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Changes in guidelines for Caesarean sections is in the news. The Independent suggests that the shortage of midwives is “linked to rise in Caesarean births”.

The BMA warns new government proposals could give the private sector an advantage in the commissioning support process.


The banks have run the global economy into the ground. Bankers, encouraged by the government, gambled recklessly with our money, and they lost. Spectacularly. Remember 2008? In the UK, the government decided it had to step in with a bail-out because these banks were ‘too big to fail’. According to the Bank of England, the cost of this bail-out now exceeds £1trillion. The result is that all high street banks- from Barclays to RBS- owe their existence to public financing.

What did we get for our billions? A banking system that serves ordinary people rather than the super-rich? No. Regretful bankers who refuse to reward themselves with massive bonuses? No. How about increased financial regulation to ensure this crisis couldn’t happen again? No. The government has done nothing to stop it being business as usual for banks.

What’s worse, the money that was given to the bankers is the money now being taken from the poorest in society, guaranteeing a rise in poverty, debt and inequality. Nearly £7 billion will be paid out in bank bonuses this year. This sum is more than the first wave of public spending cuts. We are not all in this together because it’s us who will pay if education, health, housing, libraries, woodland and much, much more, disappears from our lives.

Who’s telling us we must make these cuts? A government led by a cabinet of millionaires, in bed with the bankers, which is now pulling off an audacious con-trick in front of our eyes.

This is how their story goes. The crisis was caused by a bloated public sector. We binged away all our money on luxuries like healthcare and free education and council services, care for the elderly, for people with disabilities, school sports and free school meals for children living in poverty. Now the country is bankrupt and we must repent, detox, cut back. We have to relinquish our welfare state to appease the circling money men. Welcome to the Age of Austerity but don’t worry because we are all in this together.

We say – don’t believe their lies. This is their crisis, but there is no austerity for the bankers.

Conservative election poster 2010

A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.

NHS caesarean guidelines aim to push down demand for procedure | Society | The Guardian

No woman who wants a caesarean should be refused one, but if women have the risks of surgery explained to them, the numbers should fall, according to fresh NHS guidance on childbirth.

The National Institute for Health and Clinical Excellence (Nice) has tried to deny speculation in the media that the new guidelines meant women would be entitled to a caesarean on demand, but the implication remains that nobody should be turned down.

Nice said most women would choose a vaginal delivery if they received proper information, and its guidelines committee said they did not recognise the concept of women choosing a caesarean because they were “too posh to push”.

Most women who asked for a caesarean had either physical or mental health issues that made them unable or unwilling to try ordinary delivery, they said.

Midwife shortage linked to rise in Caesarean births – Health News – Health & Families – The Independent

Warning comes as health body revises guidelines to allow women to demand surgical delivery

Caesarean birth rates may rise from their present record levels unless urgent action is taken to address the “massive” midwife shortage, childbirth experts have warned.

The warning came as the National Institute for Clinical Excellence (Nice) updated its guidance to enable women to demand a Caesarean section, even when it was not medically necessary and despite its higher cost to the NHS.

The move is intended to help medical staff to intervene earlier with women who may be worried about natural childbirth. Evidence shows most can be reassured about the safety of a vaginal delivery. But if, after discussion of the risks and benefits, a woman still wants a Caesarean, they should be able to have one, the guidance says.

The previous guide, in 2004, said “maternal request is not on its own an indication for Caesarean section” and could be declined by a doctor.

Experts launching the guidance yesterday said they expected demand for Caesareans to fall as a result of earlier intervention and new advice that those who have had two or more Caesareans, and those with HIV, may safely opt for a vaginal birth.

However, a report from the Royal College of Midwives yesterday said the maternity services faced a “looming crisis” as a result of a 22 per cent rise in the birth rate since 2001 and a shortfall of almost 5,000 midwives in England. Lack of midwife support during birth was an important reason for high Caesarean rates, Malcolm Griffiths, consultant obstetrician at Luton and Dunstable Hospital and chairman of the Nice guideline group, said.

Government proposals ‘prioritise private companies’ – News – Practice Business

The BMA warns new government proposals could give the private sector an advantage in the commissioning support process

New proposals from the government would give the commercial sector an in-built advantage in the commissioning support process, the BMA has warned today.

Draft guidance from the Department of Health – ‘Developing commissioning support: Towards service excellence’ – makes a number of recommendations about how clinical commissioning groups (CCGs) should function from 2013, including how the technical and ‘back-office’ functions should be provided.

Current primary care trust (PCT) clusters are forming commissioning support units and from 2016 would be encouraged to form social enterprises and partner with the private sector.

These proposals would position commissioning support in a full-scale market and introduce commercially-focused criteria to determine who is eligible to provide this support.

These criteria would make it very difficult for CCGs to employ their own commissioning support staff and for NHS commissioning support bodies evolving from existing PCT clusters to compete against large, established commercial organisations, the BMA believes.

As such, CCGs would be left with little choice but to use these large, commercial organisations to provide a huge range of commissioning support services, from transactional services such as payroll and IT services, to equipping CCGs with the complex and sensitive population data that inform commissioning decisions.

There are significant concerns that this would lead to an imbalance of power between clinical commissioners and large, commercial providers of support, says the BMA, undermining the government’s proposals for genuine clinician-led and locally-focused commissioning.

27/11/13 Having received a takedown notice from the Independent newspaper for a different posting, I have reviewed this article which links to an article at the Independent’s website in order to attempt to ensure conformance with copyright laws.

I consider this posting to comply with copyright laws since
a. Only a small portion of the original article has been quoted satisfying the fair use criteria, and / or
b. This posting satisfies the requirements of a derivative work.

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