New mothers are left frightened and alone after childbirth, because midwives do not have time to care for them, a major study has warned.
The report by the National Childbirth Trust (NCT) says staff shortages have left increasing numbers of mothers feeling isolated at a time when they are desperate for reassurance.

The charity’s poll of more than 1,200 first time mothers found 59 per cent did not get the “emotional support” they felt they needed after giving birth – compared with 51 per cent in a similar survey a decade ago.

Women who had undergone a caesarean section were the least happy about their experience.

Asked about the 24 hours following birth, 66 per cent said they had not received enough support, compared to 57 per cent of those who had a natural labour in hospital, and 24 per cent of those who gave birth at home.

Mothers who had gone through traumatic labours said they had been left to cry themselves to sleep, while others said overstretched midwives had no time to offer a kind word of reassurance.

In total, 42 per cent said there were not enough midwives to care for them, compared with 33 per cent, when the question was posed in 2000.

Those who gave birth at home, or in a midwife-led birth centre, were less likely to describe shortages of midwives.

The NCT findings show that despite a large investment in maternity services, and pledges from the last Government to make care “woman-centred” with a choice of where to give birth, many women are being denied even basic care.

Among the poll of 1260 first time mothers, 44 per cent said they did not even get the physical help they needed, while 55 per cent said they did not get enough information or advice in the weeks after having their first child.

Anne Fox, the head of campaigns and public policy for the NCT, said; “It’s clear postnatal care urgently needs improvement – our report paints a dreadful, shocking picture of care in the UK – we’re letting women and their babies down.

“Many of the problems these women highlight seem to be due to staff shortages or lack of visits once they had left hospital – and this issue needs to be addressed if the quality of postnatal care is to be improved, particularly for vulnerable women.

In the report, new mothers describe being “absolutely terrified” and alone during their first night in hospital, frightened to ask for help from staff who responded to them rudely.

One mother said: “As soon as the baby was born, I felt I was on my own. I spent the first night after the birth of my son in floods of tears and unable to sleep as every time I closed my eyes the nightmare of my birth experience came flooding back.

“Nobody came to check on me to see if I was OK, even though I know I was sobbing loudly and uncontrollably.”

Louise Silverton, Deputy General Secretary of the Royal College of Midwives, described the report’s findings as “disappointing,” but said the study sent a compelling message to those in charge of NHS budgets, about the need to keep investing in maternity services.

From: http://www.telegraph.co.uk/Midwives-have-no-time-to-care-for-new-mums-report-warns

A political row has erupted after Andrew Lansley the health secretary was accused of making “a significant U-turn” over plans to scrap NHS Direct, in the face of widespread public anger.
Andrew Lansley said that NHS Direct would remain but that its telephone number would be replaced so that from 2013 people could call 111 for non-emergencies and 999 for emergencies.

“I have not announced plans to scrap NHS Direct. I have announced plans to phase out the NHS Direct number,” the health secretary said in a letter.

This appears to contradict statements from the Department of Health last month, including to the BBC, that said the service would be scrapped. The new 111 helpline is already being piloted in the north-east of England.

However, there are concerns that fewer medical staff will be employed by the new service. NHS Direct employs 3,400 people, 40% of whom are trained nurses. It was reported that the ratio for the new helpline would be lower.

The threat to the telephone service, which costs £123m a year to run, provoked an immediate backlash. In the fortnight since the story broke, more than 16,000 people have signed a petition to save NHS Direct, which provides general health advice and information about out-of-hours GPs, walk-in centres, emergency dentists and 24-hour chemists.

Lord Prescott, the former deputy prime minister, played an active role in the campaign – including changing his Twitter picture to a “Save NHS Direct” badge.

Significantly, the Royal College of Nursing said it would be “shortsighted” of ministers to axe a service that had saved the NHS more than £200 million by dispensing advice over the phone.

Labour attacked Lansley for a “significant U-turn” that had seen the health secretary “rowing back” from previous statements. “It’s an incredible victory for the campaign to save NHS Direct,” said Andy Burnham, Labour’s leadership contender and spokesman for health.

A series of letters between Lansley and Burnham, the previous health secretary, reveals a combative exchange. Burnham accused his Tory counterpart of “misrepresenting his position” as Lansley claimed that the 111 number was Labour’s idea and he was “getting on with what you failed to do”.

In a statement the health secretary said: “This is the latest political stunt from [Burnham]. He seems more concerned with trying to boost his leadership campaign than discussing our policies accurately.”

Unions warned that the future of medical staffing levels in the new service would remain an issue. Dave Prentis, general secretary of Unison, said: “Staff will still be confused and worried the government may have another change of heart. I would like a guarantee from the health minister that the 1,300 nurses working for NHS Direct will still have a job there this time next year.”

Despite its popularity, the medical establishment has been divided over the benefits of phone line. Earlier this summer British Medical Association chairman Dr Laurence Buckman said that getting rid of NHS Direct could be one way of cutting back on spending — adding that the “expensive” phoneline delayed healthcare reaching patients.

From: http://www.guardian.co.uk/nhs-direct-closure-Andrew Lansley backtracks

Ministers are considering ‘privatising’ an NHS agency that provides 50,000 nurses and other workers to the health service.
An advert has been placed for private sector investment in NHS Professionals, a company owned by the Department of Health, which provides bank staff to fill shifts in the health service.

Unions criticised the plan saying it was privatisation and that NHS Professionals was set up to stop the NHS being ripped off by private agencies charging large sums for staff to work unfilled shifts.

NHS Professionals has 50,000 staff on its books who cover around two million shifts in 77 organisations around England.

Karen Jennings, head of health at Unison, said: “The whole reason that NHS Professionals was set up, was because private agencies were ripping off hospitals by charging them outrageous fees for recruiting or finding staff for shifts. It makes no sense at all to bring back private companies who will want their slice of the action in return.

“This proposal is purely about Tory plans to promote privatisation and hive off parts of the NHS to private companies, regardless of the consequences on patient care.”

A Department of Health spokesman said: “This is about exploring ways that the commercial skills of the independent sector can make NHS Professionals Ltd a more efficient business and save the NHS money.

“NHS Professionals Ltd is a business, not a public service, and like any business it must ensure its services are as efficient and effective as possible. We want to discuss options with potential independent sector investors that could help to achieve this, and ultimately improve services outcomes for patients.”

It comes as the Royal Berkshire Hospital Trust announced up to 600 jobs will be cut to make £60 million worth of savings in the next few years, pledging that frontline staff would not be affected.

The Royal College of Nursing said last month that thousands of NHS jobs were being cut despite Government promises to protect frontline services.

The nurses’ group said it was aware of almost 10,000 posts lost through recruitment freezes, redundancies and people not replaced when they retired, or which face cuts in the future.

From http://www.telegraph.co.uk/Ministers-accused-of-privatising-NHS-nursing-agency

The Department of Health has spent almost £500 million on management consultants, including deals with firms which have hired senior Labour figures and high ranking civil servants.The disclosure of more than 100 contracts worth a total of £470 million last night engulfed the labour Government in accusations of “cronyism”.

Among those recruited by the favoured firms are a former health minister, an ex-adviser to the health secretary and a senior Whitehall official responsible for encouraging private sector involvement in the NHS.

Doctors’ and nurses’ leaders expressed concern over the use of resources which could have paid for more than 60,000 hip operations, or the annual salary of 22,000 nurses.

Critics also said the revelations indicated that the “revolving door” between the labour Government and its favourite consultant firms was spinning ever more quickly, with former senior politicians, officials and advisers linked to companies profiting directly from the policies they had introduced.

Lord Warner, a Labour peer, who was a health minister until December 2006, now acts as an adviser to PA Consulting group, which received £4.9 million from the Department of Health (DoH) in 2007/8.

Until last December he also advised Deloitte, which received almost £3 million in the same year.

Since resigning as a minister in 2006, the peer has also registered interests working for six other health care, technology and IT firms.

Matthew Swindells, policy adviser to then health secretary Patricia Hewitt between 2005 and 2007, who was earning £195,000 at the DoH, is now group managing director for health at Tribal, which earned more than £2 million from the department in 2007/8.

KPMG, the finance firm, secured £4.9 million in the same year. Last month the firm announced the appointment of Mark Britnell, currently on gardening leave from his £235,000 role as DoH director general for commissioning.

The civil servant was responsible for a policy to encourage more private sector involvement in the health service. He drew up plans which allowed a shortlist of firms – including KMPG – preferential access to lucrative NHS contracts.

Under rules intended to reduce conflicts of interests, Mr Britnell has been told that he cannot lobby the Government for his first nine months in his new job.

Other figures to have crossed from Government to private sector firms which won the management consultancy contracts include Sir Michael Barber, who was Tony Blair’s chief adviser on delivery – focusing on education and health – from 2001 to 2005.

Since September 2005 Sir Michael has been a partner at McKinsey, which was paid £9 million for management consultancy services to the DoH in 2007/8.

Lord Birt, the former BBC director general, was Tony Blair’s strategy adviser from 2000 to 2005. In 2006 he was appointed as an adviser to Capgemini UK, the British arm of the global outsourcing giant.

The DoH figures show that Capgemini UK was paid £3.2 million in 2007/8 for management consultancy to the DoH and the agency running the NHS IT programme.

Information released under the Freedom of Information Act discloses for the first time the details of 111 management consultancy contracts held by the DoH and two of its central agencies.

In total, the DoH, its IT programme Connecting for Health and the NHS Purchasing and Supplies Agency spent £470 million on management consultants in the three years from 2005/6 to 2007/8.

It came after the department had made hundreds of its own staff redundant via an “efficiency programme” intended to save money.

The spending came in addition to an estimated £350 million spent annually on consultants by 150 primary care trusts. Research has shown consultants in the NHS earning up to £2,000 a day for project work.

Matthew Sinclair, from the TaxPayers’ Alliance, said: “It is particularly alarming that many of these management consultants are political cronies or have only recently finished working for the Department of Health.”

Dr Mark Porter, deputy chairman of the BMA’s consultants committee, said: “These consultants aren’t just taking money from the front line, they are often drawing up policies which in themselves damage patient care.”

Dr Peter Carter, general secretary of the Royal College of Nursing, said: “We are unable to find any evidence about whether this represents good value.”

Andrew Lansley, the health secretary, said: “This lays bare the hypocrisy of Labour’s claims to have cut back on Government administration costs.”

PA Consulting group said Lord Warner’s advisory work for them did not relate to any contracts held with the DoH. Deloitte said the peer’s role as a strategic adviser ran from March to December last year.

Lord Warner said he only began advising PA Consulting in Autumn 2008, and was no longer advising four of the eight companies he has worked for since stepping down as a minister.

He added: “Provided people leave a decent period after they are in office before they take up such posts – which I did – provided they clear it with the Advisory Committee on Business Appointments, which I did, and provided they register the interest in a public document – which again I did, I don’t think it is right to stop people who were involved in Government forever from working elsewhere. I would defend to the death the right to have a free flow of labour.”

From: http://www.telegraph.co.uk/Millions-spent-on-NHS-management-consultants-with-Labour-links

The NHS is suffering potentially devastating cuts to jobs and patient services as the Government’s austerity drive hits the health service, doctors’ leaders have warned.Thousands of doctors and nurses face being made redundant or not replaced if they leave, while many hospitals have cut treatments, the British Medical Association has found.

Despite ministers’ assurances that the health service would not face the same cuts as other departments, many hospitals are feeling the strain, according to the BMA.

Andrew Lansley, the Health Secretary, has boasted that frontline services would be protected. But it emerged yesterday that in his Cambridge constituency, Addenbrooke’s Hospital is planning to sack 170 nurses and up to 500 staff in total over the next year.

A survey for the BMA asked 361 doctors, who between them represent committees at all of Britain’s hospital trusts and some larger primary care trusts, how the NHS was being affected by the demand to make £20billion of cuts.

It comes as the Coalition faces political pressure to reverse its pledge to ring-fence health spending.

The BMA found that 43 per cent of those who responded said there was a freeze on recruiting doctors and nurses at their trust. Almost as many, 40 per cent, said that patient treatments, including varicose vein operations and blood tests, were being rationed.

GPs in Bedfordshire said they had been told not to refer patients with certain conditions, such as skin lesions and cysts, to hospitals except in exceptional circumstances.

Nearly a quarter of those who responded said that their trust was planning to make workers redundant. Although the majority of these would not affect frontline staff, the union warned that cuts to administrative workers could force doctors and nurses to spend more time on these duties and less time with patients.

The poll – to which 92 doctors responded – represents the first real evidence of how the NHS has been hit by the cuts. It found trusts were trying to make annual savings of six per cent on average. The Government has promised to guarantee NHS spending growth in real terms but the BMA says this will be “minimal”. The association called the cuts potentially “devastating”.

Dr Hamish Meldrum, the chairman of the BMA, said: “Whilst we accept that difficult decisions need to be taken in this tight financial climate, there is a real danger that cutting back on health now will have a long-lasting impact on our ability to maintain high-quality, comprehensive and universal care in the future.”

The warning came as senior Tories broke ranks to object to plans to protect health service funding.

Lord Lawson, the former Chancellor, and Nadine Dorries, a Tory member of the Commons health select committee, said that health funding should not be ring-fenced.

Ms Dorries told the BBC’s Politics Show: “I think we need to find the political courage to accept that there is excessive waste in the NHS and that it’s unfair to expect other departments to take all the hits.”

The Royal College of Nursing said earlier this year that about 5,600 jobs were under threat across 26 hospital trusts. In a “worst case scenario”, the true figure could be as high as 30,000, it said.

A spokesman for the Department of Health said: “Alongside all the public services, the NHS will need to deliver significant savings over the coming years.

“The department is very clear that savings should be implemented in a way that does not affect the quality of services and the Secretary of State has been very clear that every penny saved will be reinvested back into patient care.”

From: http://www.telegraph.co.uk/NHS-suffering-devastating-cuts-to-jobs-and-services-warns-BMA

Heroin should be routinely prescribed on the NHS as a way of weaning drug users off their addiction, the head of the country’s top nursing union has said.

Peter Carter, the general secretary of the Royal College of Nursing (RCN), also said he was in favour of “drug consumption rooms” to enable addicts to take drugs safely under medical supervision, and to cut rates of drug-related crime.Nurses gathering at the RCN’s annual congress in Bournemouth had earlier discussed providing heroin to addicts where other attempts at treatment have failed.

Results of pilot studies in London, Brighton and Darlington suggest that allowing users to inject themselves with the Class A drug under medical supervision can cut local crime rates by two thirds over six months.

Aberdeen has been considered as a potential future pilot location in Scotland.

But some experts are concerned at the prospect of providing legitimate “shooting galleries” in publically-funded clinics, despite the increasing use of methadone, the heroin-subsitute, and a lack of abstinence-based programmes.

Amid controversy over how to treat chronic drug users, members of the RCN, the country’s largest nursing union, discussed the possibility of providing heroin on the NHS today but did not hold a vote for or against the move.

Speaking in a personal capacity after the debate, Dr Carter, the former head of Central and North West London Mental Health NHS Trust, said that he believed in providing drugs, needle exchanges and locations for users to inject substances safely.

“The fact is heroin is very addictive,” he said. “People who are addicted so often resort to crime, to steal to buy the heroin. It obviates the need for them to steal.

“It might take a few years but I think people will understand that if you are going to get people off heroin then in the initial stages we have to have proper heroin prescribing services.” Dr Carter added that more research was needed into consumption rooms, which have been tested in Sydney and Amsterdam.

Experts found the programme stopped users injecting in school playgrounds and stairwells.

“Critics say you are encouraging drug addiction but the reality is that these people are addicts and they are going to do it anyway,” he added.

Radical proposals for the most chronic drug users were first advocated in 2002 by the then Home Secretary David Blunkett. The gave rise to pilot programmes in England in which users inject themselves with pharmaceutical diamorphine imported from Switzerland, under medical supervision.

From:
http://www.timesonline.co.uk/tol/news/uk/health/article7108342.ece

A survey by the RCN found thousands of jobs were already earmarked for cuts in an attempt to slash costs.

Health trusts are planning to cut thousands of staff “by stealth” to deliver £20bn of “NHS efficiencies”, according to a survey by the Royal College of Nursing. Labour reacted by promising that there would be more jobs in the health service at the end of the next Brown administration if it wins the election.

The move comes as Gordon Brown addresses the RCN’s four-day annual conference today. More than 4,000 nurses have gathered in Bournemouth for the event, which is expected to be dominated by NHS finances.

The nurses’ union has been riled by a warning from Sir David Nicholson, the chief executive of the health service, that up to £20bn of savings will have to be found by 2014.

A survey by the RCN of 26 of the 168 English health trusts revealed that 5,600 jobs were already earmarked for cuts in an attempt to slash costs. That figure could rise to more than 36,000 in a “worst-case scenario” if the trend was replicated across all hospital trusts, said Howard Catton, head of policy at the Royal College of Nursing. The loss of posts – including redundancies and staff not being replaced if they leave or retire – could happen over the next three years, he added.

In an online survey of 287 nurses earlier this month, the RCN said hospital wards were already operating with an average of 13% fewer staff than officially needed. Nine out 10 nurses said that patient care was being compromised by short staffing.

There is little doubt that the nurses’ union, which has 400,000 members, has political clout. Last year Brown became the first prime minister to speak at the conference in its 93-year history – to a warm reception by delegates.

Although health has not been a major focus of this election campaign, the issue of NHS job cuts is an explosive one for Labour. In 2006 the then health secretary Patricia Hewitt was jeered and slow-hand-clapped by nurses as she tried to address their fears about NHS deficits.

Andrew Burnham, the health secretary, told the Guardian that savings would come from wage restraint, cutting management costs by a third, and asking “some nurses and doctors to take on different roles in different locations outside of hospitals”.

“It is unlikely that we would need fewer people in five years in the health service. Labour will ensure sufficient funding to frontline NHS services so that they do not need to make any compulsory clinical redundancies and we will ask the NHS to co-operate across organisational boundaries and work towards ensuring this basic guarantee,” he went on. “Cutting doctors, nurses and frontline staff would be costly, counterproductive and would risk a return to the kind of NHS we saw under the Tories.”

The problem for Labour is that decisions on savings are being made at a local level. The RCN points out that managers at some trusts are already openly equating efficiency savings with job cuts.

In an open letter to staff, the chief executive at Salford Royal, a foundation hospital, said: “We are about to enter a financial crisis that could ruin all that we have achieved … this means reducing costs by about £16m a year [and] providing safe standards of service with about 250 fewer people for each of the next three years.”

The market reforms that Labour implemented have made it possible for hospitals to identify savings easily. Dorset county hospital, which made 28 posts redundant in March, admitted that its strategy to “attract more patients” with 300 new staff had failed, leaving a putative black hole of £11m in next year’s budget. The hospital issued a blunt press release: “These extra patients never came and so we are left with rising costs but without the income to cover them.” .

The Conservatives say that their promise to outspend Labour on the NHS insulates them against the charge that the health service is not “safe in their hands”. They say that thousands of NHS medics will lose their jobs over the next five years under Labour’s “secret” cost-cutting plans, which would see 651 fewer doctors and 2,050 fewer nurses across England.

Disclosures made under the Freedom of Information Act at the request of the Tories show half of NHS trusts that responded were planning reductions in the numbers of full-time equivalent doctors and nurses.

The shadow health secretary, Andrew Lansley, said: “We will back the NHS. Conservatives will increase funding for the NHS each year in real terms. So instead of Labour’s cuts to doctors and nurses, we will support the recruitment of staff we need, like specialist nurses, midwives and health visitors.”

From: http://www.guardian.co.uk/politics/2010/apr/26/health-trusts-planning-job-cuts