Labour plans to cuts hundreds of NHS hospital wards

Plans that could lead to the closure of hundreds of hospital wards are being drawn up but will not be made public until after the general election, opposition parties have said.

Last year, the Government asked NHS authorities to come up with proposals to reorganise the service to save money as a result of the recession. Details have started to emerge of what is likely to be a rolling programme of cuts that contrasts sharply with assurances from Labour and the Tories that the NHS was “safe”.

So far, only the plans for London have come to light. Campaigners claimed the proposals threatened services such as casualty and maternity units at 13 out of 36 hospitals in the capital.

The failure of health authorities in other areas to disclose their response has prompted allegations that proposed closures, which could be politically damaging to the Government, will not be published until after polling day.

The scale of the cuts has caused a rebellion among Labour ministers who have openly defied the Government by publicly protesting at closures at their local hospitals.

Next week, health ministers will come under pressure from the Conservatives and Liberal Democrats to disclose the scale of the plans, with the Tories calling an emergency debate on the issue.

Norman Lamb, the Liberal Democrats’ shadow health spokesman, said the scale of the cuts to hospitals was likely to be “vast”, with potentially “hundreds” of wards closing.

He said: “The Government will be desperate to avoid these cuts ahead of an election. We could end up with the threat of cuts to services being a key issue in the election campaign. The electorate will feel conned if they come out after the campaign.

“It is hard to judge the scale of this but it could be vast. It could be hundreds [of wards]. The savings they have to achieve are enormous. What has emerged in London could be the tip of the iceberg and the public is unaware of the scale of potential cuts.”

Mike Penning, the Tory shadow minister for health in London, said: “I see no reason why these reports cannot be published before the election. Labour must be straight with people about the cuts that they are planning to make to their local NHS.”

The cutbacks are partly as a result of Lord Darzi’s 2008 review of the NHS, which recommended more community based treatment in large GP centres and bigger, specialist treatment centres in hospitals.

Authorities were asked by the Department of Health to draw up plans to implement Lord Darzi’s review. But last year, they were told to reconsider their proposals after the recession.

Opposition parties have claimed that health authorities were considering closing or merging key hospital departments, many of which have received millions of pounds in investment in recent years.

The NHS is coming under pressure to find other savings despite government claims that the health service would be protected from widespread public spending cuts.

In this month’s budget, Alistair Darling, the Chancellor, is expected to announce that the NHS will have to find savings of up to £10 billion a year. Liam Byrne, a Treasury minister, said last month that hospital buildings were likely to be mothballed as services were moved to community based health centres.

Dr John Lister, the author of the British Medical Association’s recent report on the plans, described the scale of the cuts being proposed as “a disaster”. Threatened hospital closures are likely to become one of the key election issues.

Labour ministers and MPs faced claims of hypocrisy after starting pre-election campaigns to block closures at their local hospitals. Ministers were pictured protesting against closures and writing to residents setting out their opposition. Many fear they will lose their seats if they are seen to back government policy.

Last weekend, David Lammy, the Higher Education minister, was joined by other local Labour MPs when he led a march to “save” the Whittington Hospital casualty department in north London.

The Whittington also faces cuts to maternity services, although £600,000 of public money was recently spent on its new birth centre. Other high-profile Labour MPs campaigning to protect hospitals in their constituencies include Margaret Hodge, the Culture and Tourism Minister who represents the marginal seat of Barking. She has led a campaign to save the Accident and Emergency unit at King George Hospital in Ilford.

Mike Gapes, the Labour MP for Ilford South, also backs the campaign. “I will fight a Labour government, a Conservative government or a Martian government to keep a hospital in my constituency,” he said yesterday.

Last night, Andrew Lansley, the shadow health secretary, said: “Labour MPs are campaigning on a general election manifesto which would lead to the first cuts to the NHS budget for years, but yet they still try to portray themselves as local champions by protesting against cuts in their own backyards.”

From:
http://www.telegraph.co.uk/Hundreds-of-NHS-wards-to-be-shut-in-secret-plans

Hospitals must cut services to stay afloat, watchdog quango warns

Hospitals will have to reduce services, sell off buildings and move into smaller premises to cope with financial pressures in the next few years, the head of the foundation trusts’ regulatory body has warned.

Accident and emergency departments treating only a few serious cases may be downgraded to minor injury units

William Moyes, who steps down from his role as executive chairman of Monitor after six years told The Times that too many hospitals were not grasping the economic challenges ahead.

While political parties have promised to protect NHS funding and avoid service cuts, Mr Moyes said it was inevitable that some hospitals would have to reduce services and sell off assets to keep afloat.

Any hospital department that was treating too few patients to cover its costs risked compromising the quality of care, he said. Some maternity and paediatric units, which are very costly to run, might be merged or relocated, while A&E departments could be downgraded to minor injury units if they had a small number of serious cases that could be sent elsewhere.

“People need to know where they are making money or losing money. If you find a service where the income can’t cover the cost, you may eventually have to question whether the income is ever going to be sufficient, and whether this is in fact the wrong activity for the hospital.

“In quite a lot of places the number of births is too small to support the cost of giving a high-quality service. You have three choices: increase the flow of patients, move the service elsewhere or stay as you are and risk compromising the care.”

Mr Moyes, who oversees the regulation of finances and governance of England’s 125 flagship foundation trusts, said that as well as focusing on core departments, trusts would need to consider stripping out “uneconomic” facilities such as pathology laboratories and scanning units in some hospitals that were being used for very small numbers of patients.

“There may be surplus assets — buildings, land, equipment, stuff they think they might need in years to come under their development plans — and in some cases working in a much smaller physical space and disposing of all the hospital penumbra that can be brought into the main building.”

Mr Moyes said he had requested that foundation trust chief executives resubmit a “downside assessment” — stripping back their budgets — to get a more realistic grasp of the funding pressures they faced. He said that he was disappointed when, on being asked to revise their financial predictions in September, a number of trusts had resubmitted even more rosetinted forecasts of growth.

“You can’t assume everything will go well and if a problem arises the Department of Health will bail you out,” he said.

His warnings were echoed yesterday by Sir David Nicholson, the chief executive of the NHS, who described the coming years as “extremely challenging”. Giving evidence to the Commons Health Select Committee, Sir David warned of pay cuts and service reorganisation. “It is going to be very tough,” he said, adding that tighter budgets would mean the 1 per cent pay cap demanded by the Treasury would be treated by NHS managers as a maximum rise, not an entitlement. His comments came a day after inflation hit 2.9 per cent when unions are already angry over a pay freeze on council workers.

“There is essentially a trade-off between pay and numbers of jobs,” he told the committee. “In a cash-limited system, that is the big unknown for us. We need to talk through with the trade unions and staff associations about what that trade-off is.”

Sir David has previously warned that the NHS would have to find productivity and efficiency savings of between £15 billion and £20 billion over the three years 2011-12 to 2013-14.

The head of the Audit Commission added to the debate, saying that political pledges to safeguard spending on health and education were “insane”.

Steve Bundred told the Commons public administration committee that billions would have to be saved. “It seems to me absurd to imagine that the only services where no efficiencies can be found are those that have been the most generously funded for ten years,” he said.

Mr Moyes said he thought that an “unintended benefit” of future economic turbulence would be to heighten hospitals’ understanding that they had to operate with a robust business model.

“A lot of hospitals, even the very good ones, are at the stage of learning how to think long-term,” he said. “We are good at strong visions, big pictures, but we need to learn to be very good at pessimism and what will happen if things are not going to turn out well.”

From:

http://www.timesonline.co.uk/tol/life_and_style/health/article6997644.ece

David Cameron sets out policies to boost NHS

David Cameron has pledged to protect spending on the NHS as he set out twenty policies to boost Britain’s health services if the Conservatives win the forthcoming general election.

Launching the Conservatives’ election campaign, Mr Cameron said that health care was his top priority and that he represented “the party of the NHS”.

The Conservative leader pledged to channel more health spending to poorer areas to tackle the growing gap in life expectancy between the wealthier and less well off.

A new maternity service giving mothers greater choice will also be set up if the Tories are elected.

Mr Cameron published the first chapter of a “draft manifesto” detailing twenty Conservative policies for the NHS.

These included a pledge to end mixed sex hospital wards, a plan to withhold funding from hospitals which infect patients with MRSA, and new proposals to give patients detailed information about the quality of treatment from each doctor, hospital or surgery.

Patients will also be given more opportunity to manage their own care and could receive treatment for minor ailments at their local pharmacist.

In a speech to Conservative activists, Mr Cameron said: “Today, the Conservatives are the party of the NHS. But talk is cheap. You've got to back that with action, and we have.

"We are the only party committed to protecting NHS spending. I'll cut the deficit, not the NHS. And don't for one minute buy the Labour claim that they'll do the same. They won't - and their own figures show they won't.

"Unlike us, they have not committed to protecting areas of the health budget such as public health and capital investment."

Mr Cameron accused Labour of failing to tackle the gap in health between rich and poor, describing it as "one of the most unjust, unfair and frankly shocking things about life in Britain today".

"Health inequalities in 21st century Britain are as wide as they were in Victorian times," he said.

He promised the Tories would introduce a new health premium that would divert cash to the poorest areas and "banish health inequalities to history".

"With our plans, the poorer the area, the worse the health outcomes tend to be, so the more money they can get," he said, adding that local people would decide how it was spent.

From:

http://www.telegraph.co.uk/David-Cameron-sets-out-20-policies-to-boost-NHS

NHS offers hospital to private bidders

An NHS district general hospital, complete with accident and emergency and maternity services, is being offered up for takeover by the private sector for the first time, alongside bids from other NHS organisations.

But the conditions being attached to the seven year franchise to run the 369 bed Hinchingbrooke Hospital in John Major’s former Huntingdon constituency are so stringent that analysts said there was not likely to be much private sector interest.

The offer comes as Andy Burnham, the health secretary, has stressed that while NHS organisations are the labour government’s “preferred provider” of NHS care, services can still be franchised or tendered where they have proved financially unsustainable.

Whoever wins the contract, however, the NHS will continue to own the assets, according to the East of England Strategic Health Authority, which is running the tender. Staff will remain on NHS terms and conditions and will not be transferred to the winning franchisee.

All current services will have to be retained. But the franchisee will have to take full demand and volume risk with no guarantees on future revenue. In addition, on a £92m turnover for the past year, the operator will be expected to help pay back at least some of the £38.9m of debt that the hospital has accumulated over the years and which it owes to the rest of the NHS.

The health authority says there is significant private sector interest in the deal, as well as interest from NHS foundation trusts and other health service organisations.

But the NHS Partners Network, which represents private providers of NHS care, said the offer “appears to lack commercial reality”.

Private providers have been told some of the conditions may be negotiable, said David Worskett, the network’s director. “But it doesn’t seem to give sufficient scope for doing things differently to make it an attractive proposition,” he added.

William Laing, of analysts Laing and Buisson, said the private provider that wins the contract is “being asked to take all of the risk while being denied the tools needed to make any real changes”.

The health authority said it was expected to take 18 months to conclude the deal.
 

From:

http://www.ft.com/cms/s/0/11981a30-c4b7-11de-8d54-00144feab49a.html

Health Direct asks- what is the point? A hospital has over run it's budget with no sign of financial balance in the near future. So some paperpusher in the DoH has come up with the bright idea of external funding. 

Great- except that they don't really want the hassle that will go with the spin. So wait 18 months until a change of govt with new masters. In the meantime, let's waste some poor business sod's time by looking at prospective red tape. 

Ergo 18 months time no new money, same old problem.

National swine flu vaccination to start this week

A national swine flu vaccination campaign will begin this week, with high risk patients and frontline health workers the first to receive a single dose jab, the Chief Medical Officer has announced.

Sir Liam Donaldson said that from today hospitals would start vaccinating priority patients, such as people receiving cancer treatment, with the first deliveries to GPs for other at-risk groups including those with chronic conditions and pregnant women from October 26.

Sir Liam said that while overall rates of infection were rising slowly, and at similar rate to recent weeks, he was more concerned at the proportion of people ending up in critical care. Of the 364 patients currently in hospital, 74 are in critical care – the highest total in the pandemic so far.

The death toll also rose at a sharper rate, with 10 recorded in the last week, taking the UK total past 100. 

There have been a total of 83 deaths in England, 4 in Wales, 4 in Northern Ireland and 15 in Scotland. The announcement came as it was confirmed that a 17-year old pregnant woman from the Borders had died after contracting swine flu in the last 24 hours – the second pregnancy fatality of the week.

Professor David Salisbury, the Department of Health’s head of immunisation, said that Pandemrix, the vaccine made by GlaxoSmithKline, would be used for the first roll-out. He dismissed suggestions that as an adjuvant vaccine it carried more risks for pregnant women, and said that the fact that it could offer immunity with a single dose - rather than the more lengthy time period required with the UK’s other supply, the two-dose Celvapan – made it far more preferable.

Sir Liam added that postal workers’ decision to stage a national strike was “extremely unwelcome piece of timing” which, though it would not impact on vaccine delivery, would disrupt GPs’ letters sent out to those being called up for vaccination.

“While the rates of infection are not increasing more quickly, I am concerned at the relatively high proportion of patients in hospital in a serious category,” he said, adding that there was a school of thought suggesting that while the virus had not changed, it might carry a greater impact now the country was entering its seasonal flu period. “I also remain concerned at the rates of child hospitalisation," he said.

On the topic of vaccinations for pregnant women, he added: “While the disease is mild for the majority of people including pregnant women, pregnant women are at higher risk of complications caused by flu. I know they wish to reduce risks to themselves and their unborn babies and therefore the sensible would be to have the vaccine. I do not want to see pregnant women dying from a preventable disease, and that is the bottom line.”

From:

http://www.timesonline.co.uk/tol/news/uk/health/Swine_flu/article6876657.ece

Labour closing maternity increasing, say Conservatives

Labour closes maternity services increasing, say Conservatives with nearly 50 per cent of hospital trusts having to close to maternity admissions at least once in 2008.

The Conservatives, who collated the figures from freedom of information requests, said they demonstrated Labour's "terrible record on maternity".

Fifty of 104 trusts that replied to the requests said they had closed to admissions or diverted women elsewhere at least once during the year.

In a similar survey of 83 trusts for 2007, 42 per cent said they had to close at least once.

In total, there were 553 closures in England in 2008, up 38 per cent from 402 in 2007, the Conservatives said.

Labour's record

Shadow health secretary Andrew Lansley said: "These figures are a telling reminder of Labour's terrible record on maternity.

"Every one of these figures tells an awful story of mothers being turned away from hospital at a hugely emotional time - when they are due to give birth. Labour seem to be deliberately running down maternity services in some hospitals as a precursor to shutting down maternity units altogether."

"The labour government must increase midwife numbers as they promised, make sure local maternity units get their fair share of NHS funding, and sort out their disastrous negotiation of EU rules on doctors' working hours."

In 2007, the government committed to improving the safety of maternity services, including by appointing 1,000 midwives by September and "up to 4,000" by 2012. Last January it said an additional £330m funding would go to primary care trusts for maternity over three years.

However, a large proportion of primary care trusts are not earmarking the money for maternity, meaning it may not reach services.

Stretched

Royal College of Midwives director for England Jacque Gerrard said: "Capacity within maternity units is being stretched to the limit and beyond, resulting in closures.

"The Department of Health, however, has set a target to recruit the equivalent of another 3,400 full time midwives by 2012, and it has started to increase the money going into maternity care.

"Some of this money, however, is not finding its way into the hands of the people at the front line to employ more midwives and improve maternity services.

"The Royal College of Midwives is urging people who run health services locally to be more proactive and use money earmarked for maternity services actually for maternity services, so that women are not being left worried and deeply disappointed."

Patient safety

A spokesman for the Department of Health said: "Sometimes units do have to temporarily shut their doors, usually for very short periods of time.

"We appreciate that it is distressing to be told that your care is going to be provided elsewhere but this is always undertaken in the interests of safety for the mother and baby.

From:
http://www.hsj.co.uk/news/2009/02/maternity_closures_increasing_say_conservatives

One in 20 midwife positions unfilled

One in 20 midwife positions in NHS hospitals are unfilled despite a labour Government promise to would recruit 1,000 more midwives.

The NHS may not be able to give women a single dedicated midwife during pregnancy and labour, as promised by ministers.

Figures show that 583 midwife posts in NHS hospitals are vacant and 276 maternity support worker jobs are unfilled.

Barking, Havering and Redbridge Hospitals NHS Trust has the higest vacancy rate, 39 per cent. If its 76 full time midwife positions, 29 posts need to be filled.

One in five maternity units (22 per cent) across the country have cut midwife numbers in the past year and some have reported that their maternity unit has been cut in half. Heart of England NHS Foundation Trust has 101 full time midwives last year but this year has 47 which is a 54 per cent drop.

The figures were obtained using the Freedom of Information Act by the Conservatives.

This week, Professor Cathy Warwick, general secretary of the Royal College of Midwives, said tens of millions of pounds that were meant to increase the number of midwives have not been received by hospitals.

"On the very busy labour wards that are struggling to cope with the rising birth rate, midwives are having to look after sometimes two or three women in labour and that's when the woman ends up being left alone. That's not only unacceptable, that's not safe," she said.

The failure to pass on the money, part of a drive to improve maternity services, means the NHS will not be able to honour promises by ministers to give women a single dedicated midwife during pregnancy and labour.

Alan Johnson, the health secretary, in February pledged £330m of extra funding over the next three years to implement the Maternity Matters strategy whose guarantees include giving women the choice of whether to give birth at home instead of at hospital. He also promised that he would recruit 1,000 more midwives to the NHS by 2009.

Health Minister Ann Keen said: "Claims that midwife numbers are falling are complete and utter nonsense.

"Validated figures from the latest NHS workforce census show the number of midwives has surpassed 25,000 for the first time and we know there is continuing growth towards recruiting an additional 1,000 midwives by September 2009, rising to 4,000 in 2012. There has also been a 25 % increase in the number of students entering midwifery training since 1997."

From:
One-in-20-midwife-positions-unfilled

NHS hospitals lose 32,000 beds in a decade

More than 30,000 hospital beds have been lost since Labour came to power, with record cuts in NHS wards last year- which Health Direct chronicled.

The cutbacks mean increasing numbers of hospitals are going on "black alert" – which involves closing their doors to new patients because they are full.

Patients' groups described the loss of the beds, at a time when overcrowded wards have seen soaring rates of killer infections, as "a national scandal".

The reduction contradicts a pledge from Tony Blair at the turn of the century that there would be 7,000 more NHS beds by 2010.

New figures, seen by The Telegraph, show that the number of health service beds fell more than 8,000 last year, as the NHS began a reorganisation process which will mean the closure of dozens of hospitals.

More than 40 per cent of maternity units turned away women in labour last year because they had no room.

Meanwhile, ambulances have been forced to queue outside overstretched hospitals, treating patients in car parks just yards from accident and emergency departments. The new statistics, revealed in response to a parliamentary question by Ed Vaizey, the Conservative MP, show that almost 32,000 NHS hospital beds went between 1997, when Labour took office, and 2007.

More than 8,400 beds were cut in the year ending March 2007, the largest fall in 14 years. One in six beds has been closed over the decade. There are now 167,019 beds in NHS wards, compared with 198,848 in 1997.

The figures emerged as health authorities are drawing up plans which will see the likely closure of dozens of district general hospitals. The East of England health authority has admitted that two accident and emergency departments and a maternity unit could close.

Andrew Lansley, the shadow health secretary, said the labour Government's financial mismanagement had forced hospitals to make cuts which could risk lives. "These bed cuts were financially driven: the sharp rise in the numbers closed happened at a time when the health service was under desperate pressure to clear a massive deficit."

Katherine Murphy, from the Patients' Association, said: "This is a national scandal. More than 30,000 beds have been lost at a time when demand is increasing."

In the same decade that the beds were cut, death rates from the infections MRSA and Clostridium difficile rose five-fold. Investigations into the biggest C. diff outbreak in Britain, which killed 90 patients at hospitals run by Maidstone and Tunbridge Wells trust in 2005 and 2006, found that overcrowding amid pressure to meet hospital waiting targets was a factor behind the infection's spread.

More than 2,000 maternity beds have been lost since 1997. Research by the Conservatives found that last year, 42 per cent of maternity units had refused to accept women in labour on at least one occasion.

Sue MacDonald, from the Royal College of Midwives, said: "We feel the cuts have gone too far."

Norman Lamb, the Liberal Democrat health spokesman, met officials recently after pressures on his local hospital, the Norfolk and Norwich, forced it to declare an emergency "black alert," closing to new admissions, with 10 ambulances "stacked" outside, treating patients.

From:
NHS-hospitals-lose-32%2C000-beds-in-a-decade.html

Two in five trusts turn away women in labour

Women in labour were turned away by 42 per cent of trusts last year, figures obtained under the Freedom of Information Act show as labour's maternity promises look stillborn.

The figures, obtained by the Conservatives, show that one in 10 trusts closed their doors to women giving birth more than 10 times in the last year. Larger maternity units were the most likely to close.

Of the trusts that closed, 26 per cent had less than 3,000 births last year, the minimum for an "efficient" service, according to the government.

42% of NHS Trusts providing maternity services had to turn away women in labour last year because they were full.

New statistics reveal that nearly one in ten Trusts had to close more than ten times, with the Scarborough and North East Yorkshire Trust shutting its doors 39 times in 2007 alone.

Andrew Lansley said the figures showed maternity services are already "overstretched", making a mockery of Labour's plans to close maternity units.

The Shadow Health Secretary attacked Labour's plans to cut smaller, local maternity services and concentrate them in big units:

"Women don't want to have to travel miles to give birth. And they certainly don't want to have to travel even further because they're turned away by the hospital of their choice."

http://www.conservatives.com/tile.do?def=news.story.page&obj_id=143112

NHS is paying for immigrant baby boom

The NHS is spending £350m a year to provide maternity services for foreign-born mothers, £200m more than a decade ago, the BBC and Health Direct has found.

Immigration has raised the birth rate so fast that some units have closed, so that midwives could be moved to areas of urgent need. A unit in Ascot, Berkshire, shut for two months in 2007 because staff had to be transferred to Slough.

The NHS says it is working to "build in" the extra capacity needed.

Maternity units have turned expectant mothers away because they could not cope with unprecedented increases in the local birth rate.

When Labour came to power, the NHS spent around £1bn a year on maternity services, with one baby in eight delivered to a foreign-born mother.

Ten years on, spending has risen to £1.6bn, with almost one baby in four delivered to a mother born overseas.

While the number of babies born to British mothers has fallen by 44,000 a year since the mid-1990s, the figure for babies born to foreign mothers has risen by 64,000 - a 77% increase which has pushed the overall birth-rate to its highest level for 26 years.

In central London, where six out of every 10 babies born has a foreign-born mother, senior consultants and health managers blame the lack of resources to deal with the pressures of migration for unacceptably poor standards.

Professor Philip Steer, editor of the British Journal of Obstetrics and Gynaecology, said: "The Department of Health has been taken by surprise. The demographic change, the sheer numbers, has in some areas increased very substantially without there being any forward planning really to allow for that."

According to figures from the Office for National Statistics, in 2006 there were 15,000 more Eastern European babies born here than a decade earlier.

The statistics go on to show that 11,000 more babies were born to a mother from the Indian sub-continent, while 8,000 extra babies had mothers born in Africa.

Heatherwood Hospital in Ascot closed its maternity unit for two months in the summer of 2007 because of an "unprecedented increase" in the local birth rate.

Midwives were moved to Wexham Park Hospital, closer to the pressure-point of Slough where in the last year staff have witnessed an extra 150 babies delivered to foreign-born mothers.

The knock-on effect was experienced in nearby Reading where the local maternity unit could not cope with the extra demand.

Tharlie Cooper was supposed to have been born in Reading, but when mother Lavina went into labour two weeks overdue she was told that, despite her being booked in, her local birthing unit was full.

Tharlie's father Dean was furious. "Basically we got turned away and the reply I got on the phone was wherever you ended up is where you end up", he said.

He drove his wife to Basingstoke in neighbouring Hampshire where doctors conducted an emergency caesarean.

LIVE BIRTHS BY COUNTRY OF BIRTH OF MOTHER
Births by British-born mothers down 44,000
Births by all foreign-born mothers up 64,000
Births by mothers born in Eastern Europe up 15,000
Births by mothers born in Indian subcontinent up 11,000
Births by mothers born in Africa up 8,000
Source: ONS/BBC

Peterborough has seen a huge increase in births from Eastern Europeans. There were just three such babies in 2000, but almost 200 in 2006.

At the Thistlemoor Medical Centre, births among patients have increased 33% in just two years. GP Nalini Modha fears the authorities have not planned for the new arrivals.

"Hopefully somebody who is in authority is actually looking at the figures to try and work out how they're going to cope with the influx" she said.

"If you're going to provide responsible care for all the population - the indigenous as well as the newcomers - then we will have to stop and think about what we can and can't afford."

In parts of Greater London, seven out of 10 babies are now delivered to mothers born overseas.

The Strategic Health Authority argues that this partly explains why maternity services in the capital performed so poorly in last week's Healthcare Commission report.

Births within migrant groups can often be more difficult, more dangerous and more expensive - with much higher rates of type 2 diabetes, tuberculosis and HIV among mothers who often turn up very late in their pregnancy.

London's chief nurse, Trish Morris-Thompson, admitted that the NHS had not realised how immigration would affect maternity services.

"The timing of the impact is much quicker than we had anticipated", she said. "We're working with our commissioners and our maternity providers now to ensure that we're building in the capacity they need."

From:
http://news.bbc.co.uk/1/hi/health/7215624.stm

Labour units failing to meet maternity guidelines

More than four in ten maternity units in England offer poor or below average care, a report by the healthcare watchdog concludes today.

A similar proportion of hospitals fail to carry out proper ultrasound scans to check for problems affecting developing babies in the womb, the Healthcare Commission said.

Official guidelines recommend that at least 11 checks should take place, including studying the baby’s heart function, length of spine and the development of its face and lips.Yet the report found that only 61 per cent of scans performed by NHS trusts include all such checks recommended by the National Institute for Health and Clinical Excellence (NICE).

In addition, only 11 per cent of trusts were meeting screening standards for Down’s syndrome, which were updated by NICE in April 2007. The remaining women could be receiving insufficient information about the health of their child before birth, the Commission said, potentially putting themselves and their babies at risk.

Critics said that mothers and babies were not getting the high quality care they deserve.

The study found that 63 out of 148 (42 per cent) trusts with full maternity services in England were performing poorly or fairly. Poor performance and regional variations in care are largely linked to staffing shortages, the watchdog suggests.

The commission ranked 21 per cent of trusts as “least well performing”, 22 per cent “fair performing”, 26 per cent “best performing” and 32 per cent “better performing”. A survey of more than 26,000 mothers was included as well as data from NHS trusts. The Commission gave warning that some trusts had been unable to supply full information.

Norman Lamb, the Liberal Democrat health spokesman, said: “It is simply unacceptable that one in five maternity units is putting mothers and babies at risk.”

Dame Karlene Davis, of the Royal College of Midwives (RCM), said that Britain remained among the safest countries in the world in which to give birth.

Findings
48% of the trusts performed poorly or fairly
1 in 3 women did not have a named midwife
10,000 midwives needed to improve quality of care
Source: Healthcare Commission

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article3248136.ece

Cameron promises a bare knuckle fight to save NHS District Hospital services

David Cameron the Conservative leader, attempted to regain the political initiative today by promising a "bare knuckle fight" with the Government to save local NHS hospitals from closure.

Amid speculation that Gordon Brown is planning an early election, Mr Cameron sought to reassert his centre-ground credentials by claiming that labour Ministers are attempting to close district hospitals.

"The basic point here is we believe the district general hospital is an absolutely key part of the NHS," the Tory leader said.

"People have put money into the NHS, they’ve paid increased taxes and they want to see their district general hospital improve. People simply do not understand why maternity units and accident and emergency units are being shut down when actually accident and emergency admissions are up and births are up."

He added: "The labour government’s new health minister, Sir Ara Darzi, has said ’the days of the district general hospital are over’.

"That’s why I say the Government can expect a bare knuckle fight with us over the next few weeks and months about saving district general hospitals as a key part of the local NHS."

Mr Cameron made his remarks ahead of a trip to Sussex this afternoon where he was due to visit a hospital.

"What people will see in the run-up to the next election is that all the problems the country faces today - whether it’s NHS closures, family and social breakdown, whether it’s a weak pension system, whether it’s the stealth taxes they are having to pay that are making the cost of living so hard to meet - they can trace all of those decisions back to Gordon Brown sitting at a desk in Number 11 Downing Street as Chancellor," he said.

Speaking later, a Department of Health spokesman said that the Tory leader had quoted Lord Darzi out of context.

From:
http://www.timesonline.co.uk/tol/news/politics/article2294162.ece

Trust to shut award-winning maternity unit despite pledge

An NHS foundation trust is planning to close an award-winning midwife-led maternity unit despite the government last week promising every woman the option of such a delivery. Heavily pregnant women in north Derbyshire will have to travel up to 21 miles on country roads because of plans to close the Darley Dale unit and cut community midwife numbers from 50 to 33.

Last week, after the health secretary said every mother would have the choice of home, hospital or midwife-led birth by 2009, the Guardian revealed that six out of nine English regions do not employ enough midwives to meet the most basic standards of care. The east Midlands already has the second-worst provision of midwives in the country, according to Guardian figures.

Chesterfield Royal Hospital NHS Trust says each birth at the eight-bed unit costs £3,217 compared with the £1,000 allocated by the government, meaning it loses £312,000 each year. The inefficiency comes because only 120 babies are born at the unit annually compared with 2,700 at the hospital, yet it has to be staffed by two midwives around the clock.

Campaigners dispute the figures and say the trust should promote the unit to make it viable. They argue the closure means women will give birth as they race to hospital. Sam Kay, a member of Moms (Maintain Our Maternity Services), said: "There are going to be babies born in ambulances and in the backs of cars ... women already give birth at Darley without planning to because they know they won't make it to the hospital in time."

Kate Carlton-Reditt, Moms coordinator and a mother of three, said the reduction in midwives to 33 for the whole of north Derbyshire would rule out home births, which require two midwives, and force women into hospital.

The public consultation, due to end on April 20, has flouted the Cabinet Office code by not involving campaigners before publishing proposals and asking closed questions with no option for the unit to remain open. Challenged on this, the trust's corporate secretary, Terry Alty, said: "We followed the code. We haven't specifically complied with it." The trust faces a judicial review and a freedom of information appeal over the process.

The trust's head of communications, Sarah Turner-Saint, said the trust needed to save £13.8m over three years. "We're making a loss on each birth at Darley and we can't afford to provide this service."

From:
http://www.guardian.co.uk/uk_news/story/0,,2054159,00.html

Health Direct applauds Sarah Turner-Saint The trust's head of communications for her candour and honesty. From the horse's mouth we have proof that patients are being directly effected by labour's costs cuts- which are nothing to do with increasing patient choice or improving NHS services, just cutting services to satisfy labour's NHS underfunding.

Labour's social engineering that is it's midwifery policy was highlighted on January 10, 2007 in
Maternity cash cut amid boom in birthrate, say midwives

The NHS is responding to a boom in the birthrate by cutting spending on maternity services, the Royal College of Midwives said after a survey of more than 100 heads of midwifery in hospital trusts across Britain. It found that two thirds of maternity units were understaffed and most were trying to save money by employing fewer qualified midwives and taking on maternity support workers instead.

The survey produced a "depressing picture" of cuts, job freezes, shortages and financial crises.

More than one in five heads of midwifery reported a cut in the number of midwives at their trust. Hospitals were also cutting budgets for the training and development of midwives, in some cases by 75% or even 100%. A few units have become totally dependent on charitable donations to fund midwifery training, the RCM added.

Ms Silverton said: "This is irrefutable proof that midwives are under enormous pressure and nothing is being done to alleviate the situation. Unless midwifery services are expanded there is no hope of the labour government's manifesto commitments being achieved."

Mothers are turned away due to midwife shortage

A dire shortage of midwives is forcing maternity units to turn away expectant mothers, a survey has found. Figures show that centres across England closed temporarily for a total of 170 days last year, during which time women would have had to go elsewhere for help.The survey, collated by the controversial research organisation Dr Foster, found that 24 of the 39 maternity units forced to close had to do so for periods of 24 hours or more.

In some regions fewer than two thirds of units were able to offer one-to-one care, in which a woman is looked after by one midwife throughout pregnancy, the report claims.

There are fears that the situation could worsen further still after the Government last week outlined plans for maternity services that could see dozens of units shut down permanently and pregnant women forced to travel further to give birth.

Louise Silverton, the deputy general secretary of the Royal College of Midwives, said: "We have 25,000 midwives in the UK but 55 per cent of them work part time. We estimate that we need 10,000 more.

"As well as a rising birth rate, the Government is asking us to do much more, such as assess women for domestic violence. Yet instead of increasing numbers, we are finding that trusts are freezing posts, so newly qualified midwives can't get jobs."

A Department of Health spokesman said: "There are various factors that influence the decision to close a maternity unit for a period of time, including staff and bed availability and the number of women and complexity of care needed.

The minister in charge of maternity care sparked controversy last week when he failed to turn up at the launch of the review of the service. Ivan Lewis, who had already been accused of hypocrisy for campaigning against health cuts in his Bury constituency, said he had to attend another event in his role as minister for older people.

He denied that he should resign from the Government because he opposed plans to cut maternity services in his own constituency.

The Conservatives, who have claimed that 43 maternity units had closed or were under threat, said they had not seen any clinical evidence of the need to change the service.

Andrew Lansley, the shadow health secretary, said: "Government nationally seems to be saying that everything has to change, while locally Labour ministers say they don't believe it and it's not justified. There's a hypocrisy in that."

From:
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/02/12/nbirth12.xml

The dire circumstances that faces the midwifery profession was highlighted by Health Direct on
Jan 10, 2007 when the RCM warned that Maternity cash is cut amid boom in the birthrate, say midwives.

The NHS is responding to a boom in the birthrate by cutting spending on maternity services, the Royal College of Midwives said after a survey of more than 100 heads of midwifery in hospital trusts across Britain. It found that two thirds of maternity units were understaffed and most were trying to save money by employing fewer qualified midwives and taking on maternity support workers instead.

Louise Silverton, the college's deputy general secretary, said: "This is terrible news for a labour government that in its election manifesto pledged every woman would have a named individual midwife to care for her by 2009. The midwifery shortage is getting worse rather than better at a time when we are experiencing a significant increase in the number of births."

The survey produced a "depressing picture" of cuts, job freezes, shortages and financial crises.

More than one in five heads of midwifery reported a cut in the number of midwives at their trust. Hospitals were also cutting budgets for the training and development of midwives, in some cases by 75% or even 100%. A few units have become totally dependent on charitable donations to fund midwifery training, the RCM added.

The survey found that midwifery units recruited an average of 6.3 newly qualified midwives last year, compared with 6.8 in 2005. The average unit had 21 maternity support workers last year, compared with 19 in 2005.

Ms Silverton said: "This is irrefutable proof that midwives are under enormous pressure and nothing is being done to alleviate the situation. Unless midwifery services are expanded there is no hope of the labour government's manifesto commitments being achieved."