Welcome to the latest issue of Gay Bishop, this month we have been looking at issues surrounding health services for residents in Reading.

Articles in this issue include;

· Shaky Foundation
· Battle at the Berks
· Intensive care required
· Keep Pushing for home births!
· If You Want Something Done Right...


Shaky Foundation

This month the Royal Berkshire and Battle Hospital NHS Trust is submitting an application to the Department of Health asking for Foundation status. The hospital wants to move away from government control and instead set up a trust of governors to run the hospital, allowing them to become part of a market in which hospitals will compete against each other for patients.

The RBH management claim that Foundation status will give local people a say in running their local hospital by becoming members of the Trust and electing governors, but health service union UNISON disagrees. UNISON point out that NHS hospitals should be for the benefit of the whole public, not just a small number of 'members’ and is concerned that the membership profile of foundation hospitals will be unrepresentative. Foundation hospital members would be self-selecting, putting themselves forward for registration, and so membership is likely to be dominated by the affluent and better educated, with a disproportionately low number of members from socially or economically excluded groups.

The Government is dismantling the public sector NHS and is replacing it with a competitive commercial market for health services. In this market, public and private hospitals will compete against each other for NHS patients and funding will follow the patients. The Royal College of Nursing has warned that Foundation hospitals could lead to the development of a two-tier health system where hospitals focus on services which are financially profitable, rather than providing a comprehensive range of healthcare services.

NHS Chief Executive Nigel Crisp has said that Foundation trusts “should adopt the same marketing techniques as Tesco in their bids to win customers in the new choice-based NHS market”. Buy-one-get-one-free operations don’t sound like a particularly attractive option to us, but leaving that aside Crisp doesn’t mention what will happen to hospitals that can’t attract enough patients – sorry, customers – in the market. What are the odds between closure or takeover by a private healthcare company?

All the evidence suggests that people are happy with hospitals being part of the government-run NHS. Only three people turned up at a consultation meeting on RBH Foundation status held at the Civic Centre, and according to a YouGov public opinion poll an overwhelming 89% of the public agree that public services should be run by the government or local authorities, rather than by private companies. And neither does Foundation status result in better hospitals: in July this year, a Healthcare Commission survey said there was no evidence that Foundation trusts improved patient care.

As Dr Jackie Davis, a consultant radiologist at a London NHS hospital points out, “We are not deceived by the rhetoric about patient choice and predict that patients may lose the one choice that is important – a good comprehensive local hospital. In a system where every part of the business must generate a surplus, patients will come second to profits. When the dictates of the market replace the public service ethos patients will suffer. The private sector will not support the NHS but compete with it, and NHS units and hospitals that cannot compete will close.”

Battle at the Berks

As many residents of Reading are aware the battle hospital has been absorbed into the Royal Berskhire Hospital. It has been awarded 3 stars and is hoping to go for its fourth star soon. This gives it the fantastic opportunity to apply for Foundation Status. What the feck does that mean? According to the representative I spoke to the other day, it means that the good people of Reading are allowed to be consulted of what they would like at the hospital. Quite why you can only do this when you have four stars, no one could answer. The hospital will get the same money from the government apparently and we, the good folk of Reading get to say what they spend it on. How do they consult us? With a quartley news letter and an annual meeting it would seem. And what do the good people of Reading want from their hospital? An accident and emergency department? Doctors? Nurses? Medical Treatment? Well, with the absorption of the Battle hospital what has this done to approve services for Reading? At least all of the services are under one roof? Well, the ones that have been transferred that is. There is concern that some services have not been taken to the Berks. Namely the air ambulance as it as nowhere to land, and also the Hydrotherapy pool – vital services we would all decry. Were you consulted on this? During the election campaign Labour candidate Tony Page published in his election material that over 600 new staff were recruited. I asked him at the time are these not just staff taken from the Battle to the Berks? He says this is not the case. It is actually some part time staff that have been recruited to work part time. So is that 600 people doing 300 people’s jobs? A wonderful example of new labour’s supply side economics! We will update you as we hear more.

Intensive care required

Never mind about obtaining Foundation status – a question of greater concern to most patients is whether the Royal Berkshire Hospital will be able to survive the months ahead without making any cuts in its services.

The Royal Berkshire Hospital has a history of financial troubles, and the hospital’s management know that it will only gain Foundation status if it becomes financially viable. The hospital overspent its budgets by £12 million in the 2002/3 financial year, and although it broke even in 2004/5, Martin Sheldon, the trust’s Chief Finance Officer, admits that this was the result of one-off windfalls in income and one-off cash savings.

This year the Department of Health is refusing to allow hospital and NHS trusts to overspend their budgets and is ordering them to make cuts to prevent this. At the end of September, the RBH Trust’s finances were running at a predicted deficit of over £2 million, leaving the hospital with a huge problem. The Health Department’s zero tolerance policy is hitting the RBH at the worst possible time of year as doctors and nurses face extra demand from patients affected by cold weather. Hospital managers now face the grim prospect of having to close wards and reduce staffing by leaving vacancies unfilled and cutting back on use of agency staff.

The British Medical Association has predicted that the government's ‘no overspend’ policy will destabilise a significant number of trusts. Will the Royal Berkshire Hospital be one of them?

Keep Pushing for home births!

A quick look at the website of the Royal Berkshire Hospital extols the virtues of their 'midwifery led unit' which it describes as a home from home. The unit does not have any doctors based in it and encourages a natural labour with minimal interventions. This got me thinking why babies aren't being born in an even more home like environment, like, er, home.

In 2003 only 3% of births in Reading were at home, this is not especially low as the national average was 2.1%. There's no reason why the majority of women (i.e, those who have had no serious complications in pregnancy) cannot have their babies at home. In fact there is evidence to show that fewer medical interventions occur when a home birth is planned compared with those planned for the hospital. This is in contrast to the above average rates of caesarean (27.1%) and instrumental delivery (15.6) reported at The Royal Berkshire Hospital in 2004. (www.birthchioceuk.com)

This trend has been seen throughout the western World with 96% of women giving birth in hospital and the developing World is catching up fast.* Hospital births are promoted as safer and there is a 'we know best' attitude in some parts of the medical profession. Of course the medicalisation of birth is fairly new as in the past women had their babies in familiar environments assisted by experienced women helpers.

When looking at why home births are not promoted more actively cost would be an assumed factor. This is not in fact the case. Home births are cheaper in terms of interventions and hospital stays. Although home births are more labour intensive (excuse the pun!) then hospital births overall they cost less on average then planned hospital births.

So, what could Reading be doing differently? A pilot scheme carried out in Peckham may suggest an alternative. The work of the Albany Practice led to a drastic increase in the number of births at home. The self employed midwifery practice provided for 216 women each year and achieved a 43% home birth rate. The practice provided good continuity of care to women and this lead to better outcomes during and after labour for women and their babies.(www.kcl.ac.uk) Schemes like this show that women can regain control of childbirth. So remember 'keep on pushing for home births!'

References / contacts
*Homebirth Matters, Midwifery Matters, Issue no 95, Winter 2005, Denis
Walsh.
homebirth.org.uk
birthchoiceuk.com
radmid.demon.co uk (Association of Radical Midwives)

If You Want Something Done Right...

So the state runs a health service for a few decades, complete with toxic 'medicines', bureaucratic management gone mad and 'black holes' worth millions - just in case the nurses, doctors, cleaners and other staff wondered where their rent disappeared to. We get sick of it - literally - so the Government decides to flog it to the highest bidder. Prime real estate and a service with an ever-increasing demand equals corporate profit opportunities galore. They swoop in like vultures, grabbing everything in sight. Efficiency??? Nah, this is about pushing drugs that make you sicker, turning three hospitals into one and flogging the land to Tescos, while 'letting the market decide' - which basically means supply of goods and services is tailored to where the 'demand' is highest. Oh no sorry, that doesn’t mean where people are most in need of healthcare. It means the best service goes where people can afford to pay most. Welcome to the class-structured healthcare market of global capitalism.

So that’s all pretty bad news, especially with pollution, poisoned food and water and all the other nasty products making our lives a greater misery. And of course it aint just here, this is the general situation facing millions of ordinary people worldwide. But some folks aren’t taking it lying down, and are figuring out that if you want something done right, you better do it yourself!

In Portland, Oregon, USA, a recently formed ‘healthcare collective’ is attempting to completely redefine healthcare as we know it. The collective is “looking at practicing in ways which negate the power of the profit system and the domination of the state as much as possible”. This necessarily has brought them to seeing their work as a “non-profit service being offered on a volunteer basis, as part of the emerging alternative economy (based on co-operation, exchange, green values, collectivism and direct democracy)” – with ‘payment’ taking the form of donations and exchange of goods and services. However, in talking with a member of this collective I realized that their concerns with modern healthcare go very much deeper.

Healing is seen in our society as something that is ‘done to us’, some action, process or medicine from outside of ourselves only known and practiced by educated specialists. But of course this is largely rubbish. Our bodies heal and protect themselves through our immune systems, regeneration and other defense mechanisms. The job of ‘healthcare’ is to give them a helping hand. However, these processes have been taken from us and mystified. How many of us understand the first thing about how to make ourselves better? All this basically means is we totally rely on the structures of government and business to stay healthy, having very little control over our own health while giving massive power to the state and massive profits to industry. Meanwhile the Portland Healthcare Collective says “Radical Healthcare workers work to make ourselves obsolete, and unnecessary. Our methods and our approach to Prevention, Diagnosis, and Treatment, aim at the empowerment of both healthy and ill people, individually and socially, and provide to people all the tools, knowledge, skills, and materials to enable them to be well, without us”.

Ever heard the saying “prevention is better than cure”? Well its time to put that into practice. To be ‘healthy’ doesn’t mean you never get ill, it means you are better protected against it and when you are ill your body responds properly. But for this to happen we all need what’s sold today as a ‘ healthy lifestyle’ – in other words, clean air and water, shelter, exercise, community and good food. But global industrial production methods are making this impossible. By-products of industry (including ironically the pharmaceutical industry!) are poisoning our water supplies, our air and our food. Recent studies have shown the average person to be carrying over 60 cancer causing chemicals in their body, not to mention the others which cause other problems and those we cant even measure properly! This is not just making us ill, but also being passed from mother to child. Today, and since the industrial revolution, problems like cancer, heart disease, respiratory illness, birth defects and many mental illnesses are dramatically increasing. The point to take from this is that the definition of ‘healthcare’ desperately needs to be widened. For starters, the kinds of medicines and methods of treatment used must start to move away from industrially produced drugs where possible – what’s the point in a medicine that makes people ill?! However, the best doctors in the best hospitals prescribing the best medicines are largely irrelevant as long as the current global system of industrial production and trade continues, and for this reason the definition of ‘healthcare’ should now include the push for radical social, political and economic change. Its up to us folks, it’s DIY or die….

For more info please see:  http://healthcare-collective.portland-or.net/

For info about the incredible self-organised community projects in New Orleans providing healthcare, reconstruction, media and community support post-Katrina please see:  http://www.commongroundrelief.org (this is so effective the US army asked them for help!!)

For further info about the effect of global trade and on health please see:  http://www.health-now.org


Holy Troublemaking
Gay Bishop’s events listing

Friday 27tth January: Critical Mass - Meet 6:30 pm by Queen Vic statue opposite the Three B’s. Critical Mass is a gathering of solidarity between cyclist and other self propelled vehicle users. We will go for a ride around town followed by a trip to the pub

Monday 30th January: AWE Aldermaston blockade - 'Block the Builders' (BtB) have agreed that if the West Berkshire Planning Committee approve the application for the Aldermaston nuclear test laser (See GB issue 1) they will carry out a publicly announced blockade . Briefing and accommodation at Newbury Friends Meeting House on the Sunday evening, or get to Aldermaston early Monday morning to stop the AWE staff getting to work. More details: www.blockthebuilders.org.uk

Reading Re-convergence
A get together of local progressive grass roots activists. Reading based workers, non-workers, anti-capitalists, migrants, environmentalists, peace campaigners and others are invited. A chance to introduce yourselves and your groups, to present initiatives and events and collaborate with others. Venue and date to be advised.
Contact email:  readingactivists@gmail.com for more information.

So just who are this Gay Bishop lot anyway?

Gay Bishop is produced on a voluntary basis by an open collective of local people and activists who want to shine the spotlight on the news stories that local politicians would prefer stayed hidden - and get to the roots of the ones they gloss over! Our roots are in the direct action movements, but we welcome new members who support our principles - please get in touch if you would like to get involved or want more information. Our email address is
 readinggaybishop@yahoo.co.uk or you can write to us at
Gay Bishop, c/o RISC, 35-39 London Street, Reading,
RG1 3JE (but we prefer email!).

We're hoping to put out Gay Bishop on a roughly monthly basis, but as we're only a small group and aren't always the most dynamic bunch in the world (read lazy, really lazy, and in the pub too much), we'll need your help to do this! We need ideas for stories, writers, people with experience at using the web, and donations. We also want to know what you're up to, so please send us details of forthcoming events to include in our 'what's happening' section. Most important of all, we need new readers - so if you liked Gay Bishop, forward it to your mates and subscribe to receive future editions. To subscribe, just send a message to  reading_gay_bishop-subscribe@yahoogroups.co.uk -
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