Category Archives: Your Views

No one puts booby in a corner, Nigel.

Maternity campaigner Jessica Ormerod responds to the UKIP leader’s statement that breastfeeding mothers ought to ‘sit in a corner’.

(Pictured above is Nigel Farage attempting to eat a bacon sandwich – a sight that is infinitely more troublesome than any mother breastfeeding their child.)

When did breastfeeding become such a sensitive issue? It’s not just Nigel Farage who gets a bit hot under the collar at the thought of a bare bosom let alone the thought of a naked nipple. I’m actually quite surprised by the UKIP leader’s prudism when he said that ‘mothers should sit in the corner when they breastfeed’ except that it fits in with a general societal assumption that breastfeeding is only acceptable if it’s not seen and definitely not heard.

And yet, around the globe, breastfeeding is the most common and the most healthy way for mothers to feed their offspring. It’s free at the point of delivery, clean at source and accessible any time, any where, any how. So what on earth is the problem?

Women are instructed by midwives, nurses, doctors, the NCT, that breast is best. FULL STOP. Failure to breastfeed your baby will result in your little bundle not achieving maximum intelligence, reduced emotional development, impaired language skills and, mummy, should you fiddle with the formula or bop with the bottle your place at your local playgroup will be as a social pariah. Get used to the disapproving glare of the motherhood masses.

Breastfeeding is no mean feat. No matter what they say, it is an art that doesn’t always come naturally and experienced support is thin on the ground. Women are given such incredibly differing and conflicting advice that many women cannot help but reach for the bottle as the cry of their baby is much louder than the tutting of the health profession.

So for the 26% of women who are still breastfeeding their young at six weeks you’d think society would give a hearty cheer of congratulations and welcome them to eat, drink and be merry. However, as it turns out, a hearty cheer is the last thing a woman can expect when nursing her new born in public. Despite the fact that most of the time even the most piercing glare won’t notice a baby suckling at the breast while mum chomps on a little dim sum, women are told that if they’re not discreet they will be sent to the loo to feed their baby or asked to don a napkin for fear that a little flesh might be glimpsed. What are people doing in restaurants? Why aren’t they concentrating on their expensive meals or engaged in frightfully absorbing conversation? Why are they looking at random women’s chests in the first place?

It’s very strange that in a country that still prints Page Three and abounds with nearly naked women from lads’ mags such as GQ to family shows like Strictly Come Dancing that we can’t cope with a mum, totally clothed with a baby lying prone across her body, with said baby’s head covering her breast. Even Facebook has got over its coy boycot of breastfeeding mothers. When are the rest of us going to manage it?

“Don’t Lose Faith In The NHS”

Chris Blount looks at the narratives surrounding NHS privatisation.

I’m lucky enough to have a number of amazing, inspiring friends and relatives who work or have worked for the NHS. As anyone in this position will know, it’s tricky to meet up with such people without talk turning to their jobs. In this way I guess you could say their profession and dedication to it totally consumes them. Or to put it more positively, they really care about what they do and not just because they get paid.

Back in 2012 when the colossal £3 billion Health & Social Care Act was being proposed by Andrew Lansley, one of these friends said to me that they didn’t understand how such massive changes were needed when patient satisfaction was at an all time high just 2 years earlier, in 2010. They questioned the widely disseminated narratives in the news that were challenging the sustainability of the NHS. There were suggestions that somehow the number of old people had suddenly exploded, the cost of treatments had sky-rocketed, or that mistakes were just too prevalent in today’s NHS. This was the seed which kick-started a debate in my mind and a yearning desire to find out more.

I was struck by how contrary these narratives were when compared to the bigger picture. The ‘bloated, bureaucratic, inefficient, accident prone’ NHS was actually one of the most efficient and cost effective health systems in the world. And costs were shockingly low. According to organizations like the OECD and the WHO, the NHS cost the UK over $4,000 per head per year less than American (predominantly private) healthcare cost its citizens. In fact the NHS cost significantly less per capita than many first world healthcare systems including Australia, Canada, Germany, the Netherlands, Norway, Switzerland, Denmark, France and Belgium. OECD figures from just a few years ago suggested the NHS was also amongst the best for efficiency, access, equity and overall quality. So what was it exactly which made the NHS so efficient and why wasn’t this reality reported?

At a time when our NHS was being cut, fragmented and gradually privatised, it was particularly striking that the private US system and part-privatised Canadian system were rock bottom of the OECD table. These health systems were also both significantly more expensive than ours. In 2009 the US spent twice what we spent as a percentage of GDP on healthcare. Despite this, they still had a shorter life expectancy, a higher infant mortality, less practicing physicians per 1,000 patients and almost 50 million people uninsured. Reportedly, the top reason for bankruptcy in the US is health bills – and keep in mind that some of those unfortunate enough to face financial ruin were undoubtedly insured. On a trip to Boston earlier this year I witnessed what appeared to be the tragic results of such failings. A homeless man, standing on a street corner holding a sign that simply read ‘I have cancer, please help’. In perhaps the richest country in the world, it’s a desperately sad state of affairs. However when you have someone over a barrel for their health, you can pretty much take what you want from them.

Since coming into power, President Obama has struggled hard against rich, influential corporations and negative advertising campaigns to implement limited improvements through the Affordable Care Act. However, more than 13% of Americans still have no cover at all and an unknown number are underinsured. Whilst the UK is still (hopefully!) some years away from this tragic scenario, we should acknowledge that this is the end game. The truth is that we’re gradually bankrupting our health service by looking for answers in the profit-seeking private sector. As the years go by we’re spending an increasing percentage of the health budget on non-clinical costs. The new CCG-led commissioning system will require more and more funds to be diverted away from care and instead spent on lawyers, managers, consultants, corporate bonuses and shareholders. This cost is increasing all the time – 1 in 10 NHS pounds is now spent on non-clinical expenses. If we’re not willing to fight for the NHS, we could ultimately end up in an American scenario where 1 in 3 dollars spent is on non-clinical costs.

Despite all this evidence, in 2012 politicians (largely backed up by sensationalist news media) suggested the NHS was unsustainable, in need of the biggest reorganisation in its history and that private companies had the answer. I suppose we shouldn’t be too surprised given that Andrew Lansley, like many prominent politicians in government, was accused of being bankrolled by a private health company, Care UK. Nor should we be all that surprised that newspapers carrying private healthcare adverts are fiercely critical of the NHS. As a lean, relatively efficient public health service gradually expands into a bloated, fragmented, expensive health industry, we can expect to see more of this corporate back scratching. As the NHA has been kind enough to point out recently, we’ve been down this road before. All you really need to do is ask yourself if you’re happy with the year on year increases in energy bills, water bills and train fares which consistently out pace inflation. Energy bills have recently been rising at about three times the rate of inflation. These sizeable cost increases you pay don’t take any account of the massive multi-billion pound subsidies many of these private companies have taken directly from the government.

As costs inflate with the new market and tendering processes, the health budget will inevitably become increasingly stretched. One worry is that this will in a way fracture the public and bring about more of an every man for himself attitude. We’ll blame fat people, diabetics, drunks, drug addicts, old people or anyone who isn’t us! The press will inevitably table various ideas suggesting some people should be charged more or even be excluded from care. One of my friends currently working in the health service predicts that in a matter of years we’ll have an ‘NHS+’ system. If you don’t want to wait for 3 months for a referral or if you want better treatments, simply pay for ‘NHS+’ out of your own pocket! A premium service sold as a kind of ‘bolt on’ to your standard NHS care and a stepping stone to private insurance funded care. Personally I think with Tory led cuts currently running down the health service, people are already losing faith and skipping straight to private insurance providers. It’s critical to realise that no political party will ever propose a ‘big bang’ style, blanket privatisation of the NHS. You will get no honest or obvious signpost that it’s underway. That would be political suicide. However this kind of step-by-step gradual privatisation, combined with a deliberate running down of public confidence in the state run alternative is a more realistic concern. It is happening right now.

So let me ask this: do you have full confidence in your car and house insurance companies to cover your costs completely should you meet with disaster? Are these companies reliable enough to cover your health too? When it comes to the health of you and your loved ones, full confidence is absolutely what you would want. When it comes to the heightened costs of medical care, a cost that can sometimes come along unexpectedly, full confidence is what you may need. As with I’m sure many people reading this, there is someone in my life whom I care about very much who relies on regular help from the NHS. This relatively young person has always led a healthy lifestyle and yet would probably not get full cover if they were American. They’ve never smoked a single cigarette, never taken illegal drugs, drank alcohol only in moderation, carry a healthy body weight and have always led a varied, regular exercise routine. Despite all of this, they were unfortunately diagnosed with an illness new to the family, which requires regular treatment using very expensive medication. You see, that’s how illness works sometimes. It’s not always, as the media tells us, a proportionate punishment for being obese, drinking too much, being inactive or even being too old. Sometimes it’s purely and simply down to bad luck.

It is very telling to me that the same newspapers and politicians who vehemently champion our courageous military, will not support (and often even criticise) our health service and its workers. That to me says something profound and very sad about us. We should, without question, want to invest in and look after our sick. If we can’t find the humanity, compassion and financial support for these people in such desperate circumstances, who can we find it for? Even if they are old, fat or addicted we should want to help those in sickness. It’s what makes us human. The most cost effective way to do this is to buy healthcare as one giant collective rather than as individuals.

You might say ‘But where are we going to find the money from? It’s unaffordable!’ Leading NHS England representatives have recently estimated that the NHS needs an extra £8 billion above inflation. It does sound like a dizzying number to get your head around at first. It is of course also important to recognize that these costs will inflate over time too. However, nothing will inflate health costs like the growing involvement of the profit extracting private sector. So is it possible for this cost to be absorbed by the treasury? Last I looked there were roughly 30 million income tax payers contributing to this pot. £8 billion divided by 30 million income tax payers is less than £23 per month. That’s less than what many people spend on the relative luxury of a mobile phone contract. That £23 calculation presumes we couldn’t save any significant costs from elsewhere in the budget. It also presumes we couldn’t make anywhere near £8 billion from VAT, stamp duty, corporation tax or other revenue streams. If income tax payers took on the entire burden, that’s only £23 for an efficient, publicly owned health service with 8% more money at its disposal. That’s £23 to ensure the sustainability of a more compassionate society where people are not made homeless simply because of ill health. It’s good to have a healthy dose of perspective with our daily headline grabbing hysteria.

Currently, none of the big political parties are promising to find that £8 billion. There’s nothing unaffordable about it though. It’s simply about priorities. So next time our politicians or newspapers tell you the NHS is an unaffordable, wasteful institute or that GP’s are overpaid careerists, or that nurses are lazy and apathetic please take a moment to question them. The founder of our NHS gave us the clear warning that it would only ‘last for as long as people have the faith left to fight for it’. So you can bet those seeking its demise will go to great lengths to strip you of your faith.

“Keep our babies free at the point of delivery”

Maternity campaigner Jessica Ormerod tells us her concerns about the Americanisation of the NHS.

In the USA having a baby is an expensive business. To bring home a new bundle of  joy can cost the doting parents $42,000 – roughly the same as a mid-range car but with a lot more noise, nappies and, however much you might be tempted, you can’t trade it in for an improved model.

At the moment in the UK, our bundles of joy are free at the point of delivery. Bed, board and midwife are all inclusive. But, in a fragmented and privatised service such as the American healthcare system women are not at the centre of care, profit and the bottom-line is. Insurance based systems are perfect breeding grounds for unregulated intervention. Women and their partners are sold ‘maternity packages’ including regular scanning, epidural, even elective caesarian – never mind if these interventions are medically indicated, never mind that research has categorically shown that allowing childbirth to be as normal as possible is best for the mother and baby. And certainly no thought to public health policy which has years of experience and knowledge about serving the health and maternity needs of our population.

Mothers understand the complexity of maternity care. We believe that every woman should have a named midwife and that women be supported in their choice of where to give birth. We want a woman-centred care model that allows midwives to focus on our needs rather than the gruelling bureaucratic process of administration. We demand a compassionate midwife to woman ratio on our postnatal wards and that women are properly cared for in the community by regular postnatal visits at home. We are fighting for the right for every woman to have a free, safe and compassionate maternity service.

You can read more from Jessica Ormerod on the Lewisham Women blog.

“This is why I fight”

Mike Stafford tells us why a public NHS is indispensable for all of us.

I picked up my prescriptions again last week. Every time I visit the doctors, I’m reminded of my most dramatic trip there back in late 2010.

I’d been having bouts of illness for several months. Fatigue to the point where walking across the room was a challenge, frequent vomiting in the mornings, and endless feelings of dehydration. I was working from home but still managed to end up too ill to work for seven days during the year.

Then, in October, I was taken out of action for a whole week. I spent four days on the sofa, wrapped in a fleece and a blanket, shivering to my bones. On Wednesday, my wife dragged me to pester my GP again; they took blood tests and called me back on Friday. By Thursday night, it took me three attempts to walk up the stairs, and I was mumbling deliriously as I did so.

On Friday, they called me in to discuss my results. After months of suffering with this mystery illness, just to hear it given a name was a huge relief. That name was Addison’s Disease. Invariably fatal at the time Dr Thomas Addison first discovered it, these days it’s medicated with steroids and has no effect on quality of life or life-expectancy at all. I was in the midst of an Addisonian crisis, the stage of the disease that comes just prior to death by circulatory collapse. Pleasant, eh?

I was taken to the Medical Assessment Unit at the Royal. Given the state I was in when I got there, the nurses informed me that the Intensive Care Unit had been notified of my arrival. It’s all of about sixty feet from the main doors of the Royal to the corridor off towards the MAU. Walking that distance was one of the most physically strenuous things I’ve ever done.

At the MAU, I was hooked up to a drip, given anti-vomiting drugs, injected with steroids and talked through the process by a medical staff whose bedside manner was invariably superb. At each stage, they let me know what they were doing and why they were doing it. From being on the brink of death on Friday morning, and having had half a Pot Noodle to eat all week (it’s funny what you can get down when you’re ill), by tea time I was in a fit state to eat, and enjoy, a whole meal. By Saturday morning, after a sleep in my own en suite room, I was ready for release. Walking through the lobby 24 hours earlier had been like climbing the north face of the Eiger. Leaving, I strode across it easily, and when I got to the car park did some Dick van Dyke heel clicks for my wife’s amusement. It was the fittest I’d felt in years.

The staff of the NHS saved my life that day, and did it with smiles on their faces and decency radiating from them throughout. As I type this I still feel a profound sense of gratitude.

When all this happened, I had less than fifty quid in my bank account. I’m a father of three; I’m not poor but I’m not exactly flush with cash. When I hear plans bandied around suggesting we need to abandon the founding principles of the NHS in order to save it, my blood begins to boil.

It takes a long time to diagnose Addison’s disease. Several trips to the GP, in fact. How many trips could I have afforded if plans to charge for GP visits had been approved? When I arrived at the hospital, what standard of care could I have expected on a ward run by the cheapest possible provider? As soon as she made the diagnosis, my GP was on the phone to the hospital to give them a heads up I’d be arriving. Could I have expected two rival private firms to co-operate so freely and effectively?

It goes deeper than that though. The NHS cured me because I am a member of the community, because I was sick and needed to be made well, nothing more. This is not the remit of a private firm, nor will it ever be. Only a publicly-funded, publicly-run health service can be trusted to place the patient at the heart of everything it does.

You can read more from Mike Stafford on his blog, ‘Returning the Favour‘.