The new suffrage movement

Friday night: I have just arrived back from watching Suffragette at the fantastic Llanfyllin Community Cinema.  I say I have arrived back but first I hadto make my way to the wetlands – my place of solitdue and thought – to sob my heart out.

That film recalled to me the immense bravery, tenacity and courage of the women of the suffrage movement and especially the suffragettes.  It reminded me of the suffering women under went to gain basic human rights.  The awful suffering.

And confronted with that, who am I to complain about the slings and arrows that might come my way for campainging for quality, humane maternity care?  How can I justify hanging back when I know it is time to step up to the challenge. When the lives of women and babies, families and communities depend on it.

I have indeed struggled for the last 2 years with a kind of slow burn exhaustion, I am indeed overworked and have a family to care for.  But so did these women and that is when it takes real courage and fortitude.

So again and now I step up to the challenge, I carve out the time, I pick up my pen and my laptop and I do my bit.  Thankyou film makers for recalling me to myself, thankyou to all those who are working for change and are so supportive, thankyou brave and courageous women who showed us the way: yours are the shoulders we stand on.

 

 

 

 

 

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Watching choice disappear

It was only about eight weeks ago that I was writing up good news. NICE (The National Institute for Health and Care Excellence) confirmed that it’s safer for around half of women to give birth at home or in a midwife led unit.
Hooray, we thought… the evidence is out there, the cautious and well respected NICE is reinforcing the benefits and better outcomes found in a natural birth.
Yet…
Since then, Calderdale Hospital Trust has failed to renew their consultant midwife’s contract and closed the long standing birth centre “temporarily” due to sickness rates. Also, the MAMs service in Airedale is shutting (this is breaking news so we have few details yet). And GPs have been sent a letter scaring them with unfounded concerns about local midwifery service 1-2-1, leading many to refuse to refer women wanting to use their services.
The debate about the guidelines was how we could increase access to natural birth to let everyone have the chance. But here in Yorkshire right now, women are being left without choices, without certainty and with the higher risks associated with hospital births: more interventions, much higher chances of a C-section, stressful environments that interrupt Oxytocin production and so on.
There are many complex reasons why any of these things are happening, but what I think links them is a clear lack of commitment to natural birth in commissioning, despite the guidelines.
Natural birth services are being seen as an ‘add on’ that can be dropped, because they aren’t closing labour wards! So can we hold commissioners to the guidelines? While health professionals get to make the final decision, “Healthcare and other professionals in the NHS are expected to take our clinical guidelines fully into account when exercising their professional judgement.” (NICE website) Therefore, we can argue that they aren’t taking guidelines fully into account if that’s what we believe, but we don’t have the right to overrule the commissioning judgement automatically.
When the future’s uncertain, one of the best things we can do is to keep sharing our experiences. The other thing we can all do is “ROAR”, as Sheena Byrom puts it. We’re organising petitions to make sure the health professionals making these decisions know that we care what happens to women during a very vulnerable experience. Here’s the link to the Calderdale petition.
Things we start to take for granted can disappear if we don’t roar.

For patient safety and justice: a newsletter

For your information and interest.  Here is another organization fighting for justice with some relevant information for those of us working with maternity care as a human rights and justice issue.

The organization is looking for Trustees by the way.

 

WELCOME TO OUR LATEST UPDATE ON ISSUES CONCERNING PATIENT SAFETY AND JUSTICE

In this edition:

1   ‘DUTY OF CANDOUR’ STILL ON A KNIFE-EDGE

2   GOVERNMENT RESPONSE TO FRANCIS  MID STAFFORDSHIRE REPORT

3   DH AGREE TO ISSUE CLEAR GUIDANCE ON COMPLAINTS AND LITIGATION     FOLLOWING THREAT OF JUDICIAL REVIEW

4   THE ‘BIG GIVE’

5   AvMA IN THE NEWS 

‘DUTY OF CANDOUR’ STILL ON A KNIFE-EDGE

One of the measures announced in the Government’s response to the Francis report on Mid Staffordshire was a statutory Duty of Candour on organisations – something which AvMA has campaigned for for years.  However, as things stand, the duty would be limited to fatal cases and those resulting in ‘severe’ harm only.  In our view, such an arrangement would actually make things worse rather than better – effectively legitimising the cover up of all incidents deemed less ‘severe’ than this.  As a direct result of intervention by AvMA, the Secretary of State, Jeremy Hunt, has agreed to review this arrangement and consider bringing all incidents suspected of having caused significant harm (‘moderate harm’ and worse as defined by the NHS) within the scope of the duty.  Mr Hunt has asked Norman Williams (President of the Royal College of Surgeons) and David Dalton (CEO of Salford NHS Foundation Trust) to report back to him before Christmas.  He is worried that an ‘unintended consequence’ of including all incidents of significant harm would be to over-burden healthcare providers with bureaucracy.  AvMA has pointed out that NHS bodies already have a contractual duty to disclose significant incidents of harm, and have been practising “Being Open” guidance which also covers these incidents for years.  The Duty of Candour will take the form of statutory ‘fundamental standards’ for registration with the CQC.  Read AvMA’s briefing for more information on how the Duty of Candour should be framed.

GOVERNMENT RESPONSE TO FRANCIS MID STAFFORDSHIRE REPORT 

Jeremy Hunt delivered to Government response to the Francis report on 19th November.

AvMA is continuing to press for the statutory Duty of Candour on organisations to include all incidents of significant harm (see separate article).  We are also seeking to persuade Ministers that a creative drafting of the CQC regulations, which will encompass the new duty, could go a long way to meeting the objectives of Francis’s recommendations which have not been accepted.  For example, the recommendations for an individual duty of candour and offence of preventing others from complying with their duty were not accepted.  However, AvMA is calling for the organisational Duty of Candour to include a requirement to discipline or refer to regulators any individual who prevents the organisation from complying with its duty.  We are also asking for an explicit requirement on employers to support and train staff in complying with the duty.

Other recommendations which AvMA were disappointed not to see accepted include:

  • national guidance on minimum staffing levels (however we are assessing the Government’s alternative proposals, which Robert Francis QC himself seems quite content with)
  • regulation of healthcare assistants
  • ring-fenced funding and consistent national model for Healthwatch
  • regulation of managers.

The Government has made much of only having rejected 12 of the 290 recommendations.  However, a closer look reveals that many are only agreed ‘in principle’ or partly agreed.

DH AGREE TO ISSUE CLEAR GUIDANCE ON COMPLAINTS AND LITIGATION FOLLOWING THREAT OF JUDICIAL REVIEW

The Department of Health has agreed to issue new clear guidance making it clear that NHS bodies must investigate complaints, notwithstanding any intended or actual legal action by the complainant.  This followed a threat of judicial review by AvMA.  AvMA has come across a number of examples of NHS bodies in England wrongly insisting complaints are put on hold purely because litigation is intended or taking place re clinical negligence.  The DH removed the bar on complaints being investigated whilst litigation was in train or intended, after lobbying by AvMA, when it revised the complaints regulations in 2009.  However, the lack of clear guidance has meant that some trusts are unaware of the change, whilst others have chosen to use the loophole to put complaints on hold simply because of litigation.  In a test case AvMA helped a claimant take to the Ombudsman, she could not intervene because under existing arrangements trusts had a right to do so.

HELP AvMA MEET THE ‘BIG GIVE’ CHALLENGE

AvMA is one of the charities chosen to benefit from the Big Give challenge this year.  By donating on line, on 5th, 6th and 7th December, you can help AvMA double the value of your donation by drawing on anonymous donors as part of the scheme.  Please donate whatever you can on 5th, 6th or 7th December and it will make a huge difference to our work.  For full details click here.

RESEARCH PROJECT ON ADVERSE DRUG REACTIONS:

The Medway School of Pharmacy, University of Exeter Medical School and the Centre for Health and Social Studies at the University of Kent are undertaking a research project on patients’ experiences of a suspected adverse reaction to a medicine.

If you would be interested in taking part in their research project please click here

AvMA RECRUITING TRUSTEES:

Due to recent retirement of trustees, AvMA is looking to recruit new trustees to join its board.  This is a voluntary position but all out-of-pocket expenses are paid.  In addition to a strong commitment to the aims of AvMA and relevant experience, we are looking for people who can add diversity to the board which is currently light on younger adults; people from ethnic minority backgrounds; and disabled people.  Click the following for more information:  Role Description.

If you are interested please write in with your CV and coverinjg letter explaining why you would like to be a trustee and how you think you could contribute:  Trustee Position, AvMA, Freedman House, Christopher Wren Yard, 117 High Street, Crokydon CR0 1QG.