Sunday, 3 February 2013

Call the midwife and hope they have room and nothing goes wrong


Call the midwife and hope they have room and nothing goes wrong

Funny that David Cameron is so eager to let the people have their say on Europe, yet he keeps the ear plugs firmly in place when it comes to vital, life-changing, if not life-endangering issues like the NHS, benefits, etc.  He even denies the knowledgeable and experienced an opportunity to speak.  

So though I was appalled by Jeremy Hunt's announcement that the excellent maternity services at Lewisham Hospital will be downgraded to a midwife-led unit with drastic cuts to the number of patients they will serve, its content didn't surprise me. It is merely another government measure to which the suffix 'fiasco' can be attached. According to Hunt, other hospitals around SE London, I suppose he means those with lots of ready-and-waiting empty beds and thumb-twiddling staff, will be hanging around eager to take up overspill. Hunt is nothing if not a fantasist and the government's actions make sense only to those who are out to gain financially. Service and the provision of care to the community is not a priority.  I'm equally appalled by Hunt's plans to downgrade and cut the size of Lewisham's A&E but I'm writing specifically about maternity because of an experience I want to share.

My daughter gave birth at the NHS Royal Free Hospital in Hampstead a few years ago. The baby was fine, but my daughter hemorrhaged so heavily during the delivery, dropping in and out of consciousness, that it took three doctors as well as the midwife to save her life.  It was really that bad. She had to have seven pints of blood and plasma transfusions and was told a few days later by the attending midwife that a small number of mothers die at the hospital in childbirth every year and they had thought that she was going to be one of them.  
With all the current NHS cuts and threatened cuts it might have crossed more than a few people's minds, perhaps enviously, that those who can afford private health need have no worries about the current cost cutting.  But this just isn't so. We all need the NHS undiluted, and so continues my story.  A few days after my daughter's near-death experience I was telephoned by a cousin of mine who wanted to tell me something that she had thought it was better to keep to herself until after my daughter's baby was born.  A couple of weeks earlier a friend's daughter had given birth in an expensive, prestigious private hospital. Again the baby was fine, but like my daughter, the mother also began to severely hemorrhage during delivery. The hospital decided that they weren't equipped to deal with the emergency and that she should be transferred to the Royal Free. She died on the journey in a blue-light ambulance.  She was 27. 

There is nothing to say that the results would not have been the same whatever the circumstances.   And though Hunt refers to a doctor-free maternity service run by midwives as "downgrading", there should be no criticism of the overworked, short-staffed profession of midwives who do a wonderful job. But Hunt's change of level of staff provision of a maternity ward, the cap on patient numbers, the inability to go to the nearest available hospital in addition to the recent proposed cuts to the ambulance service and nurses today claiming that they are "dangerously understaffed", will inevitably cause added risk and danger to life for both mother and baby. It is impossible to predict how a delivery will turn out even in the most seemingly straightforward pregnancy. Some births will inevitably require emergency attention.  Transporting the mother in a mid-delivery emergency to another location which will be finding it difficult enough to cope with its own overloaded wards is bound to become a more frequent necessity.  When a woman goes into labour under normal circumstances it is likely to be a partner or friend who takes her to hospital.  How will they assess whether she should be taken to the nearest "downgraded" centre or a "specialist" centre further away, and what if the hospital to which they are headed has just reached its capacity number of patients?  It shouldn't be like this.  We all know it.  The medics know it.  The government doesn't seem to care.

Though money and a determination to privatize are the government's motivations, in Lewisham's case it is not even a matter of bad financial management or loss.  And there are always those who somehow manage to justify such change as being so much better for the individual needs of the patients. 

At his first party conference as Tory leader, David Cameron said that while Tony Blair's priority lay in the three words "education, education, education", he could do it in three letters: NHS.  Perhaps we misunderstood what he meant by 'priority'.

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