: The U.S. has a relative undersupply of maternity care providers, especially midwives, and lacks comprehensive postpartum supports.

Women were not heard or heeded in many of these tragic events, indeed some were themselves blamed by the hospital.

Importantly, we must not forget the blame for all of these lies squarely at the feet of the government. Continued cuts year on year are destroying maternity services and the NHS as a whole. Allowing chronic staff shortages, poor staff satisfaction, high staff attrition rates, and unsafe working conditions are all political choices made by this government. Now we see mothers and babies dying. These are all political choices.

Women have a right to excellent maternity services. It is the government’s responsibility to provide this. This is the contract between citizens and the government Women must have the right to choose how they have their baby. Women are entitled to have the best advice on these choices. Women have the right to expect emergency backup when this is required. Women have the right to be both heard and heeded, especially when things start to go wrong. Women have the right to be heard and to participate in all reviews of serious incidents. Ockendon will strengthen these rights.

There is a thread in the media saying that natural births were somehow to blame. There is nothing in Ockendon to say this. Ockendon does say that poor monitoring, failures to intervene early, failure to use cesarean sections when urgently needed, and failure to listen to mothers, were all faults.

.

Midwives are a highly valued profession. Midwives can make mistakes, of course, but the faults described in Ockendon do not blame midwives as a profession. A service with a good supply of well trained, and well respected (and well paid) midwives, helps save lives.

The Royal College of Obstetrics and Gynaecology reported on staffing issues last year.

The NHS funding model included penalties for having too many cesareans in a hospital. Funding for maternity was already inadequate and complicated, relying, in many hospitals, on subsidies from other parts of the hospital budget.

Since “Austerity” started, Government funding for the NHS has been inadequate. Staff have kept the NHS afloat through hard work and determination. Staff are worn out. Too many midwives are leaving the profession because of working conditions.

The fight to found the NHS came in large part from the fight for universal maternity care. Let’s make the fight for excellent maternity care in the twenty-first century spur on all our campaigns to protect and improve the NHS

The government does not believe in the NHS. Look at what it is doing to maternity care. Since 2014 they have been working towards privatisation, a US-style model of healthcare. The loss of the NHS or further cuts and privatisation will affect women, babies and maternity. This is the future unless we campaign against it, please join our campaign group – as Nye Bevan said “The NHS will last as long as there’s folk with faith left to fight for it”

We would like to thank https://www.facebook.com/groups/marchwithmidwivesuk for some of these photographs.

See also our earlier blog post,

https://saveliverpoolwomenshospital.com/2022/02/23/weep-for-the-shrewsbury-babies/

What is Happening in Parliament to the Health and Care Bill

This is a report back from Parliament about to where we are right now with this pernicious Bill.

Margaret Greenwood MP for Wirral West is our first speaker

Rebecca Smyth a midwife and midwife educator is our second speaker. Her information on the gender divide in healthcare is well worth the listen

Because it is on International Women’s Day we are going to celebrate the blindingly obvious that women might hold up half the sky but they hold up far more of the NHS, and that there is no women liberation without healthcare

We are part of a group of organisations campaigning for the NHS stretching from Southport to Chester Ellesmere Port and Crewe, from Sefton to St Helens. That is the area covered by the new NHS pro-privatisation structures the ICS Boards.

Burning Importance.

On Saturday 26th February 2022 Greg Dropkin, a long term campaigner for Keep Our NHS Public spoke at the SOS NHS event in Liverpool against the Health and Care Bill, which is being put into place ahead of the legislation being agreed.

Greg described one of the vicious changes to our health care that is being developed.

In an emergency, all of us expect to go to A&E and be seen, no matter who we are or where we’re from.
In law, Clinical Commissioning Groups must ensure that emergency care is provided for every person present in the area. But it’s changing. In September, a badly burned Rochdale nurse went to A&E and was
advised to go to Bury given the long delay in Rochdale. When she got there, staff told her “we don’t take patients from Rochdale”, due to a directive from the Northern Care Alliance.

(Image: UGC)

Lord Davies told this story when proposing an amendment to stop any provider from refusing treatment on the basis of which Integrated Care Board the patient belonged to. In response, government Minister Lord Kamall didn’t even# mention emergency care. He said no provider could be expected to provide treatment for which they were not funded, and each Integrated Care Board must be free to decide what treatment to commission. So it’s policy. Even in an emergency, funding flows will trump patient care. Bring an electricity bill and your passport to A&E.
The National NHS is being broken into around 40 separate financial systems. Their budgets will be set
with a new Payment Scheme. The cost of a treatment will depend on where it is given, who provides it, and who is being treated. And, providers including the private sector will be consulted on the prices to be
paid. This means a postcode lottery rigged to suit private firms. If the Integrated Care Board is going over
budget, NHS England can intervene to stop spending. With local budgets and a variable payment scheme, ICBs may say, why should staff in our area be paid the same as other places with better budgets? They may impose local pay and conditions for NHS staff in their patch. That would destroy national agreements, and unions should be screaming about this threat.
Who profits? Around 240 organisations, most of them private companies, are accredited by NHS England
to develop Integrated Care Systems through the Health Systems Support Framework. Several dozen are US transnational corporations supplying the health insurance market.

Operose, which controls dozens of GP surgeries, is wholly owned by US transnational Centene, a $100bn enterprise. Under the Framework,
Operose is accredited for 22 topics, like population health management and payment reform. Its former boss Samantha Jones became Boris Johnson’s Expert Advisor for NHS Transformation and Social Care.
She is now Permanent Secretary and Chief Operating Officer of 10 Downing Street.

The Framework aims to transform the NHS into a digital and data-driven system, where clinicians rely on algorithms, remote monitoring, big data, and artificial intelligence. Labour peer Lord Hunt of Kings Heath tabled 7 amendments to the Bill promoting digital transformation. One requires all NHS organisations to spend at least 5% of their budget on digital transformation. Hunt also chairs the Advisory Board of Octopus
Tenx Health, a health technology investment company. When Octopus took over, the Tenx Board included the husband of Samantha Jones. Tenx Health co-founder Joe Stringer stated at the start of lockdown that coronavirus could be the catalyst for the mass adoption of tech across the health system. He predicted venture capital funds would take it up.
Despite Government spin, the private sector is not barred from Integrated Care Boards. They can sit on committees and the provider collaboratives where private companies and NHS Trusts will come together
to carry out the functions of the ICB using delegated budgets.
New procurement regulations will allow ICBs to award contracts without competition. Just like the crony covid contracts were handed out, overpriced, some to firms with no relevant experience, or which failed
to deliver.

We should fight it all the way. But if the Bill becomes law, we want it repealed and the NHS restored as a universal, comprehensive service, publicly provided, publicly accountable, free at the point of need with decisions taken on clinical grounds, not ability to pay

You can read more about this here

Healthcare for Women and Babies at risk in Liverpool Hospitals Merger Proposals

There are discussions, reported in the Health Service Journal on February 24th 2022 to merge hospitals in Liverpool including Liverpool Women’s Hospital.

As we come up to International Women’s Day on March 8th, let’s raise our voices once again in support of this Women’s hospital. For all our mothers, sisters, daughters, friends and lovers and every precious baby.

The report says “The prospect of creating a £2bn ‘group’ of hospital providers in Liverpool is under formal discussion, senior sources have told HSJ. The sources said talks between six NHS trusts in the city were convened this month by the integrated care system leaders in Cheshire and Mersey. Discussions have so far focused on creating shared governance processes or organising capacity, workforce and patient flows, as well as finding ways to expand the city’s relatively limited healthcare research sector. HSJ understands the prospect of joint leadership or formal mergers are not on the agenda at this stage but could represent a natural progression in the longer term. David Dalton, interim chief executive of Liverpool University Hospitals Foundation Trust, has form in creating Hospital mergers and created one of the first by establishing the Northern Care Alliance, by bringing together Salford Royal FT and Pennine Acute Hospitals Trust, which have since formally merged”.

One of the comments in the health service journal rejoiced in the profit-making potential of this merger

A city-wide group is a great opportunity for private patient growth.
Working with many Trusts over recent years has demonstrated the commercial
opportunities and service benefits that a group can leverage. These include sharing operational and commercial leadership, reducing unit costs of back office overheads, co-branding and enabling consultants to work where the NHS 24/7 infrastructure can meet the particular private patient service gaps that cannot be offered by the independent sector.


Campaigners for women’s and children’s health will not stand idly by. We demand more funding for the NHS, a simpler management structure without the involvement of private profit. We have seen the loss of beds, of A and E departments, staff shortages and overwork. We will not tolerate further cuts. In this terrible time for the NHS, what we have, we hold!

We need a focus on the health and healthcare of women and babies. The national maternity scandals, the decrease in women’s life expectancy in good health, falling life expectancy, the long-term neglect of key issues in young and older women’s health, and the mass underfunding of maternity, all point to the need for a women’s hospital. There is a gender gap in healthcare in this country. There is a gender gap in medical research and in pharma research to suit women’s bodies. So, merging Liverpool Women’s Hospitals is not acceptable.

We are fighting against the Health and Care Bill and the Integrated Care System brought in ahead of the passing of the Bill. At the heart of the Bill and the ICS, project is rationing, denial of care, and introducing charging.

Women’s health care requires improvement nationally and locally. Too many women are left to live with debilitating illnesses and injuries because research and resources have been denied. Too many babies die at birth or in late pregnancy. Gender bias in healthcare is a critical, well-documented problem that endangers people’s lives and well-being. It is a component of sexism, which is a major cause of inequity worldwide, including health inequity. There is a gender bias in healthcare “Gender bias in healthcare is a critical, well-documented problem that endangers people’s lives and well-being. It is a component of sexism, which is a major cause of inequity worldwide, including health inequity.”

Black Asian and ethnic minority women are discriminated against in healthcare. Liverpool and Merseyside have one of the oldest Black communities in the UK. Liverpool women’s Hospital is far from perfect but it is seen as a safe place by many in the black communities.

The British Medical Association described the class inequalities in healthcare for women

There are clear and stark inequalities in health between women, which are related
to socio-economic status, ethnicity and geographic region.
–Across different stages of women’s lives there are different social and economic
factors which drive health and associated health inequalities; including experiences
during early childhood, education, family building and working life and through
retirement and into older age.
– The broad health workforce must take full account of the social and economic
factors which shape women’s lives and health at different stages of life

We will insist that the Cheshire and Merseyside NHS management does indeed take full account of women’s needs.

In the Ockendon report, Donna Ockendon needed to demand that every trust ensure that the trust had a board member responsible for maternity. What a scandal that it needed to be said. imagine a hospital that did its planning without reference to maternity!

Maternity care represents the health of two lives and must be given an elevated level of priority.

The Independent webinar on maternity shows the large problems in maternity as described by Donna Ockendon and the Royal College of Obstetricians and Gynaecologists (RCOG).

We support the staff of the NHS. We are forever in their debt for their work in the NHS. We honour the work they have done and continue to do in the pandemic, under-equipped, underpaid and overworked.

We do not, however, support the management of the NHS, either under the 2012 Act or in the ICS system. Let us recall just some of the local failures:

  1. The New Royal Hospital. Overdue, over budget, badly planned, with the construction company Carillion going bust with no one in Liverpool noticing (except the workers on site who kept reporting issues but who listens to building workers?) badly constructed and still not open. The scrutiny that the contract to build the hospital should have had, was simply not there. Has anyone been held accountable? The Echo reported the problems in the Royal here (with videos).
  2. The private midwife company that went bankrupt leaving mothers, staff and the hospitals that had to pick  up the pieces in the lurch, and worse, there were babies’ lives at risk.
  3. In-Hospital acquisition of Covid in the two branches of the Royal/Aintree merger saw a damning CQC report /

Liverpool University Hospitals NHS Foundation Trust has also exhibited a growing problem with probable HCAIs [Hospital Acquired Infections]. While the trust continues to show persistently high total numbers of new patients in hospital with COVID-19 – a 7-day average of around 40 per day – admissions from the community have slowly fallen from a peak of around 31 per day on the 7th of October. This general slow fall in community admissions has been masked in the aggregate, however, by an increase in probable HCAIs that began in early October, and peaked at around 13 per day in the most recent week of reporting. In the last week of reporting, probable HCAIs made up 27% of all new patients in hospital with COVID-19.” Remember at this point hospital visitors were not allowed.

Resources taken away in the pandemic, like health visitors, have not been returned. Nationally we have an acute shortage of midwives, nurses and doctors.

Liverpool Women’s Hospital focuses on the health of women and babies. Some men are treated there for breast cancer, genetics and fertility. It is a women’s place and we do not want to give it over to a mass merger, especially in a time of discrimination against women in healthcare, and when the NHS local management did not manage the earlier merger well at all. New resources at LWH like the neo natal unit, the new imaging provision, and the wonderful robot surgery can indeed improve women’s and babies’ health. This merger cannot.

There is no evidence that large scale management works better than smaller units. Specialisms, though, do work, and the Women’s is a specialist hospital, specialising in women.

Health care is an investment that repays every penny spent. Health spending should be determined by need. Poor health care is an expense to the individual, to families, to the community and to the economy. It has been estimated that the Government could save billions by improving the health of working-age adults. Being in work leads to better physical and mental health, and we could save the UK up to £100 billion a year by reducing working-age ill health.

Poor care at birth costs the baby, the mother, the family, the schools, the NHS, and society at large.

There is a class health gap in this country, there are serious health issues in Liverpool.” Liverpool is one of the most deprived areas of the country, with more than 4 out of 10 people living in the 10% most deprived neighbourhoods in England.  Deprivation is strongly associated with poor health outcomes, from childhood through to old age” One Liverpool).

We have had ten years or more of cuts, staff shortages and mergers. This has not improved healthcare. We cannot accept more moves to make “economies” when we need more money and better-quality services. The management of health in Liverpool has not been good. In this time of crisis and enforced change, we do not need another merger.

Nor do we accept preparation for privatisation

Women’s health care requires improvement nationally and locally. Too many women are left to live with debilitating illnesses and injuries because research and resources have been denied. Too many babies die at birth or in late pregnancy.

Weep for the Shrewsbury babies.

Weep for the babies, mums and dads affected by the Shrewsbury Baby Scandal.

Have sympathy too for all the midwives and doctors and neonatal nurses, most of whom tried their best against the odds in tough unwinnable circumstances.

Don’t just mourn. Organise for a better health service. Demand that the Government fund maternity to world-class standards. Recruit and retain more midwives and obstetricians

“The Weight of Grief” The artist Celeste Roberge conveyed the physical feeling of grief

The apologists for cuts in NHS funding and services have used a thousand sugared words and phrases to disguise the damage done, created dozens of fads and fashions to disguise the damage. The language used in reports by the NHS is opaque and coded. Austerity cuts to the NHS have been fatal. Panorama tonight made that clear about maternity in Shropshire. That said, there were many management faults, and doubtless faults by those on the front line as inevitably there will be. The point is to learn from those mistakes, but that was not done.

Jeremy Hunt MP, Health Secretary at the time, said yes the NHS was underfunded, understaffed but some hospitals managed! What he neglected to say was that it was inevitable some would fail.

The Panorama report on maternity in Shrewsbury Maternity Unit was so very sad.  Save Liverpool Women’s Hospital Campaign is for all our mothers, sisters, daughters, friends, and lovers and for every precious baby. We have been campaigning for maternity safety, for additional funding for maternity and for far more midwives and obstetricians and access for all mothers and babies to safe surroundings and access to emergency care.

Donna Ockendon

We are waiting to see the final Ockendon Report on Shrewsbury.

We also champion our NHS staff. The years of underfunding could only end this way. Hunt was allowed to say without challenge that the service was underfunded and that it caused problems, but he will not take the blame. This tragedy is far far more his fault than of any midwife.

Let’s be clear, both natural/vaginal births C-sections, planned and emergency, must be available.  Making a low level of interventions a core success criterion did not work, but that does not justify refusing women natural childbirth. Both need to be available and both need extra staffing.

Gentle hands

For a decade maternity has been underfunded, understaffed, treated disrespectfully by the government and some management. Overworked staff, deprived of respect, not listened to by management, will make mistakes, sometimes appalling ones. Some staff like all humans make their own mistakes but the culture of underfunding and bullying plays a huge part. Midwives must not be the fall guys. Join us in our campaign for better maternity services, for women to be heeded and treated as full partners in their care.

A big cheer for the mum who spoke about the damage to her vagina during birth and how she wanted other women to know they are not alone.

We will write more on this in the next few days.

Meanwhile don’t forget to stand up for a fully funded, fully staffed NHS at events across Merseyside this Saturday 26th February The nearest to the Hospital is at the Top of Bold Street by St. Lukes steps at 11.30am.

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

Day of Action for the NHS February 26th 2022

Protest for the NHS!

There is a national day of action on February 26th, with people able to protest in their own areas.

In Liverpool we will march from Bold Street to Derby Square; full details to follow.

If you can help, please get in touch, either by this blog or by email to; SaveLWH@outlook.com, or TakebacktheNHS@protonmail.com or konpCheshire@gmail.com

A major demonstration for the NHS is long over due. Meanwhile the Conservative Government reckon they can get away with anything. Covid has given them a shield from public protest. NHS staff are tired and worn out from the long pandemic and years of cuts and poor pay. Many are angry, or just leaving. But the people value the NHS, we are proud of the NHS. We want to support the staff and the NHS system of universal health care as a public service free at the point of need.

In the run up to Feb 26th we will have stalls, lots of leafletting and petitions and posters put up, and meetings to explain whats happening. Please help. Invite us to speak at a meeting, set up or help with a stall in your area. We can help with leaflets. Put up a poster in your window, post leaflets through doors in your area.

Write to your MP and Councillors

Stop the Health + Care Bill which is still going through Parliament.

The NHS has been betrayed, underfunded, understaffed and privatised by stealth. Centene has taken over GP surgeries in London and campaigners are challenging it in court.

Stop the forty-two phony ICS systems, all based the US mode, slicing our precious NHS up into bite sized bits for private companies to take over.

Restore mental health care! Mental health care has been allowed to fall into the hands of private companies and care levels have plummeted. “The published figures show that, compared to 2017/18, the amount of planned spending on mental health services within the NHS has gone down by around £34 million in real terms”.

Maternity

Fund Maternity – respect midwives, protect mothers and babies! Recruit and retain more midwives!

No charges, no rationing of care in the NHS!

Tackle the waiting lists!

Stop funding private hospitals, with no proof they help NHS patients!

Stop the charges for treatments being slid in through the back door. Keep all our services!

Full Mitigation and Public Health to defend us from Covid! This means space in schools, air filtration, smaller classes, space on public transport, sick pay that can feed a family, masks where needed and boosters when necessary!

Stop Migrant charges for healthcare. They are brutal and do not save the NHS any money once costs of collection are counted. many doctors and NHS staff are paying for their hjealth care and that of their children whilst working in the NHS

Stop a major reorganisation when Covid lingers on and staff are tired.

What we do want

Renationalise and fully fund the care system, so we can provide well for everyone who needs care.

Fully fund the NHS

Invest £20 Billion now! Kick out the privatisers!

This government disrespects our very lives! #Look up!

We call for  ONE NATIONAL, FREE, UNIVERSAL, COMPREHENSIVE, PUBLIC, HEALTH SERVICE

You can help; Day of Action February 26th!

On February 26th a National Day of Action for the NHS has been called. All the big unions are involved. Many health campaign bodies are involved too.

Save Liverpool Women’s Hospital is one of many organisations raising these issues in Cheshire and  Merseyside.

Speaking up for the NHS in Cheshire and Merseyside are:

Defend our NHS Wirral

Keep our NHS  Public Merseyside

Keep our NHS Public Cheshire

Save Liverpool Women’s Hospital Campaign

Save Ormskirk and Southport Hospitals

Liverpool, Knowsley, Wirral, Cheshire West, Halton, Warrington Trades Councils

With support from many Trade Union branches.

The state of the NHS has been caused by Conservative governments, following ten years of underfunding, bed closures, insufficient staff being trained, poor pay and conditions, and a poor response from the Government to Covid.

But if we do not object, and object loudly, they will carry on doing even worse.

Conservative MPs need to know they will be held to account, and Labour MPS too if they support privatisation.

Save Liverpool Women’s Hospital Campaign urges people to support the COP26 action in Liverpool on November 6th

Women’s lungs are especially susceptible to particulates from carbon-based fuels and particularly to traffic pollution and in some countries to cooking pollution.

Babies in the womb and in early life are vulnerable to pollution. Children suffer from badly insulated and badly heated homes.

Disasters kill women three times more often than they kill men.

Above all, though our children deserve a future on our planet, in a climate system that can support human life. To do that we must keep fossil fuels in the ground.

The money spent subsidising fossil fuels would be better spent on health, care and education


Save Liverpool Women’s Hospital Campaign

is proud to join and sponsor the campaign for Climate Justice on November 6th. We support the demands for an environment fit to live in, and for a great future for all the babies born in Liverpool Women’s Hospital and those around the world.

Our children and grandchildren could live long lives in comfort and prosperity if the world drops the mass pollution machine that is fossil fuel.  The world has to change for the future of our children.

We demand action against the damage done to babies in the womb and to children’s lungs from exposure to airborne pollution from fossil fuels, especially traffic.

Badly insulated homes mean our children get ill especially with respiratory infections. We call on the government to insulate Britain to save our children and the climate

Keep Liverpool Women’s Hospital on the garden site on Crown Street, set back from Traffic. We oppose the waste involved in plans to move it to the Royal Site,  with less space and worse traffic.

Stop charging migrant women thousands for maternity care. These charges kill babies.

Devote resources not to polluting industries but to researching women’s health.

We want investment in health care as part of the Green New Deal to ensure clean air, well-insulated homes, good public transport to take cars off the road, larger well-ventilated schools, a national childcare system and well-funded social care, good youth work, support for disabled people.

Good health requires good food and that means sustainable farming for all, without the intensive farming of animals that breeds viruses.

Stop privatisation of the NHS. Stop the Health and Care Bill, invest in good healthcare for all

If we can afford to subsidise some of the richest corporations in the world to produce fossil fuels then we can definitely afford a great health service.

Midwives before fossil fuel subsidies!!

We demand major investment in health care for all and especially for women who are affected physically and mentally by pollution and stress.

We demand investment in mental health and know that a good environment helps prevent and helps heal mental illnesses

We demand the resources in staff and funding to give all women full attention during labour and good  ante and postnatal care

What practically you can do to Stop the Health and Care Bill 2021

Suggestions from simple to  complex

  • Write to  your MP and councillors. It does not matter what party. They all need to hear from their constituents. If you can, go to their surgery/ office. Make an appointment.
  • Write to a friend or family member who has a Conservative MP asking them to contact their MP. Conservative MPS are particularly crucial. Many do not  understand what goes on the NHS and  those in newly won seats are anxious about it
  • Put a poster up in your window. We will soon have car stickers.  Email us with your address and we will send them to you
  • If you are in a trade union, write to them asking them to  raise their game in the campaign against  the Health and Care Bill. We can send you a draft letter.
  • Write to your local CCG or ICS
  • Talk to friends and family so they know about it to and ask them to do any of the above
  • Send one of our post cards ( awaiting delivery) to any of the above
  • Do the above once a week or once a fortnight
  • Sign petitions including this one
  • If you have knowledge or interest write to the members of the Select Committee in Parliament during early  September

Those letters that seem individual are most effective

Slightly  more involved

Even more involved

  1. Help leaflet hospitals and other workplaces early morning
  2. Help with Stalls outside Conservative Party MPs offices
  3. Help with the Don’t blow it kill the Bill hankies for MPs campaign by embroidering a  white hanky to give to a Tory MP
  4. Help find a place to exhibit the tapestries
  5. Attend a training session
  6. Come to demonstrations ( these are limited at the moment.. we need to respect Covid)
  7. Help invent still more ideas than those above

Asking Conservative MPs to scrap the Health and Care Bill.

#DontBlowIt#NHSResistance  #NHS_Not_ICS  #SaveOurNHS #NHSPay15 

The last leg of our tour of Tory constituencies in Lancashire ended this week with a trip to the Morecambe and Lunesdale seat of David Morris MP and then a visit to the Wyre & Preston North seat of Ben Wallace MP. 

This has been a collective campaign by Unite Community Lancashire branch, along with Chorley and South Ribble Hospital campaign, and members variously  from Save Liverpool Women’s Hospital campaign,  SHA Liverpool City Region, Keep our NHS Public Merseyside, Defend Our NHS Wirral and Disabled People Against the Cuts (DPAC), and members from various Constituency Labour Parties and from Trades councils in Lancashire.

The plan was to contact the 11 Conservative MPs in Lancashire who all voted the Health & Care Bill through on its second reading. The aim was to urge them to vote against the Bill and to oppose the Integrated Care Systems into which the NHS has been remodelled. We wanted to deliver to each of them a lovingly hand embroidered handkerchief with the message 

“Don’t Blow It! Kill the Health & Care Bill Before It Kills Us”

Thanks to the CK999 and 999CallForTheNHS campaigns for the brilliantly creative  #DontBlowIt campaign and to all the volunteers around the country who have been hand embroidering handkerchiefs.

We attempted to visit 13 Tory MPs as we included a trip to Bury North MP James Daly and Bury South MP Christian Wakeford. No one in James Daly’s office would deign to come to the door and would only communicate over the intercom. 

In some constituencies, we held stalls near the MP’s office to speak to local voters. It was heartening to see the extent of awareness in the public of the dismantling of the NHS,  they knew they were being denied care, they knew it has been made so difficult to get appointments,  referrals, tests, scans and that they or their friends and family are suffering as a result. Those who worked in the NHS knew they were being taken for granted, underpaid, exhausted, expected to do more for less, their lives being put at risk throughout the pandemic. They understood that remodelling the NHS on the American system is  a terrifying prospect for us all. 

Why would any government think it was a good idea to push through the complete remodelling of the NHS and fast track legislation to legitimise what they have already done during a global pandemic which has killed hundreds of thousands in the UK and millions across the planet? 

No one admires the US system so why would a 21st Century country import that profit-driven system in place of Bevan’s National Health Service? That US system which incentivises cuts, which is a bare minimum “service”, which is bureaucratic,  inefficient and yet massively more expensive to run,  and which encourages denial of care and consequently has pain suffering and death built-in. 

The public were angry, and they couldn’t sign our petition quick enough. We often had queues of socially distanced people waiting for their opportunity to sign the petition.  

The sun shone again yesterday. Unfortunately, no one at the office of  David Morris was prepared to speak to us or meet us. They didn’t answer their phone. We were told by another occupant of the building that whoever was in his office wouldn’t come down. He wasn’t listed on the board of occupants so we couldn’t contact his office by the entrance intercom. So, we had to post his embroidered handkerchief in his letterbox.

Ben Wallace’s office in Great Eccleston was deserted. (Just like the offices of Jake Berry, Nigel Evans, Christian Wakeford). No answer at the door. No lights on. No intercom even.  Again, how do people contact him? If you can’t even catch him in his constituency during the very long summer parliamentary recess, when MPs are supposed to be back in their constituencies, it must be impossible when Parliament is sitting. But never mind we will go back another time to see them again.

Again, we had to post his embroidered handkerchief through his letterbox.

Mark Menzies – no way of contacting him in the constituency,  no office, no answer on phone.

Paul Maynard– no answer on phone, address apparently on an industrial estate.

Jake Berry – deserted

Nigel Evans – deserted

Christian Wakeford – deserted

Ben Wallace – deserted

Katherine Fletcher, Andrew Stephenson, Antony Higginbotham, Scott Benton – staff came to the door.

David Morris, James Daly – although apparently there was someone in the office, no one would deign to come to the door to take receipt of the handkerchiefs

What can we say about Sara Britcliffe MP for Hyndburn? Well, Sara’s staff could see and hear me at their door but refused initially to answer the intercom. Eventually, veteran  County Councillor and Lancashire County Council vice-chair, father of the MP, came to the door and accepted the handkerchief, leaflets and letter addressed to his MP daughter. Sadly, shortly afterwards, the MP who was not present to witness what happened,  wrote a misleading post on Facebook making false accusations against us, alleging that we surrounded her staff and intimidated them. Must be those Harry Potter books again and the Hogwarts’s school of magical thinking if I alone could “surround” one man and intimidate him? Quite a magical power! 🦄🧙‍♀️🎩 This false account was picked up and repeated by Lancs Live with no attempt to verify what happened. 

It was then picked up by the Lancashire Telegraph, again with no attempt to ask what my version of events was other than to ask for permission to use our photos, which I didn’t see until after they already used them. The Lancashire Telegraph piece was quite comical, it made fun of the MPs accusations using the tag #HankyIntimidation and for some reason they did seek a quote from Cllr Peter Britcliffe who was forced to admit he was not intimidated by me, being as he is such an experienced long-term Councillor. He would have looked silly trying to claim he was surrounded and intimidated by one woman wielding a scary hand-embroidered handkerchief! 

https://www.lancashiretelegraph.co.uk/news/19491158.hyndburn-social-media-row-save-nhs-hanky-intimidation/

We must thank Sara Britcliffe MP and her daddy, County Councillor Peter Britcliffe for increasing the publicity our visit got. 👏 It’s a pity the local media/press didn’t want to report more often and in-depth about NHS privatisation and about our tour of Lancashire. Perhaps they will use this blog to do so? 🤔

I don’t know how constituents get hold of some of these Tory MPs. It’s nigh on impossible.  Presumably, you must write to them. We did find a post-box for David Morris which is more than can be said for Fylde MP Mark Menzies who didn’t appear to have an office in the constituency at all. His constituents must have to write to him at Parliament. 

We found an address for Paul Maynard MP,  Blackpool North & Cleveleys, on another industrial estate but it was Friday 13th and we had had enough of wild goose chases searching for the non-existent offices of Mark Menzies so when we didn’t get an answer by phone we decided to stop wasting our time and petrol!

So, 13 MPs later, unlucky for some? unlucky for all of us if they wave through this Bill! 

If you are a constituent of any of these MPs please go to one of their surgeries ( if you can get hold of them and if they hold surgeries) or write to them, tell them you object to the remodelling of the NHS, don’t be fobbed off by platitudes that they “love the NHS” or the “NHS is safe and will never be privatised”. All governments of all colours have said that while continuing the long slow privatisation by stealth. This bill is the final nail in the NHS coffin, and it must be opposed outright. It can’t be tinkered with and improved by amendments, the whole premise of the Bill is dangerous and destroys the NHS denationalising it, breaking it down into 42 separate businesses with capped budgets, with private profiteers able to sit on the boards and committees making decisions about what services will be offered, to whom and which providers will get the lucrative contracts. It is about denying care. 

We can afford a high quality, universal,  comprehensive publicly provided and run National Health Service available free to all according to medical need. This model is far cheaper than the US model both for patients and the Government finances

We, the public,  cannot afford to allow the government to reduce our NHS any further, it’s already a shrunken postcode lottery provided by a hotchpotch of providers.

The disastrous remodelling of the NHS had no political, legal or democratic mandate, no one proposed it at an election, no one had the chance to vote for or against it, but they did it anyway. The top bureaucracy of the NHS, closely advised by the big healthcare corporations, created Integrated Care Systems quangos which had no legal authority, but which have gone round dictating and calling the shots around Lancashire and South Cumbria (and across the whole of England).

Sadly, many MPs, CCGs, GPs, Hospital trusts, Councillors and local authorities have meekly gone along with their diktat putting up no resistance.

Where is the evidence that the local organisations scrutinised these plans,  or did they wave them through?

Where is the regard for the health and wellbeing of the population?  The rhetoric was about Integrated health and care being better, fluffy & cosy leading to prevention of ill health, reduction of inequality and better services! Sounds lovely. But it was all magical thinking!

Social care is indisputably a mess. Council funding has been cut to the bone, the providers of services are now largely private companies running expensive disconnected businesses paid for from people’s own pockets or from the cash strapped councils. Poor  Pay and conditions have led to a terrible turnover in staff. How has it been integrated into NHS provision?

We want a nationally-funded universal care system run by public service, free at the point of need. Not a privatised fragmented service that leeches off the NHS and  local authority budgets

The Health and Care Bill says nothing about social care, it does not oblige any organisation to provide Hospital care for us. It involves the denial of medical care in return for a bigger share of the savings/profits for providers, it requires staff to do more for less, work beyond their competencies & be “flexible” meaning they can be forced to work anywhere in the footprint of Lancashire and South Cumbria or beyond and forced to work for any provider including private profiteers

WORSE STILL they plan to make £340,000,000 of cuts to services in Lancashire and South Cumbria alone and on top of all this, the measly 1% pay offer (effectively a pay cut as its well below the inflation figure of 4%) has to be funded out of existing inadequate budgets.

So, I would really like for one of these MPs to explain how that can work? How do you magically conjure up better services, better health & care for the nation while continuing to undermine the NHS, continuing to pay poverty wages & cutting staff income, continuing with staff shortages, cutting budgets, making “savings”, allowing profiteers to take out huge profits from the ICS capped budget etc?

What kind of magical thinking or delusion is this? Have they all been reading Harry Potter books, looking for unicorns and phoenixes or invisibility spells? It’s an impossibility. It’s fiction. 

We had an efficient,  integrated health system, it was called the NHS. We need it to be renationalised, reinstated and properly resourced for all our sakes and for future generations.

It is possible that some  Conservative MPs really do not understand the NHS sufficiently well to know what is going on

 For a straightforward explanation of the Bill please see this and for more detail this

Tell your MP, wherever you live in England, whichever party they represent, that you want them to oppose NHS reorganisation into Integrated Care Systems (or whatever new name they give them to pretend their plan has changed) and you want them to vote against the Health and Care Bill during the Committee stages, the House of Lords stages and when it returns to the House of Commons in late autumn.

Health and Care Bill; councillors can help scrap the Bill!

Dear Councillor

You can help save the NHS from the Health and Care Bill now in Parliament.

This bill is a threat to the NHS in total.

  • Breaking the National Health Service into around 42 geographical systems with reduced responsibilities to provide healthcare
  • The American managed (or accountable) care model, designed to create a two-tier system, a bare bones service for those who are too poor or ill to get private healthcare/insurance.  
  • Private companies getting a seat on the Integrated Care System boards. Companies could get huge contracts without competition  
  • We can expect rationed treatment, so more people will have to pay
  • Restricted funding
  • More private companies involved through the Health System Support Framework.
  • Threats to staff professional regulations
  • Local Authorities having less say but being bound by the Integrated Care  Board  decisions on annual budgets
  • Local Authorities having less say on closures
  • Using Apps, overriding clinicians’ skills and knowledge by making them follow actuarial algorithms
  • Discharge to Assess – discharge from hospital without care packages in place
  • Neglect of maternity

Who says NO to the bill?

Keep our NHS Public, Defend our NHS, Socialist Health Association, Open Democracy. Every Doctor, National Pensioners Convention. Public Matters. Socialist Health Association, 999 Call for the NHS. Health Campaigns Together. We Own It. British Medical Association, Labour Party Conference Policy. All the local health campaigns working together in Cheshire and Merseyside including the local trades councils

What you can do: Add your name to the opposition. Help tell your electors of this risk. Vote for your council to cease cooperation with the so called Integrated Care System. The only integration is with the private sector, Care is till privately owned, under funded, unstable, means tested and far from comprehensive and it is privately owned( and very profitble. We want a service not a sytem

Call a meeting in your area.

The NHS has already been badly damaged by the Government:

  • Poor funding for a decade
  • Outsourcing
  • Shortage of staff
  • Poorly paid staff
  • Bringing in private companies
  • PFI (Just look at the “new” Royal)
  • The chaos of privatised and means tested Social Care.
  • ICS system  introduced without legal sanction
  • Years of cuts in beds
  • Mental health service in ruins
  • Children’s mental health services damaged
  • Dental care not available for many
  • Maternity services needing urgent investment and better staffing
  • The pandemic deaths
  • Children getting illnesses of poverty
  • Millions wasted on propaganda by the big corporations involved in the NHS
  • GP surgeries taken over by private companies
  •  Propaganda hiding the truth of cuts


Our Alternative

  • A fully funded, fully staffed NHS
  • Publicly owned, publicly delivered
  • Free at the point of need
  • A national service across the whole country.
  • Good pay for staff
  • Health care for all and end to migrant charges and the migrant surcharge
  • Fully funded maternity services and  healthcare for women
  • Mental health care  given greater priority
  • No more hospital closures
  • Good healthcare for children
  • Fully funded public health services

Health care makes a country richer and happier, not poorer. It is an investment which returns financial as well as health benefits to the country, communities, families and communities.

Public service is more efficient than private sector health care in every country.

A national care and independent living service, for our elders  for  disabled people, and all who need support. It should be fully funded free at the point of need but  distinct from the NHS. End the privatised free for all in social care

The NHS was built by cate backgroundtend will be defended by  a mass movement.

Why should a Labour Council cooperate with ending the NHS? The damage will be blamed on local councils. Voters will blame you along with the Conservatives

A public campaign to stop this bill can win to show how the government and their cronies in the private companies are risking our health

The football fans made the government change their mind, so can we

This is the time to say NO

Share this video which explains this well•https://youtu.be/7vjoR7LnDqU