Health charge plans threaten women's health

The UK government plans to extend charges to primary and emergency care - and maternity care.

In March the government plans to publish details of how it intends to extend charges for healthcare services to emergency and primary care.

GP consultations will still be free, but services like minor surgery or physiotherapy might be charged for.

And while ministers have assured would-be patients that they will not have to pay for emergency treatment at the time, from 2015, they are likely to be faced with a bill afterwards.

Patients from overseas are also expected to have to pay higher fees for NHS-subsidised services like eye care, dentistry or medicines.

These changes will affect some classes of migrants, such as those coming from outside Europe without indefinite leave to remain, short-term visitors from outside Europe, visa overstayers and failed asylum seekers, who will have to pay for NHS services.

The government plans to eventually introduce a Visa Health Surcharge for these groups - once paid, NHS services would be available to them on the same basis as the will be to residents.

These changes come on top of charges for NHS services introduced in 2011 for non-European migrants not 'settled' in the UK.

But it is not clear whether those with private health insurance would be exempted.

Maternity Action, which campaigns for the rights of pregnant women and new mothers, is concerned about the lack of clarity surrounding private health insurance, and worries that maternity care is often not covered in these policies – leaving pregnant women and new mothers exposed.

Last month Maternity Action published research which suggested that thousands of migrant women were leaving antenatal services and giving birth at home, or turning up in hospitals in labour and with severe complications.

Pregnant asylum seekers already have worryingly high rates of maternal morbidity and mortality.

Maternity Action’s director Ros Bragg told the Guardian recently: “"We are in contact with a lot of midwives who tell us women are disappearing from antenatal care because they cannot pay for it.

“This is unacceptable. We are very concerned about the charging arrangements currently in place."

Susan Bewley, professor of complex obstetrics at King's College London, told the Guardian that  the policy of charging migrant women for NHS antenatal care put pregnant women in danger.

"They may be put off accessing antenatal care that's good for them and their baby. If health professionals misinterpret their duties towards this group of women they might not come for scans, other checks or to deliver their babies," she said.

"We know that when women fail to access early antenatal care or any care at all, it can lead to poor outcomes for the mother and the baby," she continued.

"We live in a civilised society. It is dangerous not to look after pregnant women properly and not doing so reflects very badly on us all."

Story published in Women's Views on News, February 6, 2014

Parental leave reforms don't go far enough

Paid leave for prenatal appointments, provisions for breastfeeding and equal pay for parental leave missing from new regulations say campaigners

Last week the government announced changes to parental leave rules which will give women a right to up to a year’s maternity leave, but enable her to return to work after two weeks if she wishes and share the remaining leave and maternity payments with her partner, as long as they qualify.

Fathers will be entitled to unpaid leave from work to attend up to two ante-natal appointments, and adopters will be entitled to the same pay and leave as birth parents.

All employees will now be able to request flexible working.

Ros Bragg, from Valuing Maternity, a campaign for better employment protection for pregnant women and new mothers said: “We are really pleased that women’s rights are protected for up to 52 weeks of maternity leave and that women have the option to share leave with fathers and partners.

But she added that the campaign had concerns about other aspects of the reforms.

In a guest blog, Emma Pickett, lactation consultant and co-chair of Association of Breastfeeding Mothers, called for clear rights to breastfeed on return to work.

In the UK, a breastfeeding mother had the legal right to ‘rest’ but not to express and store her milk.

Health and safety guidance might suggest that an employer could provide a room and a time for a mother to pump but they are only required to allow her to rest.

“We don’t want to rest. Give us 10 minutes to use our double electric breast pump perhaps 3 times in a working day and most of us will be able to continue to give our baby’s breast milk for as long as we want to,” she said.

“It will make continuing to breastfeed while working normal and manageable. We need never assume that a woman returning early to work would of course be ending breastfeeding.”

Valuing Maternity produced a checklist of measures which would promote real equality in shared parental leave.

These include paid time off for fathers and partners to attend anti-natal appointments, four weeks paid leave for all fathers and partners and statutory pay for paternity leave and additional paternity leave to match maternity pay.

We should be valuing pregnant women and new mothers, not sacking them

Story published on Women's Views on News, August 16, 2012

A few years ago I attended a friend’s baby shower.

My friend told the group that one of her husband’s colleagues had been made redundant because she had a young child and was unable to work until 8pm like her male colleagues.

She worked for a large City bank in the UK and received a big pay-off. Some of the women said that they would be delighted to be made redundant.

Now one of the women has herself lost her job because of pregnancy. She is among 30,000 each year who are sacked or forced to leave their work because they are pregnant or looking after a young child.

A further 200,000 are treated less favourably because of pregnancy or maternity, according to a study by the UK Equality and Human Rights Commission in 2005.

Valuing Maternity is a new campaign set up in the UK to fight maternity discrimination and improve services, information and support for pregnant women and new mothers.

Supported by the Maternity Alliance, unions like the National Union of Journalists and UNITE and advice groups like the Citizens Advice Bureau, it is encouraging women to tell their story.  Trudy’s is typical.

Before she became pregnant, Trudy’s boss said she was an excellent worker.  Her company was entering her work for national awards, and during her pregnancy her manager assured her that she would be able to return part-time.

As her maternity leave came to an end the boss changed tack and insisted that Trudy would not be able to fulfil the travel commitments of the job and suggested that a freelancer, who had been covering her role, should be retained with the same job title and equal responsibilities.

“My life was made absolute hell.  I was constantly undermined by the person I was sharing a job title with,” Trudy says.

“Meetings were held without me being there – even when I was in the office. I wasn’t included in conversations essential to the running of the business.”

Her work was often changed by her colleague at the behest of her boss.
“In short, I was seen to be no longer the trusted, respected employee I was previous to having a baby,” says Trudy.

It all came to a head when her manager suggested that the freelance colleague should be promoted to a position above her, taking on Trudy’s responsibilities and leaving her with the less important work.

Trudy saw this as an attempt to demote her and launched an appeal with the support of her union.

While this was happening Trudy continued to work to the best of her ability. She did not take time off, even when she or her child was ill.

“My confidence was shattered.

“On a personal level, it affected my home life with my partner and child, and I would often be depressed and weepy on my days off.”

Eventually Trudy took a job in a less prestigious department.

“I did feel that I had to compromise my career and I strongly feel that I could have continued in my previous role and excelled,” she says.

After nine months working at the new job, she became pregnant again and is now on maternity leave. Her current manager is also a mum and extremely supportive.

“I have no doubt that after my previous maternity leave, my manager was actively trying to get rid of me and she was uncomfortable with employing mothers.

“I strongly believe that it was viewed by my managers that in becoming pregnant, I had decided to sacrifice my career; that as soon as I was a parent it somehow changed my commitment to work and my ability to do my job. I couldn’t disagree more!” she concludes.

Louise Taft, a solicitor at Prolegal, says she has seen a rise in maternity discrimination cases since the onset of the recession in 2008.

“When the economy goes bad, the number of unfair dismissal cases as a whole goes up, but the proportion of pregnancy discrimination cases is about the same.

“We find many women are discriminated against when they have pregnancy related illnesses,” she says.

Ros Bragg, director of Maternity Action, says the number of women seeking advice from her organisation has more than doubled in the last year.

“The redundancy process is used as a way of shifting pregnant women and new mothers out of their jobs.

“The processes can be complex and this can make it difficult for women to prove they lost their jobs due to pregnancy discrimination.”

Bragg says that the law offers women relatively good protection against discrimination.  The problem is with compliance.

“Many women are not aware of their rights. Few are able to access advice when they need it particularly in light of cuts in advice services.

“Few have the personal or financial resources to pursue a case in late pregnancy or when looking after a new baby.”

Bragg says the Government should send a clear message to employers that they must comply with their legal obligations to pregnant women and new mothers.

“Unfortunately we are seeing messages from Government that pregnant women are a burden,” she says.

Well funded advice and information to enable women to exercise their rights and research into the effects of pregnancy discrimination in different industry sectors with targeted intervention to address this is also vital.

Bragg says in the absence of up to date research it is difficult to say which sectors are the worst offenders, but believes that women in the care industry may face particular problems.

“A lot of women are care workers and there is very poor practice in relation to manual handling in these jobs, leaving pregnant women having to choose either to leave their jobs or move and lift people or heavy equipment,” she says.

“Women are often very anxious that they are perceived as trouble makers when they are merely asserting the rights assigned to them in legislation. This reflects very negative attitudes towards pregnant women in the workplace at the moment.”

Bragg believes that discrimination faced by migrant women is often compounded when they become pregnant.  Maternity Action recently published an advice leaflet in Polish, as they are one of the largest groups of women from abroad having babies in the UK.

“Demand has been enormous. The number of downloads has been greater than the number of Polish women who had babies in the UK,” she says.