Alan Johnson, Health secretary, Live webchat here on Weds 16th April 12.20-1.15

[carriemumsnet]

Alan Johnson, Labour's Secretary of State for Health, will be here on Weds to answer your questions about the NHS. He's happy to talk about anything health -policy related, but some of the topics he's specifically covering during "health week" are: access to NHS services, hospital cleanliness, midwife provision, and a "personal" NHS offering maximum choice and control over the services they use.

As always, those of you who can't make it on the day can post your questions in advance here. Or grab a sarnie (healthy of course ) on Weds lunchtime and come and pose your questions in person.

Why was the postnatal ward so short staffed that was I unable to get any breast feeding help after the birth of my child, and even then only because i transferred out of the consultant unit to the midwife unit?

why were there no postnatal groups in my town?

why have antenatal classes been scrapped?

why did I have to deliver my dead baby on a busy labour ward, passing new mums with their perfect newborns along the way?

why was i not seen by anyone for 6 weeks after this traumatic event?

the service i have received during the pregnancy and birth of my 1st child, and the loss of my 2nd pregnancy, were on the whole excellent, but this was largely due to the exceptional support i received from individuals in the NHS rather than the system itself, which seems to hinder their efforts.

Mr Johnson,
I am a doctor, and have worked in the NHS for the past 7 years. My first child is due in a few weeks, and after maternity leave i would like to work, and continue to train, part time. However, the government has withdrawn funding for flexible trainees, meaning I am forced to either return to work full time, or sacrifice the career I have spent the last 7 (12 if you count med school)years working towards. This penny pinching will result in the NHS losing many dedicated and experienced doctors it has spent hundreds of thousands of pounds training, and is further increasing the flood of hospital doctors into general practice.
Your excuses please.

Testing

yes you are dear

Mr Johnson,
Perhaps you would like to explain your "personal NHS offering maximum choice" when surveys show that the majority of patients want to be treated at their local hospital and aren't much interested in the choice of further flung places?
Isn't it the case that the NHS is a very expensive burden that the government has to shoulder, and that what you would really like is to start privatising it as much as possible? And isn't it also the case that the huge amounts of negative press you are giving to GPs is a part of trying to make primary care as unpopular as possible, easing the transition from free at the point of service care to pay as you go polyclinics? Can you admit that the government, when negotiating the new contract, were wanrned by GPs that if we were given targets to achieve, we would achieve them; so it is a bit unfair to whinge when we do in fact hit those targets and our pay goes up in accordance with you contract? Yes, we are expensive, but you made us that way. Shame you can't pay the nurses, porters, and so on a wage equal to their hard work too.
Is it possible to see that as much as the politicians want shot of the NHS, we'd be quite happy to see the end of the politicians making headline grabbing 'initiatives' instead of addressing problems that need solving.
You shut down 2 of our local Cottage Hospital 2 years ago, and we have had an almost constant beds crisis at the local DGH ever since, with patient care suffering as a consequence. Today I had to argue with that same DGH to keep a patient in because the family could not cope with him at home; had my Cottage Hospital been open I would have kept him there. The hospital had no quarrel with the fact that the patient needed admission, they simply had no beds.
The NHS is a money pit, I agree, but the moeny thrown at it if often thrown in the wrong direction, from the ridiculously over budget computer system to costly consultations with management directors over whether or not the Health Board will save a few quid shutting a Cottage Hospital.
Oh, and while you're here, perhaps you can help me: where am I going to find child care for my 2 children for me to work the extended opening hours that our patients have never asked for, for which there will be no lab back up, and potentially no out of hours coverage for either. The same goes for our receptionists who will be manning the desks - possibly on their own, late at night in an isolated rural practice.
Thanks so much.

Hello Alan, I've got a little tip for helping with the superbugs. When my sister did her nurse training in the late 60's woebetide if they went home in their uniform never mind pick the kids up, go for a Tesco shop, stuff their pockets with goodness knows what. Nurses are bloomin marvellous but they look like cleaners. Elderly patients in particular can't work out who is who.

Btw closing down my local A&E means if I have a heart attack I have a 45 minute journey before I get any proper help. Oh yes, I know the paramedics are trained but a ride down country roads ain't gonna help me much.

I've got another tip re dealing with superbugs. How about making sure the cleaning staff actually clean? I was in hospital for ten days following the botched birth of my son - for the entire time a huge clot of blood - like a piece of liver - from another mum remained lodged in the plug hole of the bathroom I had to use. (Fortunately I was only allowed showers at that point.) I was way, way too ill to deal with it - and, more to the point, why should I have had to? It was visible to anyone who used that bathroom - that it was never cleaned up (in what is considered a flagship hospital) gives a massive pointer as to one area that needs dealing with sharpish. So what steps are you taking to make sure hospitals are cleaned properly on a daily basis?

it interests me this cleaning bit.

I mean WHY should it be any different to years gone by? Maybe the cleaners aren't being managed properly, paid enough, what?

I mean, you've got managers coming out of your ears, but they just don't seem to be, er, managing .....

As I understand it, cleaning is contracted out in many NHS hospitals. Not surprisingly, it isn't done well.

That is surely one thing that can be changed?

The Project 2000 way of training nurses has led to a reduction in their practical skills ,a ward full of health care assistants some trained to NVQ3 level some untrained.

The trained nurse is left to do drug rounds and paperwork rarely clapping eyes on the patients.

I think HCA's are the backbone of the ward and the NHS would fall apart without them ,but shouldn't the backbone of the ward be actual trained nurses?
Research based degree courses are unsuitable for such a practical job.

Bring back the old style nurses.British nurses used to be admired the world over for their exemplary training.Sadly this is no longer the case.

So my question is ,will you change the way nurses are trained to allow them to actually care for the patients not the paperwork?

Mrs Pnut - very good question indeed. We are in Scotland and will having to spend a lot of money to attend AVT. Our DLA would cover the appointment cost but won't go anywhere near travel from Scotland.

Anyway, my own question to Mr Johnson is this. My one year old daughter is about to go on the waiting list for a cochlear implant. On the NHS she is entitled to only one implant yet she wears 2 hearing aids and is profoundly deaf in both ears. The first draft of the NICE report on implants recommended 2 for prelingual children but then withdrew that recommendation in the second draft. I wonder why. Could it be that the English PCTs campaigned for the recommendation to be withdrawn on cost grounds? I do understand that NHS resources are finite and need to be allocated on some sort of cost benefit basis. However, we are talking about an extra £20,000 per implanted child to give them a second implant which is effective for their entire life. Several other countries give 2 as a matter of course and the UK is lagging behind. Would Mr Johnson be able to comment on that?

Finally, on a more positive note, we have been extremely well supported by the various healthcare professionals involved with us as a family. She was diagnosed through the Newborn Hearing Screening Program. I cannot stress how glad I am to have had such an early diagnosis for her and I think the UNHS Program is a very good thing indeed.

1. When will the government stop pretending that seeing a paediatrician with an interest in allergy is adequate? My child has seen both allergy consultant and paediatrician (we moved) and there is no comparison. I would like to chose a hospital with an allergy consultant but I don't have that choice!

1. Alternative medicine is sometimes more cost effective than traditional medicine. Why not allow doctors to prescribe it when cheaper?

1. Please look again at the provision of dental care, if you move it is almost impossible to find an NHS dentist.

Dear Mr Johnson,

I too would also like to know about nurses pay. We are encouraged to no longer call the people we treat patients, instead clients or service users. Quite rightly we are constantly striving for a patient centered approach. We are criticised for not smiling enough, the state of our attire and for poor hand washing skills.

We are expected to take on extended roles and do more and more, paperwork and computer work levels constantly increase. And yet we are expected to do all this, smilingly when we are becoming worse and worse off due to below inflation pay rises. The recent changes to taxation means again that nurses working part time are even worse off. Unfortunately our main trade union has no backbone. I fail to see any other reason why we are valued less than teachers, say.

Also If I can raise the subject of budgets. As I understand it, the ward budget has to allow for many factors. If we have a client with expensive dressings it comes out of the wards budget. Some dressings cost thousands for a relatively short course of treatment. Some wards are more likely than others to require this type of dressing and therefore the budget suffers. Another rising cost seems to be the use of interpretors, which can cost hundreds of pounds for only a few hours work.

Also I work on a ward where the nursing staff is mainly made up of young women and there also seems to be something in the water! There have been up to four or five members of staff off on maternity leave at any one time, when the budget only allows for two. Therefore the ward budget paying for maternity leave, plus the extra cover costs incurred by this leave means that the money left for basic supplies and equipment is diminished, basically affecting client care. How can this be fair? Could there not be a central budget within each hospital to cover costs like these, which probably balance out over the whole NHS trust?

I'm sure I don't need to tell you that nurses are feeling very demoralised and undervalued. Surely for the government to want NHS clients to receive the best care this issue needs to be addressed and steps made to improve it?

Dear Mr Johnson

Why is the breast cancer survival rate in this country so low compared with other western countries?

Hello Mr Johnson

Why do the PRESCRIPTION CHARGES go up in England

BUT down in Scotland

??????

Why is that fair???????

Thanks

RTKM

.

Agree with the cleaning - had a cleaner come through the ward regularly (not sure why it had to be before 6am), but while she might have been able to tick a box to say that she pushed tbe broom around, no actual dust/dirt was in fact removed, just rearranged. And don't let me get started on the state of the bathrooms.

At the time I just wished Hattie Jacques would come along and lay down the law - these were obvious and fundemental problems...

And this is not to disparage the understaffed nurses or the cleaners who were probably inadequately trained contractors, but someone must surely be responsible for checking that things are in fact clean. Who are they and why are they not doing this? Not rocket science.

helo mr johnons
i am poorly

(p.s is he the one wiht the groovy son?)

Why is it that despite obesity being a massive problem in this country and one which will surely put a huge strain on the NHS due to associated health risks such as diabetes, heart disease etc, do GPs not really take this seriously enough?

Why are GP's allowed to charge patients ridiculous amounts of money for a signature on a form?
It doesn't take up hours of their time does it? In most cases, the recptionists fill in any bits of the form that need filled in and all GP has to do is sign it

Why do you not get a antenatal scan until 20 weeks in Bristol, this is very close to the abortion deadline should a woman need to have one and your family, friends and employer would know you were pregnant by then.

Hi Mr Johnson.
Am I the first person to post a message?

I am 27 weeks pregnant expecting my 3rd child. Are you going to give mothers the choice of going private if they are not happy about their local maternity provision? I have had horrid experiences with my last 2 births that my husband and I are looking to see if we can afford to have the baby privately this time round.
I cannot go to the other side of London to a better hospital because they are over stretched. What advise would you have for me? thanks

Why are formula companies able to advertise follow on milk for 6 month old babies as it is not classed as a breastfeeding substitute?? You are not able to give cow's milk to babies until they are one year's old, so how is this not a breastmilk substitute?

Sexually Transmitted Diseases are increasing. Most sexually transmitted diseases can be cured if they are diagnosed and treated in their early stages so why is access to genito-urinary medicine clinics so difficult and insufficient education being given in schools.

Hi all,
We asked Alan Johnson to send a few advance answers through - as it's unlikely he's going to be able to cover everthing in the alloted time. Here they are for you to digest. He'll be back in an hour or so to talk more.
Best,
MNHQ

Alan Johnson:
Hello everyone, and thank you for inviting me to Mumsnet. I probably won?t have time to answer all of your questions, but I?ll do my best to get through as many as I can ? I?ll start with a few that were posted yesterday.

Several of you asked about breastfeeding, and support for mothers who want to breastfeed. I agree that breastfeeding is best for babies, and the government recommends breastfeeding for the first six months of a baby?s life. More mums do breastfeed now ? more than three-quarters ? but breastfeeding rates are lower among mothers under 20 and those from disadvantaged groups, and so apart from all the other benefits, increasing breastfeeding will help us tackle health inequalities ? a key Labour government priority. Our recent Obesity Strategy highlighted breastfeeding as a key way of reducing childhood obesity rates, and we?re doing a number of things to promote breastfeeding as the norm for mothers. A lot of that is about education, with an information campaign along with continued support for National Breastfeeding Awareness Week, a National Helpline for breastfeeding mothers, and work to ensure that maternity units have an environment that supports breastfeeding. But we also want to do more to encourage employers and businesses to support employees and customers who breastfeed.

A few questions about dentistry ? I know lots of people are concerned about access to NHS dentistry, and we do need to increase access. But we should acknowledge the wider context: children?s oral health is better than it?s ever been. We are making real improvements, and we?re allocating more money to NHS dentistry, ring-fencing dental budgets until 2011, and demanding that Primary Care Trusts deliver year on year increases in the numbers of patients accessing dental services. Also, local health services now have a duty to provide urgent dental treatment to those who need it, so you can get treatment if it?s clinically necessary, even if you don?t have a regular dentist. And we?ve simplified the system of charging for dental treatment, replacing the old system of almost 400 different charges with just three charge bands and cutting the maximum charge by 50%. By the way, as you probably know, children under 18, pregnant women and women who?ve had a baby in the last 12 months are among the groups entitled to free NHS dental treatment.

On maternity services and midwife shortages ? the birth rate is rising, and we need to keep pace with that. We?ve recently announced £330 million in extra funding for maternity services over the next three years, and that will pay for a substantial increase in the number of midwives ? an extra 1000 by 2009, and an extra 4000 by 2012. That includes encouraging former midwives back into the profession with a ?golden hello? package with a grant, free training and help with childcare and travel costs ? we want to bring back the expertise of good midwives who?ve left the NHS. This will help us with our commitment to deliver by 2009 choice for all women in where and how they have their baby and what pain relief to use, depending on their circumstances. We?ll also give more choice in antenatal and postnatal care.

Sfxmum asked about MMR ? why not make single vaccines available on the NHS? Well, the simple answer to that is that MMR is safe. There just isn?t any credible evidence linking MMR to autism and bowel disease, and more and more evidence that there is no link. We have to base our policies on the evidence available, and the evidence says that MMR is the safest way to protect children against measles, mumps and rubella. We don?t offer single vaccines because this involves more appointments, and more chances that children will miss appointments or catch measles, mumps or rubella in the gaps between the vaccines ? if we offered single vaccines, more children would get ill. About 85% of children have received their MMR vaccine by their 2nd birthday, and this figure is going up. That?s good news. But obviously lots of parents are concerned: getting the facts on MMR is really important, and for more on this you should visit www.mmrthefacts.nhs.uk.