Don’t let the vultures in.

The NHS must not go the way of the Care Home sector.

A CQC report on Liverpool’s Health Care is advising the NHS and the Liverpool Council to work in financial and planning partnership with the private nursing home sector, and other private providers. Haven’t we had enough with Carillon? This is to be discussed at the Health and Wellbeing Board. The Liverpool Integrated Care Partnership Group, would include this sector and other private providers in an integrated planning organisation. Further details of the whole plan canbe found here

old people crossingThe elderly care home sector is very seriously flawed. The system is dominated by big business including hedge funds. A hedge fund is “an offshore investment fund, typically formed as a private limited partnership, that engages in speculation using credit or borrowed capital”. Football fans will have heard of them.

Private sector homes for the elderly now have a combined market value of £11.9 billion; five times that of Local Authority Homes. About half of residents get some Local Authority funding, and some get NHS funding, but most residents have to pay a lot themselves.

The system is run for profit by Big Business and has a poor record.

There are four major companies, owning what often appear to be independent care homes.  Companies that appear independent can be owned by other companies. Three of the big four, HC-ONE, Four Seasons and Care UK, are owned by private equity companies, complete with debts, according to the Financial Times. Private nursing homes are  owned by big business out to make a profit

Four Seasons Health Care has been in deep financial crisis, of its own making, resulting in a crisis in Widnes last year. This is not a crisis from lack of funding from the Government or local authority but from the financial model they use. Many of them are owned by hedge funds, are financially insecure, and can close because of bad debt arising from speculation.

In Widnes, the Millbrow Home had to be rescued from a near financial collapse by the public sector at the end of 2017. This model of care takes a profit, but does not take responsibility. The responsibility seems always to drop back onto the public sector.

Remember Southern Cross?

“Southern Cross Healthcare (Group plc) was a private provider of health and social care services, predominantly through the provision of care centres for elderly and some younger people. The group was the largest provider of care homes and long-term care beds in the United Kingdom, operating over 750 care homes, 37,000+ beds and employing around 41,000 staff. Following rapid expansion financed by the sale of leases of its homes, its shares fell 98% from early 2008 to early 2011, reducing its market value from £1.1bn to around £12m. The company had severe financial problems in 2011 and declared insolvency the following year”. (


This sector could be voting on plans and allocation of our Local Authority and NHS resources

This is out of order…

Image: Yui Mok/PA WireThe men and women in the homes have the right to respect and the best available care, including medical care. The law and organisation of the Care Home System is not fit for purpose.  It shows all the very worst elements of privatisation.

The staff working in social care can be fantastic, kind and loving but are overworked and underpaid. Many are so overworked they are leaving or having breakdowns. Care on the cheap does not work.

Unison quoted a worker”I have seen many good workers leave frustrated at the poor pay and the way zero hours contracts are used by way of punishment and reward. If you turn down a shift, hours you were depending on can be taken and given to others, sometimes with only hours’ notice. I have seen how many use this as a way to simply force out staff who may have complained about quality of care. Is this acceptable? Duty of care means that we have to raise concerns, yet many are too scared of the implications financially if they do.”

unison nurseWe need residential and nursing home care for  some our growing numbers of older and ill people. No one wants people kept in hospital for longer than they need to be there. Although if  so many  hospital beds had not been closed it would be less difficult to keep people in hospital a little longer.

The profit driven private care home sector though, must not have a say in Liverpool’s Health Service or in Council funding decisions. No to an integrated system!

The CQC report lists three sets of local social care providers as part of the local system:

“Adult social care”

49 active residential care homes:

  • One rated outstanding
  • 35 rated good
  • 10 rated requires improvement
  • One rated inadequate
  • Two currently unrated

41 active nursing care homes:

  • 16 rated good
  • 15 rated requires improvement
  • Six rated inadequate
  • Four currently unrated

72 active domiciliary care agencies:

  • Two rated outstanding
  • 34 rated good
  • 11 rated requires improvement
  • 25 currently unrated

This sector, with this local and national record, should have a say in our NHS, our Local Authority Care. Really? What about due diligence?

board2We need good social care

Hospitals negotiate daily with the private sector to accommodate people in need of a care home placement. It is  both routine and difficult because there is not a comprehensive universal service as there should be. What we have is a patchwork of services, some good, and some bad. Significant parts of the service are owned by big companies there to make a profit.

The care home system is inadequate, run for profit, and privately owned and should have no say in how the NHS or Local Authorities are run.

The market does not work in public service. It is inefficient and ineffective. The problems in the sector are not to do with shortage of cash, but to do with maximizing profit through hedge funds.  The needs of our elders come second to profit. The sector needs to be reformed. We have to use the system until the next government acts or Local Government finds a way to take it back in-house.  Do not let them take charge. This system must not be allowed to taint our NHS.

Care homes were one of the first sectors to be privatised

“In the 1980s a significant shift from the public sector provision of elderly care to private sector homes occurred, with the proportion of private facilities increasing from just 18% in 1980 to 85% by the end of the century.[2]

We need to nationalize the care home service, cut out the hedge funds and their speculation, and set some decent standards.

We need publicly owned, publicly provided care homes, with reliable funding and good levels of investment, effective monitoring and good planning, like the NHS used to have.

We need a full regulatory and training system. We need staff with secure jobs, who go home fit to raise a family, to enjoy their leisure, not tired to the bone.

Cruel and disgusting Government cuts

Liverpool City Councils funding has been mercilessly slashed and this has damaged funding for social care. Out sourcing and reducing the working conditions for staff has solved nothing. It has made things worse. The private sector is not efficient at providing public services.

Liverpool Echo reported in 2017 “Since the coalition Government came to power in 2010 and began an era of austerity and swingeing cuts to local councils, Liverpool’s authority has had to make total budget reductions of £330 million.

In 2010, the council received £523.72 m in Government funding, compared with the £243.90m it will receive this (2016) year. That figure will drop even further to less than £215m by 2019/20 meaning the council will have to find more ways to make savings and raise vital cash

We urgently need a better care system. A detailed report in 2015 described some of the difficulties vulnerable patients faced when discharged without good care. Delayed discharge figures were at the forefront of NHS managers’ minds during the winter/spring beds crisis in the NHS. Patients can be discharged only to come back into hospital shortly afterwards. There is a need to improve medical care in the care home sector.The private sector must not be given any kind of decision-making role, whatsoever, let alone sharing risk and gain.

Labour is committed to a national care service. A Labour Council should not be dancing with the devil, but should be preparing to implement its party policy.





Response to One Liverpool Operational Plan for Liverpool Women’s Hospital

These are the key points made about the future of the Liverpool Women’s Hospital, as set out in the One-Liverpool-Operational-Plan, published by Liverpool Clinical Commissioning Group in May 2018.

In the document, these points are set out as a table. We have extracted and answered each point in text form.

Introduction to their document

The reconfiguration of women’s and neonatal services currently delivered by LWH at the Crown street site to address issues with clinical standards and service co-dependencies  This phase of the project is to conduct a public consultation on proposals and to develop and gain approval for  Decision making business case.”

This sentence omits the word “maternity” yet this crucial to the role of the Liverpool Women’s Hospital. Let us hope that maternity is included in the overall term of “women’s services”


Each of the points in the document from the CCG refers to the idea that the Crown Street site should close and another building be put on the Royal Liverpool Site. (The number of beds involved is not mentioned, nor are the plans to persuade mothers to give birth at home). Read more

Marching to save Liverpool Women’s Hospital – Join us


On 22nd September 2018 we are marching, again, two years after our first march.

Sadly  plans are being put forward, again, to fundamentally change our hospital which sees 8,000 babies born there each year and over 50,000 appointments for a whole range of  health services for  women and babies and some specialist services for men too.

At 12 noon on September 22nd 2018 there will be a march from the Liverpool Women’s Hospital to demonstrate against these plans which are little different from earlier ideas.. We will continue our campaign across the summer to let people know what is happening and how to help defend  services for the women and babies of Liverpool and beyond. We really do need as much help as we can get. We can win if the people of Liverpool get behind this camapign. Don’t forget Huddersfield Royal infirmary was saved  in May 2018 by a brilliant campaign.


The Clinical Commissioning Group (CCG) intends to put consultation in place this Autumn with action in 2019. The details are in the One Liverpool Operational Plan. We will report on the plan as a whole in another post .

The document is quite hard to read as it is presented in narrow columns so we will copy each column separately.  (It’s quite funny to find the worst examples of management speak “Rationalisation of optimisation of corporate workforce” being one such. We think it means cutting admin  and manual staff. The NHS has been doing that to lower grades for a generation and it has not helped, not one bit.)

We will repond to each of these points in another post

The rest of the section about Liverpool Women’s Hospital is as follows

  1. Liverpool Women’s Hospital
  2. The reconfiguration of women’s and neonatal services currently delivered by LWH at the Crown street site to address issues with clinical standards and service co-dependencies  This phase of the project is to conduct a public consultation on proposals and to develop and gain approval for  Decision making business case.”
  3. 1. Complete NHSE assurance process
    2. Complete approval process
    3. Complete Public consultation
    4. Development and approval of Decision Making Business Case
  4. 30-Jun-18
  5. The safety of women’s and neonatal services provided by the Trust will be improved, via:
    Services which meet national and local clinical guidelines Reduction in clinical risk Reduction in over-occupancy in the neonatal unit Improved staff satisfaction regarding the delivery of services Improved clinical outcomes for patients Reduction in staffing and transport costs relating to patient transfers Reduction in backlog maintenance risks
    The quality of women’s and neonatal services provided by the Trust will be improved, via:
    Increased patient satisfaction
    Increased staff satisfaction
    A reduction in regulatory oversight and intervention
    Improvements in the CQC rating at the Trust
    Improved diagnostic capabilities
    Improved ward facilities which meet national standards
    Increased parental accommodation
    Optimised patient flows
    The financial sustainability of the Trust will be improved, via:
    Rationalisation of optimisation of corporate workforce
    Avoidance of an increase in CNST premiums required to be paid by the Trust
    Reduction in facilities management costs
    More efficient use of space within the hospital

Please come and join the fight to save our hospital.

Snip od the plans for the hospital

March on 22nd September 2018. Save Liverpool Women’s Hospital, Save Maternity Services, Save the NHS.

On 22nd  September 2018 Save Liverpool Women’s Hospital Campaign will march from Liverpool Women’s Hospital  to the Albert Dock and Labour’s Annual Conference

hands off our NHSOur slogans are

Save Liverpool Women’s Hospital, Save all Maternity Services and Save the NHS

We are campaigning for  a fully funded, fully staffed, publicly provided NHS.

End the crisis in the NHS now

Invest in our mothers, in our babies, in our people

Invest in our hospital, on site.

Reinstate all breast-feeding support services

Invest in mental health

For decent pay, bursaries and lower workloads for all NHS staff.

For an end to privatisation and for services to be brought back in house

For a full reinstatement of the NHS

For an end to rip off  PFI building finance in the NHS and public service

Not one more winter crisis; fix the NHS. This winter there were 10,000 “additional deaths” in England and Wales in the first few weeks of 2018. “This rise of 12.4 per cent, or 10,375 additional deaths, was not due to the ageing of the population” These policies are costing lives

Not one Doctor or Nurse who wants to work in the NHS and is fit to do so,and has a job offer to face deportation.

Health care for every mother and baby and health care for all, 

Not one more  contract to go to for profit organisations. These companies are there to make profit and public services are suffering from this

Campaigners have to encourage NHS Staff that together we can change this mess

The fight for our hospital is part of the struggle for the NHS. We face the largest corporate interests who see it as a business opportunity. Remember Carillion and the Royal Liverpool Hospital rip off. The NHS was founded as a public service for the people

£ The NHS as a national service is fully affordable, when it gets the same proportion of public expenditure as other western European countries pay for their health care, the same proportion as the UK used to pay before 2010.This is less than the appalling US system

Good health care is good investment in the population and prevents much human pain and grief.

Privatisation just makes money for the shareholders.The whole model is flawed as a method of delivering public service

please helpHow you can help

Spread the word.

Distribute leaflets,

set up small meetings to discuss it, donate.

Set set up a stall,

Sign the petition, take it door to door

Keep us informed,

Come to meetings

Follow us on Facebook Save Liverpool Women’s hospital, and in our blog, Save Liverpool Women’s hospital. Join NHS  campaigns

Donate to the campaign

Raise it in your toddler groups, in your unions, in your community groups

Bring your banners, bring your friends and family on the  demonstration on the 22nd September


April 2018 Update

Update: We want to keep our hospital on site, fully funded and up graded.
(Whilst reading this please keep in mind:

  • Carillon, that wonderful bankrupt monstrosity,
  • The much needed, though flawed and long delayed new building for the Liverpool Royal,
  • The terrible debt that comes from the PFI funding of that building,
  • The overwhelming evidence of danger to babies from exposure to traffic pollution,
  • The chequered history of the leadership of the CCG.
  • The huge STP changes nationally and locally going through the NHS…oh and
  • The Maternity Review and the Merseyside Women and Children’s Vanguard plans,
  • Personal maternity budgets
  • A few of the Mayor’s grand plans and even more.

Got all that?)
Liverpool Womens Hospital is still here, still safe, still solvent, still providing care to women, babies and some men.Still (as far as we know) providing it’s full range of services.
Great that Liverpool Womens Hospital is doing much needed improvement to the neo natal unit, though this seems a little slow to get off the starting blocks. It’s some months since the money was allocated for the upgrade to the neo natal unit
It is far from perfect but it’s a good hospital.
So what next?
The local NHS “commissioning” body still intends to go to consultation on its proposals to reduce, and move the hospital after these local elections.
Their plans remains to use a PFI (!!!) funding scheme to “rebuild” a smaller service on the same site as the benighted New Royal Liverpool Hospital with fewer beds.
So we pay more, to get less, and, as a bonus, put massive pollution into the lungs of 8,000+ babies a year.
And they could well pay thousands to PR people to make enough people think it’s all a good idea.
So we begin again our campaign to defend Liverpool Womens Hospital.
We need you to help.
Please message us if you want to know how to help.

Seacombe Pop Up Worries

Speech for the Pop up Maternity Unit public meeting 28 03 18
Thank you for coming
Nearly three years ago I read of the threat of closure over Liverpool Women’s Hospital, I set up a Facebook page and an electronic petition which got and still gets thousands of signatures and page likes. For all or mothers, sisters, daughters, friends and lovers and the babies

So why are we worried? We totally endorse the right of women to choose the kind of setting where they will give birth. We also support their right to keep and improve existing services. It is crucial that such choices are based on safety of mother and baby. We also support the choice of hospital birth either in an obstetric lead unit or an alongside unit, the choice the overwhelming number of mothers make in 2018, and a choice which is denigrated in many reports.

There are four kinds of birth settings used in England; the hospital, an alongside maternity unit which is co-located at a hospital and a Free Standing maternity unit which is located some way away from a hospital. Then there is home births. They are all currently considered safe for low risk mothers having a second or subsequent baby, but access to an obstetric hospital in an emergency is crucial for all. A Pop up maternity unit is one that has been set up as an experiment, a pilot without the normal capital investment and planning. The pop up in Seacombe is in a room in a children’s centre that housed a Sure Start centre before the cuts.

We campaign in a tradition of women fighting for decent care at birth that goes back, here on Merseyside, to the early 20th century. The Women’s Cooperative Guild published a bookbanner called Maternity. Letters from Working Women
The petition and Facebook page started a journey in understanding and becoming truly angry about what was happening to the NHS, to women’s services and to maternity services. I have children and grandchildren so had seen the NHS in action, good and bad.
A short while later I had a phone call from junior paediatric doctors asking for help in their campaigns and found out about the shortage of such doctors, nurses and related professionals and lack of investment.
We were joined in our campaign by longer-term campaigners who had fought (and failed) to stop the 2013 Health and Social care act and the spread of PFI. They did though raise real awareness of the issues Across the UK tens of thousands of people are fighting to defend the NHS and their numbers are growing.
So why are so many NHS campaigns worried?
• Because the NHS is starved of funds and much of those funds are diverted to profit making contractors who make £871 million profits
• Because the national health service is being fundamentally changed though accountable care programmes now renamed integrated partnerships
• Because this regime has resulted in an appalling crisis this winter, but next year’s will be worse and it is not accidental. It is fully avoidable. We will have avoidable deaths next winter if policies continue as they are now.
• Because this crisis is being used to pave the way for privatisation
• Government policies have been linked to 120, OOO unnecessary deaths of deaths especially following cuts to health and social care in UK since 2010
The additional deaths are not just in hospital. There were Ten Thousand additional deaths not caused by flu or any other measured indicator.
The hospitals are inadequate to cope with the population. The number of beds per head has been consistently reduced, to the lowest in comparable countries, deliberately and by policy. The number of doctors is inadequate, and that is the result of government training numbers. Are these NHS gurus now saying they got it wrong? Are they apologising? Are they resigning? Far from it. It is part of Conservative long-term plans
Before I turn to maternity and paediatrics let me look briefly at the worst hit service, mental health.
Mental health


has been starved of resources. You may have heard of the 2 million pound damages awarded to parents whose adult children had died from neglect in mental hospitals but now the situation is worse.
“Mental health trusts left with less funding than 2012 due to government cuts, new analysis reveals
Income for mental health trusts £105m lower in 2016-17 than five years earlier in real terms”
Many in patients are now sent to private providers one of whom boasted how they did well out of NHS shortages
“Cuts to mental health services have led to a situation where there is enormous demand, with little capacity to meet the need. In the five years up to 2016, mental health trusts in England had £600 million (US$751 million) slashed from their budgets. Meanwhile the number of people seeking mental health community help has jumped by almost 500,000 a year, to 1.7 million, since 2010”.
Therefore, we have every reason, when we consider maternity, to be worried.
Maternity is the most common reason to use the NHS. The current administration want to see that change and for more mothers to give birth at home. Since the introduction of the NHS, giving birth has become much safer. Maternal Deaths dropped from 500 per 100,000 births to less than one in 7,000
Nine out of 10 mothers give birth in Hospitals and for many that is their choice but it is a choice the current admins of the NHS want to change
Costs by planned location of birth
Home – £1,066
Freestanding midwifery unit – £1,435
Alongside midwifery unit – £1,461
Obstetric units – £1,631
They are also preparing for personal budgets for maternity, which could adapt to patients buying care from private contractors or the US model of population based funding.
Funding good care in pregnancy, at birth and in the first two years of life is an investment well worthwhile and one that pays off in economic as well as health and happiness. Investment in good maternity care makes the whole country better off.
– Published factors that raise the risk of maternal death include:
Being over 35
• Obesity
• High blood pressure or heart disease
• Anaemia
• Foetal abnormalities
We add to this list the great risk of poverty. The still birth rate doubles for poor mums and we live in a poor area. This pop up is in a poor area, it is in the bottom 2% of areas for wealth in the country

We have followed the maternity Review, the Merseyside, Cheshire Women, and Children’s Vanguard
We know the following
They want to reduce the number of hospital births
The NHS is short of midwives, midwives are over worked. Staff stress has become a risk factor Maternity units had to close their doors to women on 382 occasions last year.
The maternity tariff is inadequate
An NHS spokesperson said it was ok to travel for four hours in labour.
There is a push to close maternity facilities“ to regionalise obstetric care because of the shortage of obstetricians, from 147 to as few as 118,
The NHS focus of “choice” not safety in their publications though good work on safety goes on through MBRACE
The Maternity Review favours including private providers. It also favours giving women a choice of four versions of place of births but not which city they give birth in if the NHS decides to close a maternity facility
We have a private contractor working here in the Wirral, and there are concerns from CQC reports. But according to the internet, it runs a clinic, Bidston and St James children’s Centre in Birkenhead already. So we were especially concerned when we heard that the local CCG were intending to set up an accountable care system using this private company
The purpose of a company is to make a profit. The purpose of the NHS is to provide health care
NHS spending on care provided by private companies has jumped by £700m to £3.1bn with non-NHS firms winning almost 70 per cent of tendered contracts in England last year.
Private care providers were awarded 267 out of a total of 386 contracts made available in 2016-17, including the seven highest value opportunities, worth £2.4bn.
Richard Branson’s Virgin Care scooped a record £1bn worth of contracts last year, meaning the company now has over 400 separate NHS contracts, making it the dominant private provider in the NHS market

On Wednesday 7th March 2018 we raised our concerns about the pop up maternity unit and plans to create an accountable care maternity model using One to One midwives, a private company, with Catherine McClellann and Simon Banks of Wirral CCG
We asked about the section from the minutes of the CCG

“The implementation of the National maternity services review is on track and continues to progress with putting into place the recommendations of the report. Wirral is in the process of piloting an Accountable Care Maternity model with the acute provider subcontracting to ONE to One Midwives to deliver the full range of services included in the Better Births report. The Improving Me team (Vanguard site) has chosen Wirral to also pilot a “pop up” midwifery led unit within the community”

Mr Banks at first denied this had been said but we were able to show him the document.
He said that accountable care is parked/stalled because of the legal challenges
He said that the pop up would be run by Wirral University Hospital Trust (Arrowe Park)
It would not be a run by the company One To One Midwives
The midwives will be using a “case load model”. These are not extra midwives. It is a “redesign” of the Community Midwife team providing “continuity of care”. We think caseload model this is difficult in a situation where there is a shortage of midwives. It will remain an aspiration until resources are provided, and training midwives can take years
The pop up will he said be covered by the Clinical negligence scheme for trusts
Mr Banks reported on improvement in stillbirth figures (These figures really do need to improve)
Mr Banks said there were arrangements for rapid transfer as used for home births. We asked about Ambulance response times, which we have seen as problematic. He did not see this as a problem.
We asked about lone working for the midwives. Mr Banks said there would be other staff there during the day. The team will do antenatal and post-natal care from the Seacombe centre.
There is only space for one mother at a time in the pop up unit
It will be accessible 24/7, open 12 hours a day
There will be a loop system to divert cases to the hospital if the midwife is not available at the pop up or it is already in use.
We asked what would happen when the mother goes into labour. The mother will phone the midwife. The midwife will go down to the pop up (this has since been changed to the midwife will go to the home initially and see if transfer to the birth centre will be feasible)
We asked about the central phone information system mentioned in the vanguard video
(See about one minute 22 seconds in) We were told the single point of access booking in system would not function at present. We are concerned that this system could direct women to options that they would otherwise not consider. Choice of birth setting is highly influenced by initial advice.
We asked to see the consultation they had undertaken, they said they would forward it.
We asked about personalised budgets, which are a feature of the Maternity Review? Catherine Mc Clellan replied that they do not want midwives involved in such calculations, in costing each intervention and procedure.

We asked about the One to One company. We were informed the company were under High surveillance ((or something similar), they can provide ante natal and post-natal care.
He said they have to work to national agendas
Mr Banks suggested we looked at this
We had seen this previously and consider it to be methodologically questionable and without a solid evidence base.
We asked where the capital money had come from for this pop up unit. He said none had been spent apart from a small grant for decorating. The council had provided the building, equipment was from the hospital. If there was a call for this kind of a service then perhaps, the NHS might do some capital investment but the NHS had no capital to invest, (this was his meaning if not his exact words)

We asked could the pop up do instrumental delivery or ventouse? The answer was no.
We asked could they do pain relief or epidurals? The answer was no.
We then visited the children’s centre and met the midwives, who are lovely, as expected.
We do not think that the size of the team is realistic for the service advertised, even with all the good will in the world is applied by the midwives. Sleep, self and family care, holidays and sickness mean this is a very small team to provide 24-hour cover.
So what is the situation This expresses some major concerns.

We do support women’s choice in child birth but it needs to be a well informed personal choice not one pushed by appalling policies as listed above.

We will continue to monitor the situation locally and nationally.

Birth chair

Why no extra staff for an extra service?

We will continue to question the situation
We suggest those who want to know more nationally read this also

Please donate to our campaign

We  produce leaflets, organise meetings and workshops, organise events and coordinate with other NHS and maternity campaigns. For nearly three years now we have campaigned to Save Liverpool Women’s hospital, campaigned for more midwives, nurses and doctors, campaigned for  enhanced  funding for neo natal services, mental health for mothers.

We oppose the ending of bursaries for nurses and midwives.We support better pay and conditions for staff. We oppose   outsourcing staff, clinical and non clinical

We campaign against the STPs, the maternity vanguard, personal payments and down grading maternity services.Please donate to help us  spread the word about  campaigns for a fully funded NHS and fully funded maternity service, free at the point of need for all women, free from privatisation and  a service that is  constantly improving infant and maternal survival rates. We face a hugely well funded publicity campaign by the management of the NHS and the Government and much of the media. It is only our supporters who can give us a chance of success. Please donate.

Donate Button


We have to learn how to run this campaign as we go along. Today we have learned to create  a  donate button. Please make all the blood sweat and tears worthwhile!. Give us  just a little  money to continue our campaign


Keep Our Health Care National

(These are some of the notes used speaking for Save Liverpool Women’s Hospital at rallies for the NHS on February 2/3rd 2018.)

Keeping Health  National
The NHS is at a tipping point. We demand that the NHS be funded properly and be fixed, that the running sores of privatisation be tackled. Lack of adequate funding and privatisation have caused real harm, and other plans are afoot that are doing grievous damage.
midwives cleaners etcIt is not the market that has kept the NHS afloat, stricken though it is, but the work, often unpaid and always underpaid, of the NHS workforce, of doctors and Nurses, midwives, the related professions, the porters, health care assistants, cleaners, and oft maligned admin staff. These rallies are to give you, NHS workers support as well as to loudly protest.
We want more funds for the NHS, we should match what other advanced countries spend on health.
We want our health service to be National, not regional, not local, but National.
To be for all of us, equally; babies, mothers, elders, employed, unemployed retired, carers, manual workers and office and shop workers, everyone regardless of class wealth or creed
We want it to be national so we can gain those huge economies of scale that have made the NHS the most cost effective health care system in the world in international comparison tables.

Maternity care needs it to be national, to develop good maternity provision and to make the fight for good maternity care more powerful. We cannot leave a few women in each area fighting for good maternity care, it need as national service and a national campaign. Good care for babies in pregnancy, at the birth and in the months after birth, is crucial to the health and well-being of the community.
We want the NHS to be national so we can, by sharing our risks across a whole population of nearly 66 million, afford for everyone to have the best available treatment. We want it to be national so it can reflect our great national wealth.

We are the sixth richest country on the planet; we are the financial hub of the western world,
We want the NHS national, paid for from general taxation, paid for as a public good. A healthy population free of the fear of nofinance-2t being able to afford health care makes for a happier, heathier more productive nation
We want it national, so the workings of the NHS should be transparent and answerable to parliament for public scrutiny.
We want it national as some protection against the global economics, the economics of inequality.
“Last year saw the biggest increase in billionaires in history, one more every two days. This huge increase could have ended global extreme poverty seven times over. 82% of all wealth created in the last year went to the top 1%, and nothing went to the bottom 50%.
Dangerous, poorly paid work for the many is supporting extreme wealth for the few. Women are in the worst work, and almost all the super-rich are men. Governments must create a more equal society by prioritizing ordinary workers and small-scale food producers instead of the rich and powerful.” Oxfam
We want the NHS to be national so it is not private, nor for profit, nor rationed and not offering restricted care based on economics outcomes rather than patient care, as we find in an accountable care system. By being national, we can run the best system in the world without spending anything like as much as the Unites states does on health care.
We want it national so it is too big for corporations to swallow whole and privatise, as they have privatised the railways, water, the post office, British Telecom and electricity and gas. We want it national to give it some protection from free trade agreements.
We want it to be national so we can share research, professional development and expertise without cost barriers to that sharing.
We want it to be national, not broken up and privatised. The NHS is a beacon of humanity, of social solidarity and a contributor to the nation’s good mental health
But our National Health Service is being run by the Conservative government to its own bizarre ideological policies, policies that prefer to be spoken about only behind closed doors or behind blinding propaganda. They will never openly say they want privatisation but Jeremy Richard Streynsham Hunt, the Secretary of State for Health and Social Care since 2012 wrote a book about it and Simon Stevens head of the NHS, in his previous role coordinated a major paper on privatising health care for DAVOS
“Simon Stevens himself, who, at that time was head of UnitedHealth’s Global Division, acted as Project Steward of the Steering Board for the first World Economic Forum report, working with chief executives of leading healthcare companies, including Apax Partners, Novartis, Merck, Medtronic and Kaiser Permanente, as well as the Directors of Health at the World Bank, the WHO, and the European Commission.” Socialist Health Association

Too few beds

hospital bed
The NHS is underfunded, and short, by policy, of beds. So, we see the horrors of patients for hours on trolleys and even on the floor. Over 30 years the number of hospital beds has halved, as the population has increased
Germany manages to provide 8.1 hospital beds for every thousand of its citizens, compared to 2.6 in the UK. It employs 4.1 doctors per thousand people compared to 2.8 in the UK; People with private insurance don’t jump the queues, because there aren’t any
The winter crisis was entirely predictable. We are short of doctors, nurses, midwives and other medical professions, and this is from appalling government planning. This rundown is policy. This is not from stupidity, it is deliberate. Who cancels bursaries during a shortage of nurses?
We must have a fully funded NHS, paid for by general taxation. It is a matter of life and death.

We do not want the National Health Service broken up into 44 footprints, STPs and Accountable care systems and organisations, or ACOs by any other name. We want a national health service. No corporation could run the NHS as a whole so it is being broken into bite sizes pieces covering a geographical area, at a size that the private sector is used to running in the USA.
In our area, Merseyside and Cheshire, we are expected to make nearly a billion pounds worth of cuts, and the NHS bureaucrats are working towards an ACS, whatever people might tell you and it lacks any basis in law or democratic scrutiny.
Keep Our NHS Public highlight the dangers
“They incentivise rationing of services and – even more concerning – denial of care and so are fundamentally at odds with social solidarity and the values of equity and universalism that underpin the NHS;”
The plans currently being implemented expect, “Acute providers to (make) downward adjustments to budget projections to reflect national efficiency expectations such as the requirement for acute providers to reduce activity growth” They say they will reduce spend in acute settings. “If the budget does not align with affordability most appropriate response amenhands off our NHSding service scope”
This means that the STP plans increasing cuts not increased spending, over a long period.
So we campaign for the NHS to be a fully funded national health service.
We have to change this government to make it so
We need every person who can give some time to the campaign to do so. The only way we can win this is by a huge campaign.
For our mothers sisters daughters friends and lovers and for the babies
For the men too, young and old, we need the NHS.Christine jones

with thanks to Christine Jones, Romona McCartney, Alan Gibbons and Steve Carne for images

Pop Up Maternity Unit, Maternity Review, the Women and Children Vanguard


A pop up maternity Unit? Really? In the middle of the crisis in the NHS? During a crisis in ambulance attendance times? During a crisis in Midwife recruitment and workload ? During a financial crisis for the NHS?

We would ask:

Why is this safe?

Who will oversee its safety?

How will its work and its staffing be planned?

Will it be staffed day and night?

Where is the risk assessment?

Where is the Equalities assessment?

Who will manage its policies? Stringent policies in a maternity units save lives. The Morecambe Bay scandal proved that; for a critical view of Morecambe read this

What ambulance stand by is planned? Ambulances on the Wirral right now are not exactly speedy.


The Merseyside and Cheshire Women and children’s Vanguard have made a very strange decision to open a pop up midwife unit in a children’s centre in Seacombe, on the Wirral.

What is going on?

We need better births, greater care for women and babies, fewer still births, fewer maternal deaths.Women should have more care in pregnancy, in labour, after the birth and in the baby’s first year of life.

We need many more midwives, working under less pressure, more obstetrician, more neo natal nurses and all the related professions.

We need more pediatrics (baby and children’s) doctors and nurses.

We need much better mental health support around pregnancy and early motherhood.

We need breastfeeding support to be expanded funded and staffed by well-trained and well paid staff, linking with volunteers who are themselves breastfeeding.

We need support for infant nutrition for bottle feeding mum’s, not leaving this to big business who exist to make a profit.

We need good public health, removing environmental hazards like traffic, traffic pollution,unhealthy food products and stress.

So we do need a lot from our NHS maternity and pediatric services

The Maternity Review and Better Births is a long-term plan from the government, led by Conservative peer Baroness Cumberlege

It is slathered in words about choice, that women must have choice about the way they give birth.

The context of crisis cuts and massive underfunding in the NHS and its multi faceted privatisation deprives the maternity review of any credibility.

Under the banner of the Maternity Review the national NHS have set up Vanguards or pilot schemes to develop their plans. One of these Vanguard areas is Merseyside and Cheshire

If this seems to good to be true, it is too good to be true.

Whilst in other areas maternity units are closed against the wishes of local women, and while we need many more midwives, and junior obstetrician, this government conducts expensive experiments about which kind of midwifery unit is required.This is not in response to local requests but as part of a national plan.

Women in many parts of the country are fighting to save local maternity services. Save Liverpool Women’s Hospital Campaign went to Barnsley to help their protests at not being able to have babies in Barnsley. Personalisation does not go as far it seems as keeping maternity services local

Maternity Campaigns across the country are objecting to long journeys to give birth. A man from the NHS said it was ok to travel for 4 hours in labour.

We have significant lack of choice in real life.

There is also the spread of a for profit private midwifery contractor commissioned by the NHS in Merseyside and Cheshire.

Many services in the NHS have already been put out to private contractors.

Cheshire and Merseyside and Children’s Vanguard is doing some good, in that it is commissioning some additional mental health support for new mothers and we can see this at Liverpool Women’s Hospital

However some of what it is doing is of serious concern. Some background is required to make this clear.

Kinds of Places to give Birth

There are a number of places where women can give birth. These places are:

In an obstetric unit where there are specialist Doctors and where doctors are being trained and where research is being carried out. Midwives work here also.

More complex cases are dealt with in obstetrics units.These units operate as a resource and centre for other providers, when births which were expected to be straightforward become complicated.It is here that planned and emergency Cesarian sections take place, and where women can have epidural anaesthesia

One alternative is a midwife led unit alongside an obstetrics unit.This is staffed by midwives, not doctors, and is intended for women who are likely to have straightforward labour. If there are difficulties in labour mother’s can be transferred to the obstetrics unit.These units (and certainly the one at Liverpool Women’s Hospital) allow a more homely, less medical approach to childbirth.

Some areas of the country have a midwife led unit not attached to an obstetrics unit.These are called free-standing midwife led units.They have the advantages of an alongside Midwife led unit in that they are less medical, but are without the down the corridor access to the obstetrician.If there is a need to refer to an Obstetric team the woman would be transferred in an ambulance.In some parts of the country this is the main kind local provision.

Then there are home births using NHS midwives. For very low risk mother’s this is a great service. Again if things get complicated the women in labour can be transferred to the obstetrics unit by ambulance.

Another option is birth with a private independent midwife, where a qualified self-employed midwife works directly to the woman in pregnancy, in labour and after the birth and is paid by the mother not the NHS. Again if there are problems the woman is transferred to the hospital.

(We are not aware of any independent midwives working in our area but would love to talk to them if they are around.)

There is also a for profit company, contracted by the NHS, employing midwives not in the NHS to provide home births.The NHS pays for the service but it is not part of the NHS, it is a contractor.

If the woman in labour has difficulty the woman is transferred by ambulance to the obstetrics unit, but the private midwife has to hand over all care to the hospital.

A very few wealthy women use private maternity hospitals mainly in London.

Some of the poorest women without recognised residency rights in the UK but living and often working here have no right to free maternity care.How they cope varies from woman to woman but is rarely good for mum or baby.

So we have an array of services.

The Merseyside and Cheshire Women and Children’s Vanguard wants to set up an additional free-standing midwife lead unit in this area because they say women must have this additional choice.There is no free standing Midwife led unit in the area. So in their wisdom they are setting up a pop up centre, in a children’s centre in Seacombe. run out of Arrowe Park Hospital but not on the hospital site. Incredibly it has been described as somewhere which will not be staffed until the woman phones a midwife, says she is in labour and arranged to meet the midwife there.We think this is peculiar.

‘Pop up’ birthing centre offers new choice to pregnant women

A nationally pioneering ‘pop up’ birthing unit based in Wirral’s Seacombe Children’s Centre will provide enhanced choice to expecting mothers in the area.

Containing facilities for women to give birth, the community unit will be open from March 2018 and offer women a safe alternative to hospital birth in a more family-friendly environment closer to home.

Based at the local children’s centre, the unit will encourage women with a low risk of complications (something established clinically during discussions between a woman and her midwife) to give birth in a non-medicalised setting where wrap around services are also available to support families postnatally and beyond.

As the first birthing centre nationally to launch in a multi-purpose community setting, the new facility will provide key insight into the cultural effectiveness and uptake of more community-focused birthing options. The facility will be run by experienced, highly skilled midwives from Wirral University Teaching Hospital NHS Foundation Trust (WUTH), and if successful, could inspire the development of permanent freestanding midwifery led units (FMLUs) across the Cheshire and Merseyside region.

The Seacombe pop up is opening in response to NHS England’s Better Births Report (2016), which identifies that the 87% of women nationally will give birth in a hospital, but only 25% of women would choose that as their first choice. This is backed up by guidance provided by the National Institute for Health and Care Excellence (NICE), which states that freestanding midwifery units are “associated with a higher rate of spontaneous vaginal birth” compared with births in other settings.

Catherine McClennan, Programme Director for the Improving Me Cheshire and Merseyside Women’s and Children’s Services Partnership (the NHS programme driving the initiative), said: “We have been working with local women and healthcare providers to explore new models of care that provide meaningful choice to families. Our pop up birthing unit based at Seacombe Children’s Centre is the first of its kind nationally, and has been driven by the voice of women. I’m delighted that we’ve been able to lead the way in offering people a more personalised pregnancy journey.”

By supporting women to give birth in a community setting, the unit aims to offer a more relaxed and familiar ‘home from home’ experience. They are also more likely to be looked after by a midwife that has helped them throughout their pregnancy and remain in a private space (with their partner/family welcome to stay with them) throughout the duration of the birth.

Debbie Edwards, Associate Director of Nursing /Head of Midwifery at Wirral University Teaching Hospital, said: “We welcome the opportunity to be involved with the roll out of the Birth Centre, which will make a big difference to the choice that women have regarding their place of birth. The unit will provide women and their families with an optimum birth environment.”

Cllr Bernie Mooney, Wirral’s Cabinet Member for Children and Families, said: ‘‘I am really proud that Seacombe children’s centre will be home to the first community-based birthing unit nationally. The unit will provide women with a real choice about where they can give birth safely and comfortably and that is a huge step forward for families in Wirral.’’

Improving Me is a partnership of 27 NHS organisations across Cheshire and Merseyside aiming to improve the experiences of women and children. The Partnership is one of NHS England’s Vanguard New Care Model initiatives and an Early Adopter for the Better Births recommendations.


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“The unit will provide women and their families with an optimum birth environment.”

What does this even mean? The women who might use such a service are the very very low risk mothers, those suitable for home births. So not first time mothers, not anyone with diabetes or epilepsy or is over weight. Is it safer than an obstetric unit? Safe than an alongside midwifery unit?

Is it home? with all the benefits of home birth?

No its an experiment funded as part of the process of deciding the cost the government will pay for maternity care.

Personal Budgets

Another peculiarity of the Vanguard is the idea of personal budgets.The review suggested a personal budget of £3000, somewhat less than the cost of a complex caesarean section and more than an uncomplicated vaginal delivery. The Personal budget concept only makes any sense if it is preparing for privatisation where mother’s would” buy’ different bits of care from different private providers. However women are not that daft.

There is another kind of privatisation, that which involves all of a city regions health and care services being put into an ACO and that ACO being put up for bids from global for profit corporations

To build the personal budget figure, women at Liverpool Women’s Hospital and other places are trialling choosing a menu of extras (that should not be extras) like extra breastfeeding support, or hypno-birthing classes.These costs are minor compared to delivering a comprehensive maternity service.

There is much to be concerned about.First of all maternity is a service not a production line which has each little action costed.

A comprehensive service is less expensive than a lengthy menu of choices, and should give room for choice.Money is wasted by having these market systems

The Obstetric unit needs to be there in the background to assist all the other options. It should not be costed just by the number of births it hosts. Other services are made safer by its existence. It could be a sign of success if these units were used less because women had had easier labours.That success, were it to be achieved, should not be a reason for cuts

Giving birth at home is supposed to be the cheap option but for home births to be safe there is a need for ambulance and Obstetrics back up services.

In couple of years time the maternity tariff ( how much maternity services are paid by government) is supposed to be reviewed. Supposedly, the menu of choices being offered to women trialling the personal maternity budgets will feed into these decisions.

We think these “additional services” should be standard.

Another thread in this tapestry of peculiarity is that of hubs.

In Liverpool maternity services through the Vanguard, the CCG, Healthy Liverpool and more, are planning maternity hubs not for labour but for ante natal and post natal services.

This is part of integrating health and social care services.Health visitors have already transferred to social services At present community midwives for pre and post natal care are linked to 29 GP practices

They are to move to hubs in certain areas, we are told to put them in pram pushing distance.Now how can 5 places be in pram pushing distance in a city? Is it not more likely that 29 GP surgeries would take less pram pushing?

Health Visitors are no longer employed by the NHS and are employed by the Council.

Once a service is provided by social services the patient has significantly less rights than they have as an NHS patient.Social services can be charged and the “client” does not have automatic rights to the service.

Women need to be telling their MPs now that the maternity tariff should be generous, not inadequate and destructive as it is now.

Sustainability and Transformation plans are being run out across England. Local population level medical and social care systems are being constructed.These systems are solar to US models. The system is put out to contract which can be bid for by some company or body, not necessarily the NHS. Health and Social care are being integrated, even across local government boundaries.The NHS is free at the point of need, paid for from taxation, and providing the best available treatment.

Social care is means tested and has no obligation to provide the best treatment or care.Staff do not have the same education training, obligations or working conditions or trade union recognition.

Health care is free at the point of need.Social care is not.

Providing population level care with a fixed budget must mean rationed medical care. This rationing of services has already started for example rationing fertility treatment, hearing aids, cataracts and more is underway in some areas.
Maternity is the most common reason to use the NHS.Costing maternity for accountancy purposes, and reducing that cost it is essential to the Accountable Care system.The courts have defacto stopped this move to ACOs untill it has been discussed in Parliament, thanks to a crowd funded legal case by campaigners

Integration of health with social care is essential to that system.

“National” matters. Huge benefits are found in our National system, benefits in research, professional education, in maintenance of standards, in regulating treatments and much more.

The right to access to the “best available treatment”is essential especially on giving birth, for mother and baby.This would be under threat in a city region population level care contract or ACOs.

Local Maternity Systems

The maternity review wants to deliver a local maternity system just like the accountable care systems. If anyone ever doubted that this was part of the national plan to regionalise the NHS, and break its national system, to cost it so as to be attractive to international bids then they should read this

“The learning from the process for Pioneers, to get to a position to be able to offer a PMCB, provides some key experience and lessons for other LMS, looking at the Better Births ambition for all women to have a personalised care plan in place for their whole maternity pathway. It has also flagged areas for wider development to support this transformation in the system. In response to this, we are developing a number of national tools that will be available for all LMS:

  • A model service specification for maternity services
  • A model qualification criteria, to support the procurement process
  • A decision aid for women on the standard pathway, to support their place of birth decision, and accompanying professional guidance
  • A checklist for quality information for women
  • A minimum standard for clinical governance and safety protocols across an LMS
  • Case studies on lessons learnt from Pioneers and wider developments.

We hope these tools will support LMS in their transformation plans and we are excited to work with LMS who want to drive forward the personalisation agenda, both through the bespoke support offers that are being developed, and through direct discussion on the tools and experience that we can share with systems as they develop their plans.

As maternity systems begin to deliver real personalisation of services, we are excited to share and learn from the excellent local initiatives already in place across the system. If you would like to know more about how we might support your LMS or share your experience or challenges with us, please get in touch:

Women want, and say so daily, a fully funded National Health Service, local maternity care, including fully supported home births, local alongside Midwife lead units and safe Stand Alone midwife units.

We most definitely do not went wholesale privatisation, as we would see in an ACS or a privatisable local maternity system

A further blog post will go into this in more detail.