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.

To sfxmum and others who've asked about our policy with regards to mis-carriage - it seems to me from your comments and from talking to the Mumsnet people here that we really should seek to ensure a common set of standards across the country. I think I'm in at the start of a new campaign and it's something I will talk to Ministers about when I return to the Department. Mumsnet have informed me that I will not be allowed to forget this issue!

What plans do you have for improving our (I use "our" in the loosest sense of the term) Health Visitor service.

They appear to be shockingly understaffed, training, knowledge and clinics vary wildly, and a different system seems to be set in place from borough to borough.

One of the biggest bugbears parents have on Mumsnet is due to incorrect information disseminated by Health Visitors. I note that another parenting website has teamed up with Health Visitors. I am concerned that a question be asked, and then the thread closed so that you cannot see what advice is being handed out to this person, which in my view, isnt a step forward.

Your thoughts?

Have you gone, mate?

I actually think you'd make an excellent leader (deffo the housewives choice not that I am one).

And I do actually see some improvement in health services in my area (though it started from a pretty low starting point). So much more needs to be done though.

I have a (totally selfish) question about testing for gene mutations. I need a test (my Genetics Consultant says so) but my hospital won't fund it. My sister's hospital will. The difference is purely geographical - I'm in Bath and she's in Cambridge. Why does this happen?

farking hell Starlight, that sounds like Baghdad A&E at the height of their erm, liberation.

or do you think it was A&E Gaza stylee.

Just to clarify, I ask about health visitors as they are the only point of contact for mums to ask questions about child's development etc before child starts school. In my area, Barnet, my 3yr old wasn't seen after his six week check until he was 2yrs old (and then only because he was home when the health visitor was checking my 10 day old baby. Also, my baby is now 14 months and hasn't had a 1 year check up and there is no sign that any clinic near me will offer one. Is this really right in a developed country?

god heavens VVV, it isn't just Health Vis. who have crap breastfeeding knowledge, none of the midwives I have encountered and seen plenty of posts here on MN where the Midwives are just as inept.

this is partly why formula has to stop being advertised to hcp's and they should be given proper training in bfing.

they, like HVs do not have to update their knowledge

are you still listening Mr J?

Indeed Starlight. Chase Farm is one of the worst hospitals I've had the misfortune to be in (and that beats having a bed in Edgware General with squished cockroaches next to it).

Yet recent reports and reviews of its maternity services have flagged it up to have done quite well. This is entirely in conflict with experiences I, and other mothers have had there. I suspect that Alan Johnson has gone, but I'd like him to look into this if he could.

The attitude of some members of staff were so appalling it reduced me to tears at a time when I really needed some support and help. I dont understand how surveys and reports can be so wildly different to my two experiences of maternity services, and several experiences at A & E.

To ktmoomoo - the most common complaint about postcode lottery is the availability of drugs but you have pointed to another aspect relating to procedures. The policy is that once NICE has approved a drug or procedure it should be available everywhere. This is an area that we are considering addressing in the NHS Constitution that we plan to publish on the 60th Anniversay of the NHS in July. There is a problem in respect of the amount of time that it takes for NICE to properly consider whether to licence drugs or procedures. In the period upto licencing PCTs have discretion. I think the way we should seek to resolve this, particularly with cancer drugs, is by speeding up the NICE proceedure, if we possibly can. One final point on this - if the NHS isn't to be a hugely centralised command and control system so that it can be clinically led and locally driven there are bound to be differences between different regions of the country. But this shouldn't relate to the availability of drugs and procedures as I've mentioned above. Many people have asked about Scotland - I support devolution. It was a Government policy successfully implemented and we cannot complain that having devolved power, the Scottish Executive decide to do things differently. However, the basic principles of the NHS haven't changed and issues such as free prescriptions and car-parking etc whilst important do not represent the central issues around which the NHS is established.

Oh I agree Kiski, but the are classed as a slightly different resource so I wanted to clarify the distinction between the two, even though both services are sorely lacking.

sigh< I obviously always ask really pants questions. Either that or I don't speak loudly enough. ahem

To cmotdibbler and monkeybird - I wish the issue of health care acquired infections was as simple as who does the cleaning. Unfortunately, it's not. In the worst case, which was Maidstone and Tunbridge Wells, the cleaners were directly employed. We find examples of hospitals which have completely overcome the problem where the cleaners are contracted. I think that the important point about cleaners is that they must be a central part of the NHS team and feel valued as such. Five years ago, hospitals felt that cleaning should only be done at night or when there was as few people around as possible. Now everyone wants their cleaners to be visible. As I saw at the Royal Free yesterday, where they do have directly employed cleaners, it's the way cleaners are treated that's important. Many hospitals are going back to directly employed cleaners but, as I say, there's no evidence to suggest that contracting out was the major cause of the rise of superbugs.

If you haven't gone Alan, I would be more than happy to share with you the horrors that I endured during my three miscarriages. If you would like to think about how it is to be told that your baby has died during a routine scan, left in a room filled with pictures of babies for a hour when you then find that they have forgotten about you, and then sent on your own to traipse through a hospital to then explain yourself what has happened to more staff, then that was just the start of my first miscarriage and it got worse from there.

Please, please, anything that you can do to push the subject of care for women and their partners in this area would be wonderful - the MC Association do what they can, but with a budget of only 200,000 a year to do the only real support and information for families they can't do a lot.

so alan , wat can i do to get my opperation or do i have to keep waiting till lincoln get their act together , is it worth apealing again

Oh! You're still here. Please excuse me!

flossish

flossish know that feeling lol!

To Minerva1 and others - the biggest complaint that I hear is that there are not enough health visitors. I committed Government last year to increase the numbers and I'm working very closely with Ed Balls at DCSF to ensure that in Sure Start centres for instance we have the right level of cooperation with the health service which usually involves health visitors. The issue about quality of training hasn't come up as often but I will look into this particularly as it relates to the earlier point about breastfeeding in general and a feeling that perhaps very good professionals who have been in post for a long time are not being kept up to date with new developments.

Oh, and absolutely - its not about so much who the cleaners are employed by, but how they are empowered to make decisions, the area they are expected to clean per time unit, and whether they are paid enough to recruit and retain staff who wish to and can do a great job.

I'm glad that you saw that for yourself at the Royal Free, although I'm sure they didn't show you the parts of the hospital which are in such a poor state that no one should be expected to work there.

whispers: he's not doing too badly eh? better than some we could mention...

lol tutter

very quick comment:

i had excellent labour care with both of my children - really

i had shocking postnatal care. this is common, according to my unscientific poll of friends

i understand that problem re not enough hv's alan.

however, if they do decide to get more, can they also have proper training? especially in infant feeding issues - erm, breastfeeding.

not having myths handed down from the old hands to the new ones. and certainly not cross-fertisilised withinformation propoganda provided by the formula companies.

cmotdibbler, like the Queen and roses, I imagine AJ has a permanent smell of bleach and Purell handrub up his nose...

Thank you more health visitors would be great. I shall wait to see if it materalizes in my area. Please please read the rest of my post too, even if you don't directly reply. I feel really strongly that we should be encouraging women to stay at home to look after their children (as they do in many European countries - see France) rather than put them in nurseries, institutions at such a young age to the detriment of social behaviour and standards in general. I know everyone here is complaining mainly about NHS services for maternity/miscarriage/children/cleanliness and all that and it needs attention but please think about changing the way our society works and views children. It would dramatically affect our future for the better I believe. Read any Steve Biddulph to understand!! Great to see you on here by the way. Hope you take away lots of useful stuff and act on it!