Woman's Hour - Women in business and three tier lockdown. Working as a midwife. Patricia Devlin. Children's play in hospitals.

Episode Date: October 13, 2020

As the new three tier Covid lock down system comes into force in England we talk to some of the businesses which’re now facing stricter restrictions. Hannah Butler who runs the Victoria Hotel in the centre of Nottingham – a city which is now in the high risk tier - and also to Tanya Harrison who runs a hair salon in Liverpool which is now in the highest risk tier. And as the Northern Ireland executive meets today to agree what new measures are needed to curb the steep rise in covid cases there, Tina McKenzie from the Federation of Small Businesses will assess the economic impact of any new restrictions.In her book Overdue: Birth, Burnout and a Blueprint for a Better NHS, Amity Reed describes what led her to becoming a midwife, in particular her desire to properly support and care for women throughout pregnancy, birth and postnatally. The reality of working in over-stretched and underfunded NHS maternity service soon shattered her illusions. The former midwife joins Jane to talk about her experiences as a midwife. A journalist who writes about paramilitaries, has made a formal complaint to the Police Ombudsman for Northern Ireland because investigations into threats she’s received have come to nothing. A year ago Patricia Devlin, who’s a crime journalist for the Sunday World, was posted a message on Facebook saying “Don’t go near your granny’s … Trisha. You will watch your new born get raped COMBAT 18!” It’s not the first threat she’s had but it’s the first time her baby’s been threatened.Lisa Beaumont has just been awarded Health Play Specialist of the Year from The Starlight Children’s Foundation, for her work at Leeds Children’s hospital. She joins Jane to discuss the help she provides to seriously sick children, and the impact coronavirus is having on the service she can provide. Presenter: Jane Garvey Producer: Dianne McGregor

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BBC Sounds. Music, radio, podcasts. Hi, this is Jane Garvey and welcome to the Woman's Hour podcast from Tuesday, the 13th of October 2020. Hello, good morning. Welcome to the programme. Today, Amity Reid is with me. She's American. She's the author of Overdue, Birth, Burnout and a Blueprint for a better NHS. She spent three years working as a midwife in the NHS and she's got a lot to say about the way the system works and how it could be better. So looking forward to talking to her this morning. We also welcome Lisa Beaumont. She's Health Play Specialist of the Year, has done some wonderful work over the years at Leeds Children's Hospital,

helping the patients there to enjoy play, even though they're obviously not in the best of health. So Lisa Beaumont with us this morning as well. But we have to start with the big news of the week, really, the new three-tier COVID lockdown system, which comes into force in England tomorrow. We're going to talk to three women who are up against it, very much in the thick of things at the moment.

Tanya Harrison is the owner of Harrison Hair Studios in Bootle in Liverpool. Of course, Liverpool is now at Tier 3. That's the highest risk. Hannah Butler is with her mum running the Victoria Hotel in Nottingham City Centre. Nottingham is at high risk Tier 2. And Tina McKenzie will join us too from the Federation of Small Business in Northern Ireland. The Northern Ireland executive meets today to decide exactly what Northern Ireland is going to do. Steep rise in cases of coronavirus there this week.

Let's start then with Tanya, because Liverpool is officially at the highest level of risk, tier three. Tanya, your hair studio is in Bootle, so not in the city centre. But how are you feeling about everything this morning? Yeah, do you know, it's a little bit worrying, obviously, for everything that's happening with all the bars and restaurants and things like that closing. Hopefully, they won't close us down.

But, you know, obviously, if you've got to close, you've got to close. And this is what we're looking at every single day now. Every day we're sticking to all the guidelines. You know, we're socially distancing. We've got full PPE with all our staff and all our customers. So it's, you know, we're just fingers crossed and just taking each day as it comes obviously the dryers are in full operation in the background there so people are still sorry no that's all

right no people are still coming in but it's not the same is it i know myself when i go to the hairdresser which i used to really enjoy it's not the experience it used to be, no matter how hard everyone's trying. It really isn't now. It's totally changed from not getting your cup of coffee. We've got takeaway cups now. We've got a tea room next door, so we get all of our stuff from there. It's everything's takeaway. We've got our magazines, which are on Q&R codes, which you've got to download on your phone

so it's not the same as sitting there with a nice magazine on your lap and when you're getting your hair blow-dried you've got your mask on you've got you know it's it's very we're very strict as well but you know most of our clients are all coming back they're feeling confident and they're feeling comfortable and we're just trying to make it a good experience is what we can a lot of people are very concerned for the economy of the liverpool area and you yourself you're in bootle so you're not in town in liverpool have you been into the city centre much i've been in once or twice and it is it's it's totally different it's it's just totally different. It's just totally different now in the city. The first time I went in was shopping with my children,

getting the school uniforms, and it was a totally different experience when you're walking around with masks on and stuff like that. And, yeah, everybody... I think everybody's trying to keep upbeat here, but obviously with everything that's going on it's a bit difficult isn't it? And in terms of the business are you worried about your future economically?

How are things there? Oh with us you know like I said we're just taking it in our stride I've took on a couple of extra staff since we've come back after lockdown because we've opened a beauty part of the salon.

Oh, she was just going into the spot. Now I'm thinking, oh God, was this the right thing to do? Yeah. Is this the right thing to do? Going for beauty, because beauty was the last thing that opened. I've got to pay my staff and I've got to send beauty therapists

to home and everything, so it is a bit scary. I'll leave you to it. Thank you very much. That's Tanya Harrison. Let's bring in Hannah Butler, who runs the Victoria Hotel, right in the centre of Nottingham. Hannah, your family's been involved with this place for over 20 years, but this must be a very challenging time for all of you. It is. It really is a challenging time.

Like the lady said before, very worrying. We've got a lot of staff that we want to look after, customers we want to keep safe and obviously still keep running the business. Nottingham is at Tier 2, which actually, from your point of view, from the point of view of running a business, isn't the most helpful, is it?

No, Tier 2 is like being in limbo. They're putting so many rules in which make it very hard for us to trade to a capacity where it's worth being open at some point. Go on, just tell me more about that. You know, with the new rules especially coming in tomorrow, it'll be interesting to see, with only families being allowed in, the footfall that comes through the door. Because it is such a social place, the British pub, it's where people go to meet other people outside the household, eat and drink.

So the effects of sort of being half open are really going to be showing after tomorrow. And from your point of view, the responsibility of all this, what is keeping you awake at night? Everything from PPE to track and trace to the staff we've got, making sure they're safe, like I say, keeping the customers safe. It's everything. It's really, really stressful. everybody is in the same boat especially in hospitality it's a hard industry at the moment do you feel that hospitality is being unfairly picked on here i do definitely um you know everywhere i've been especially is is so good everyone's being very covid aware and safe there's probably the small amount of places that aren't,

but going to the pub is a safe place to be with the social distancing measures that we've got in place and the sanitising of hands, staff wearing masks. It does feel like we're being sort of targeted a bit, I must admit. What would you say to politicians? I targeted a bit, I must admit. What would you say to politicians? I don't know. I mean, you can you can tell me, were you a political person before all this? Not so much. Not so much. I mean, they've got an incredibly hard job. I understand that. And they've got to do what they think is best for everybody. But this sort of tier two, it just,

I'd rather they sort of say, you just completely need to lock down rather than like sort of pushing businesses to visit to a pub, which seemed like the easiest thing in the world, it's just not that simple anymore. You've got to think it through. You have. I mean, we're very food led as well. We do a lot of food. So we have that trade. But I feel for the pubs that are literally just drinks and that rely on, you know, the people coming in and having a couple of pints together after work, it's going to hit them even harder than it's hitting everybody else. What are your regulars telling you when they come in? I mean, our regulars have been brilliant. They've been following all the rules, but obviously it's not nice for them.

They all want to be able to sit together and socialise together, and they can't do that. So it's just not the same experience. And do you find yourself acting as a kind of informal referee? Are you even at risk sometimes going up to people and saying, no, I'm afraid you can't sit there? I mean, the staff that we've got have been brilliant and they have come up against a small minority of people

who've not been willing to sort of separate. But obviously, we just won't serve people that won't comply with the rules. But to be fair, most of our customers have been brilliant, have been really supportive and listened to what we've been telling them and followed the rules. Well, I've got a tweet here from one of your regulars, Hilary. I go there regularly, she says, to the Victoria. It's the safest place to be in Beeston Nottingham there you go yeah she a friend of yours Hannah? I think I know who it is yeah she's been a regular here for a long long time. Oh no good for her I mean you need them just hang on in there for a moment if you don't mind. Tina McKenzie in Northern Ireland from the Federation of Small Businesses

small business what do you expect to hear later on today Tina and what do you want to hear? Don't mind. Tina McKenzie in Northern Ireland from the Federation of Small Businesses, Small Business. What do you expect to hear later on today, Tina? And what do you want to hear? Well, we've got an executive who are getting advice from the chief medical officer to say they would like and it's been leaked to say they would like a complete shutdown for several weeks. It's reported here they've asked for six. I don't know if that's correct or not, but that's been what's reported in the media. And I think the executive are really struggling to come together and agree what they should do. You know, we've got a tiny population of 1.8 million, a very good geographical spread, you know, in terms, it's not like GB with lots of big, big cities and a very, very tiny economy that really relies heavily on small businesses.

So I think they're wearing the responsibility heavy, Jane. And I suspect what they may come out with is a complete two or three week shutdown. Of everything. Of everything. I suspect that that's what's coming. And even though I know that a lot of them don't want that because they don't want that impact on the economy, I suspect because we have at the moment, we have the worst numbers in the United Kingdom. For every 100,000, we'll have 336 cases. And that's more than double England. The average.

Yes. Yeah, the average yes yeah yeah the average the average in england um hannah said she felt the hospitality was being unfairly picked on we know tanya is having a relatively tough time although she's determined to be positive in in the beauty and hair industry what about your perspective tina in northern ireland those businesses dominated by women yeah and that's the thing when you you look at even the unemployment figures that are out today, the people that are really affected by this in part-time jobs, in retail jobs, hospitality, are primarily young people and women. And if you look at the amount of women that have become economically inactive through this period, even just in Northern Ireland. It is huge. So it's having a huge impact on women.

And also the lack of available, and I'm sure it's an issue right across the United Kingdom, but the lack of available, good, reasonably priced childcare is also having an impact on women because usually those responsibilities are then left with women on top of and everything else. In the case of Northern Ireland, you've got Arlene Foster and Michelle O'Neill there at the top of things. You can't say there aren't women right at the heart of government.

Oh, certainly not. And I don't think it's about, you know, I think caring about the impact this has on women is not necessarily just about being a woman yourself. And, you know, I think of some political leaders who were women who didn't really care that much about females in society. So, and other male leaders who did. So I think it's about us all having responsibility and knowing how this is going to impact. So if you're going to come along with rules and regulations

that say these industries, these businesses have to shut, then what we'd like to see is clear guidance on, OK, how long for? What is it related to? What does it mean when the numbers change? When will we go back to some sort of normality? And you still feel you're not getting that clarity? Oh, and even from the prime minister last night,

I think there is confusion. And, you know, the new three-tier system, if you look into it and you look at the new job support scheme as well, it is not so clear for businesses. I'd like to see wide-scale campaigns on television, on billboards, in the newspapers. Let's be absolutely clear about even the simple things, reminding people to wear their masks, wash their

hands. I think we should just be doing more and more communication. People aren't so sure. No more the rule of six inside, no more the rule of six outside, but even the ministers were confused when they're asked about it. And I think it's just a lot of messages coming at once and devolved nations are coming out with different messages and think about this Jane we're on a little tiny island here and you think about how successful New Zealand's been and just because there's a border so you know just because there's a political border we're doing something completely different to the Republic of Ireland you know so it's it's it's not joined up and it's not as clear as it could be. Thank you very much Tina the thoughts of Tina McKenzie from

the Federation of Small Business in Northern Ireland. She mentioned the job support scheme. Hannah, just a quick word from you on this. This is only applicable in tier three areas. You're in a tier two area in Nottingham, but you were saying that you're in a sort of no person's, no man's land at the moment. If you were to have the job support scheme, the government would pay two thirds of your employees if you had to shut down. Would that help you? It definitely would help. I mean, the furlough scheme last time enabled us to keep our staff on and bring them back after lockdown. So it's definitely needed if we went into tier three.

All right. Thank you all very much. Really, well, I was going to say enjoyed, but you know what I mean? I've appreciated your company this morning and thanks for telling us how things are for you. That was Hannah Butler from the Victoria Hotel in Beeston in Nottingham. You also heard from Tanya Harrison of Harrison Hair Studios in Bootle and Tina McKenzie from Northern Ireland, the Federation of Small Business there. You can get involved as well, of course, on email bbc.co.uk forward slash Women's Hour via our website. On social media, it's at BBC Women's Hour. Now, this is something positive and we all need that.

Lisa Beaumont. Good morning, Lisa. Good morning, Claire. Hi. Oh, my goodness. That's just what I needed, an injection of positivity and energy from you, Lisa. Thank you. Just been awarded the Health Play Specialist of the Year Award from the Starlight Children's Foundation. This is for your work at the Children's Hospital in Leeds. Now, Lisa, tell us how you got into this sort of work. How long have you been there? I'm very fortunate to be working at the Leeds Children's Hospital now for just nearly 32 years and I got into this job many years ago when I saw an advertisement in a local paper and thought wow that sounds really interesting and I think I'd like to have a go at doing something like that and I spent a period of time in hospital as a child myself

and so I knew what that felt like so I thought you know what I'm going to give it a shot and apply for this job and that's where it all started. I was very fortunate to be successful in that application. And that's where my journey began. Right. Now, tell us about when you were in hospital as a child. I don't imagine then that anything was laid on for you. Yeah, yeah. I remember, you know, quite well, not very having parents around very much, very little to do and you know often long periods of boredom and so you know when I did start in the role first off I was passionate that the children that I worked with had a more positive experience in their hospital admission and journeys so that's what we as a team here strive to do and hope to do daily with the children

that we work with. Well we'll talk about what's the reality of life now with Covid but before the pandemic what were you able to do? Yeah so we are very patient focused and we work with other members of our multi-professional team here at the Children's Hospital and we have a therapeutic approach with different elements with our play and we have our normalising with different elements with our play. We have our normalising play, which enables our children to have some choice. When often nurses and doctors are following treatment plans, they sometimes have little choice,

and this can often be the only choice the child has. And then we do therapeutic elements around preparation for procedures that need to undertake here at the children's hospital and then followed by distraction for those procedures and making sure that we're on the same level and that they've really got an understanding of what's happening and using a tool that's going to distract them and then afterwards some post-procedural play to help them recover so that would a nutshell, be the main four elements that we focus on as health play specialists here

at Leeds Children's Hospital. There must be some children who, however hard you try, and I'm sure you do, are just not ready to play. They're just not well enough. Yep, that's right. You know, we use and adjust our sort of play resources and skills at different levels. You know, previously, you know, I've worked with children that have maybe been non-verbal and we've communicated through a range of puppets or a range of drawings.

And it's sort of, you know, building up that relationship with the child that is, you know, the number one that we try to do to gain that trust, to gain and develop that relationship so that we can support them over the weeks or months that they will be attending here for specialised treatment. So it's really investing and we're very lucky that, you know, our role enables us to invest into the children and build those relationships. What about, obviously some children become special to you, perhaps because they're in hospital for a significant length of time. And one little girl went on to fulfil her dream and she became your bridesmaid. That's such a lovely story. Just tell me about that.

Yeah, yeah. So that was many years ago when I was working on a busy cystic fibrosis ward. And I worked with the whole team there and we did lots of fundraising to try and support and make a few wishes come through which you know for computers and trips away was quite easy but one particular girl had a wish to be a bridesmaid and you know I was very lucky and I said you know one day if I get married you'll be my bridesmaid and she didn't forget and I'm very lucky that when said, you know, one day if I get married, you'll be my bridesmaid. And she didn't forget. And I'm very lucky that when I did get married, she was my bridesmaid. And it was a very special day for both of us.

That's fantastic. But of course, right now things are tough. So what impact has the coronavirus had on the way you're able to operate, Lisa? Yeah, so obviously we have to follow our trust policies and guidance and we're guided by our IPC, but we remain very positive and very patient focused here at the Children's Hospital. While our playrooms may be closed, our activities continue at bedside and we've been very creative in, you know, developing things that we can do virtually, making sure all our packs are all individually and just making sure that those very important activities

are happening at the bedside and following all our IPC guidance. But vitally important that we remain very positive for our children in hospital and continue to work with our range of professionals here to support the family as a whole. Thank you so much, Lisa. I can see that you just, and hear certainly, that you obviously do your job brilliantly well. No wonder the children love you so much.

Thank you very much for being... Thank you. Take care of yourself and continued good luck in that fantastic role. That's Lisa Beaumont, the Health Play Specialist of the Year at Leeds Children's Hospital. Now, last week we talked to some job sharers. I thought these two were absolutely fascinating.

Chartered Engineers, Helen Simpson and Chandra Morby. If you didn't hear it, make sure you go back on BBC Sounds. They are two of the women at the forefront of Britain's first hydrogen train. Here's Helen. My favourite part about my job is the innovation and development of new technologies and trying to get those onto trains. And Chandra has a real passion for project management and delivery of critical projects. Tell us a bit then about the science behind this. How does a hydrogen fuel train work? Well, there are three main components that you need. Somewhere to store the hydrogen, so there's some hydrogen storage

tanks. The second part is a hydrogen fuel cell, and the third part is some batteries, and then there's a lot of complicated electronic control system to make the three things integrate together. And what happens is the hydrogen fuel goes into the fuel cell and it's combining hydrogen with oxygen from the air to make pure water and electricity. And it's that electricity that goes into the batteries and powers the train. It was your maiden journey last week, Chandra. How did it go? Well, it was very exciting. It needed a lot of planning to get the train onto the track and a big team worked very hard to make that happen. And Helen was there. I'm sure Helen can tell you exactly how it went on the day. Helen, any incidents? No, it was fine. There were a few technical last minute things that

always happen on this type of project but the team absolutely pulled together and we managed to go between a little siding that we work out of near Long Marston in Warwickshire all the way through to Evesham and got a top speed of 50 miles an hour which was amazing for the team because the the train is a prototype at the moment. Helen Simpson and Chandra Morby who are at the forefront of the UK's first hydrogen train project. Absolutely incredible. Don't forget by the way the Women's Hour Power List. This year it's all about our planet and about the environment and women who've done wonders for the environment in the UK. You'll hear who's on our list. Loads of people suggested by you on November the 16th. Really looking forward to that.

Tomorrow, Carla Bruni will be here, French songbird. On Thursday, we'll talk about a midlife diagnosis of ADHD. And on Friday, you can hear from Dolly Alderton, whose first novel, Ghosts, is just out. I am really enjoying that. So Dolly with us on Friday morning's programme. Now, the Irish journalist Patricia Devlin has made a formal complaint to the police ombudsman for Northern Ireland because she says

investigations into threats she's had have come to nothing. Now, a year ago, Patricia, who's a crime journalist for the newspaper The Sunday World, got a message on Facebook saying, don't go near your granny's, Tricia. And I apologise for this, but this is deeply offensive, but you need to hear what she was told. You will watch your newborn get raped, combat 18. Now, this isn't the first threat that Patricia Devlin has had, but it thankfully, I suppose we should say, was the first time that her baby was threatened in this way. I mean, it is utterly unbelievable. Patricia joins us now. Patricia, good morning to you. Good morning, Jane. First of all, I mean, it's just dreadful. I think we can all acknowledge

the hideous nature of the threat made to you. What did you do when you first received it? Well, when I received it, Jane, I was absolutely shocked. I felt physically sick. And the first thought that came into my head was, I need to report this to police. And that's what I did do. I went straight to the police station with the threat and I filed a formal complaint. And then what happened? From then an investigation was

launched. I was told that the suspect who I believed was behind it couldn't be approached until they had evidence. So in early January 2020 I was told that they had that evidence, that they had information to link this individual to the phone that sent it. And from there, Jane, absolutely nothing has happened. This person hasn't been questioned, let alone arrested. And since then, I've received more threats. I've received two formal notifications from police that my safety is at risk and nothing has been done and I don't know why. And unfortunately, I had to take this decision to file this complaint with the police ombudsman in a bid to find out exactly why police have not done anything in this investigation to bring this individual to account.

Right. So to be clear, the same police force that you say has not done much in terms of the investigation has also told you that there are other threats that have come your way. It seems rather odd. Yes. Well, I report on crime in Northern Ireland and a lot of that crime involves paramilitary crime. And I report a lot about loyalist paramilitaries, as do my colleagues. And those threats that I received, the formal notifications from police tie in with that. But unfortunately, so does this threat that I received in October. Right. Well, we have got a statement here from the Police Service of Northern Ireland. They say PSNI encourages anyone with a complaint regarding police actions to contact the police ombudsman, which is indeed what you have done, Patricia.

Do you think, or perhaps I should say really, to what degree do you think there is a gender element here? There is absolutely a gender element. I have found I have been abused more online than my colleagues, my male colleagues. Her Net, her Right campaign has said that women are 27 times more likely to be abused online. I have seen female journalist colleagues suffer the most horrendous abuse. And I do believe my gender plays a role in being a target to some individuals, unfortunately. Well, presumably, the ultimate aim of these people is to stop you doing your job. That's it. And the thing is, there is a danger that women will stop doing their jobs.

Any woman with a public profile seems to be a fair game to these individuals. And unfortunately, we've seen female politicians move away from politics. We've seen journalists, a recent survey revealed how they've suffered depression, anxiety. And there's a real danger of self-censorship here, which is a threat to democracy. So we have journalists now thinking, I'm mostly female, should I post that tweet? Should I share that story that I've worked on? Because they now expect to receive abuse online and it's unacceptable and it's a danger to press freedom. Have you thought about changing your job?

I have to be honest, when I received that message, and it is the most horrendous message I've ever received in my life, it crossed my mind because these people are not only threatening you they're threatening the most vulnerable members of your family and and and people who can't defend themselves so it does cross your mind but then you have to remember the goal here is to make you stop doing your job to stop reporting and if we let them win then then then they'll carry on doing what they're doing there's no end so we have to fight this we have to speak out and unfortunately it was a very hard decision to make but it's resulted in me having to put a formal complaint in against the

police. What do your family make of your decision to do that and also to carry on with your professional life? They're very supportive. They understand my job. It's not an easy job. Working in a male dominated industry is very difficult, but they're supportive and they don't want to stop me from doing what I do. I do my job to help not only my children, but other people's children, because we're voices for people who can't speak out. So absolutely, they're supportive of me and especially in taking this complaint through to the police, because these threats need to be taken seriously. People need to be held to account. Oh, yes. I don't think be held to account. Oh, yes. I don't think anyone listening would disagree with that, Patricia. I don't expect you to have seen the Boris Johnson press conference last night.

And I'm not comparing the two experiences. But the Sky correspondent, Beth Rigby, asked a question of the prime minister and was trending on Twitter afterwards. And yes, she did get some support and some praise for her questioning. But an awful lot of critics, largely male, felt they had the right to have a go at her. And this is, it is a regular thing, isn't it? This sort of stuff happens very regularly. How do we stop it happening? That's a good question, Jane. And it's not going to, there's not going to be one solution. Certainly, social media companies need to have a greater responsibility. I think the campaigner just last week, Gina Miller, said that social media platforms have a duty of care and responsibility to users and quite rightly asked, why should they be able to profit and become billionaires while so many in society are being victimised? And they are. Carolyn Spellman, former cabinet minister, asked the question after stepping away from her role,

which she said was crystallised by the decision. Her decision was crystallised after becoming under intense scrutiny during the Brexit debate. And she said, and I think this is a great quote, the nation needs to look into its soul. What is it about our make-up that is driving misogyny? And that's the question. How do we change attitudes? Because attitudes need to be changed. How do we change attitudes? Because attitudes need to be changed. How do we do that? The government needs to help.

There needs to be better deterrence and social media companies need to be held responsible. Well, bearing in mind that that awful threat to you was made on Facebook, what have they done about it? The threat that came through to Facebook was from a profile that deactivated straight away after it sent the message. Now, Facebook were contacted and they were able to trace it. But, you know, in terms of that someone is able to go on, make a fake profile, send a message like that and then deactivate it and go into the abyss.

That's not acceptable. That can't happen. So although Facebook, I suppose they couldn't do much, that shouldn't be allowed to happen. People shouldn't be allowed to go on and set up fake anonymous profiles and send those types of threats. Thank you very much indeed for talking to us. That's the Irish journalist for the Sunday World newspaper, Patricia Devlin. Now, Amity Reid is here, former NHS midwife, author of Overdue, Birth on slightly thin ice coming over here, criticizing our NHS.

You understand why I make that point, because I think a lot of people will feel very protective of it. So tell us about, first of all, because I think you had treatment from the NHS, didn't you, when you first arrived in the country and you couldn't believe it. You just couldn't believe it was free. Yeah, exactly. I, first of all, just want to say I don't, any criticism I have of the NHS is because I appreciate it and love it just as deeply as anyone else in this country. And I think it's amazing. But yes, when I first moved here, I was amazed at the system, you know, being able to walk in and have treatment and not be given a bill at the end of it to me was just amazing. You became a midwife, you got that bit out of the way so that's good to find out, I just wanted you to be able to say that. You trained as a midwife after working as a doula, just define doula, people aren't always sure what that means. So a doula is a lay person, they don't give any medical advice but they support women in the antenatal period and usually through the birth as well and then they might give usually through the birth as well.

And then they might give postnatal support as well. So they just give information and practical support and emotional support. Right. And then you became a midwife here. That's right. And what was your, what was the first thing you noticed about the system that you believe could be improved significantly? The staffing, certainly. There just weren't enough of us to be able to do the job properly. And that's obviously been a problem for quite a while. That's not new. But I think until you've actually experienced it and been that person trying to give that care on a busy ward, you can't fully appreciate just how relentless the nature of it is. Is there too much bureaucracy, too much form filling?

Definitely. There is so much paperwork. You know, even those places who have now gone to electronic systems. When I first started out, we had to do everything by pen and paper. We're taking notes every 15 minutes. So we're literally transcribing everything we do. And it does take us away from being able to care for the women properly. When you're literally transcribing everything we do. And it does take us away from being able to care for the women properly. When you're sat down trying to write all these notes, and the bells are ringing, and you're not getting things done. You know, it does it does impact on the care you're able to give and that then has an emotional impact on us because you feel like you're always failing at either the paperwork or the patients. Yeah, okay. And you're pretty critical in this book. It's very interesting in the sense that sometimes I think we are somewhat, call the

midwife sentimental about this profession. You're not sentimental about it. And you make very clear that some midwives are actually capable of being very judgmental about the women in their care, and frankly, sometimes pretty uncaring. Just tell me a little bit about that. Yeah, I mean, I do demonstrate in the book a few instances where there has been uncompassionate or even unkind care towards women or comments made that were not very compassionate either. I think a lot of that, not all of it,

obviously some people are just, that's their personality. But I do think a lot of that, not all of it, obviously, some people are just that's their personality. But I do think a lot of those comments and a lot of those that type of care comes from a place of disillusionment with the system, their own trauma, and just burnout when people become burnt out in a system like that. And when you've gone into that profession to care for people, and you're constantly feeling like you're failing either them or the system or your managers, you kind of block yourself off emotionally. And I think a lot of that uncaring attitude can come from years of feeling that they're letting people down and having to put up some defences. We have talked about the Cumberledge review most recently into vaginal mesh, the anti-epilepsy drug sodium valproate, and then there was the pregnancy, the drug pregnancy test as well. But before that, Baroness Cumberledge had been in charge of Better Births, which was another review.

That was published, I think, in 2016 and came up with the idea that what women all really needed and would benefit hugely from is one-on-one care. What do you say about that? Better births is amazing. It came out right when I was qualifying, and I was very, very excited by it. It is, without doubt, the way that midwifery needs to work. It's what women need and want and deserve. There's been countless studies that show that outcomes are improved, physical outcomes and emotional ones. There's lower rates of stillbirth, miscarriage, premature birth, birth interventions, higher rates of breastfeeding, all of that happens and midwives themselves feel more satisfied with their work when there's one-to-one continuous care,

when you can build up a relationship. So I was very, very excited about Better Births when that report was published. Well, there's a buck coming. Yes. Go on. So when I started working as a midwife, I was very excited to be involved in it at my former trust. They were just starting to implement it. They were in the planning stages. So I went along to many of the meetings where they were trying to explain how it was going to work. But without the framework there, without the extra staffing, we were already understaffed. And the way that the changes we were expected to make in order to implement better births

was just unfeasible to many midwives. Okay, so what would it have meant for the average midwife? So it would have meant being on call. so 24 hours a day, being able to jump out of bed in the middle of the night. So for midwives who have young children or caring responsibilities, that wasn't possible. Or if their partners work opposite hours to them, that was just not possible for some of them. Some of them also just didn't want to have to do that. They felt it was an ask too far because they were already giving so much to their job, they didn't want to be beholden to it 24 hours a day. Is the money good enough? No absolutely not and many midwives

work extra shifts they do weekends holidays bank shifts on top of their regularly scheduled hours just to be able to top up their income. Okay so here that's essentially the nub of the matter isn't it if this job were better paid you wouldn't need to take the additional shifts. You perhaps wouldn't be so tired. Exactly. So can I ask, what did you earn? Well, when I first started out as a band five midwife, about £25,000 a year. Right. And I think it can rise to about £40,000 in London?

Yes. That's like once you're a band seven. Right. Which is a senior midwife coordinating the whole ward. And that would be a pretty big amount of responsibility. Exactly. Yeah. And so that's one aspect of the one to one care. But I can completely see why in an ideal world, it would benefit a woman, particularly a vulnerable woman, because that sense of knowledge of a proper relationship with another human being guiding you through the whole process, it does make perfect sense.

It does. And like I said, it does improve outcomes. They feel happier, midwives feel happier. The problem is, we're being asked to implement a gold standard system with a framework that is crumbling. So to me, it's like papering over the cracks and trying to pretend it's new walls. We need new walls. We need all of that structure there to support us to be able to give that care without it having a huge impact on us. Let's talk too about women of colour and maternity care, because we know the figures from the Embrace report are really startling that a woman of colour is I think five times more likely to suffer maternal mortality. Now, tell us about some of the stories in your book. There was a young woman,

I think you call her Alicia. What happened to that woman? So when I was a student midwife, I was was working I was assigned to work with another qualified midwife and she sent this woman's mother home this woman Alicia was in early labor she was very young yep she was a young young black woman um her mother was sent away quite an uncompassionate way um sort of sent packing and then I was continuously told not to give her any pain relief, that she was just being too dramatic and that she wasn't really in labor and she needed to just calm down. I spent a lot of time with her on the ward, just holding her hand really and trying to do my best to give her some kind of care. And in the end, she ended up having her baby in the staff toilet,

not the staff toilet, sorry, the patient toilet, because I went to check on her and she was pushing and there was no time to move her. So she gave birth virtually almost alone. We only burst into the door right as the baby was being born. So she had to give birth on her own because someone didn't believe her that she was in pain. They kept dismissing her pain. Well, that's the example you have in the book. Is that a common event? I wouldn't necessarily call it common, but it's also not uncommon. There are definitely cultural perceptions that a lot of health care workers have. So there is a perception sometimes of black women as being able to withstand pain. You do hear sometimes people say, oh, she's African.

She'll just get on with it and push this baby up quite easily and they don't make a fuss. And then you also hear comments made sometimes about Asian women, they're sometimes called Asian princesses and are told that they over-report their pain. So sometimes they too are denied pain relief or assistance because they think they're just being a bit too dramatic.

Amity Reid, who is the author of Overdue, Birth, Burnout and a Blueprint for a Better NHS. What are your thoughts on that one? Well, Richard, first of all, said paperwork is actually very important. It enables staff to see how a patient's condition is changing and affects their decisions about their care. If something does go wrong, it enables people to learn. Getting rid of paperwork will result in unsafe care, says Richard. And anonymous, my partner is a midwife and the problem is that the majority of midwives

want to do the best for their patients, but management don't care about them. How can midwives fully care for people when they're not cared for or respected themselves? Lower band midwives, with all their responsibilities, are only earning a few pounds more an hour than a person stacking shelves in a supermarket. It just doesn't make sense.

Penny says, as a dual citizen with 30 years in the NHS, I know very few Americans who are not very envious of our NHS. Good for Amity for trying to make it better. Thank you for those thoughts. And on the subject of Patricia Devlin and that appalling threat she had, Jay says reporting abuse on Facebook is awful. I've had less experience with Twitter, but it's not great either. What would be useful would be a report to police button, which could deliver the offending post or tweet to the police with the appropriate identifying information of the offender.

I've worked in software. I know this is feasible, says Jay. And from Noel, I often find myself at odds with the views of Woman's Hour, but I did want today to offer my unconditional support for that lady who'd had that terrible threat. We, the overwhelming majority, reject the perpetrators. They're outside of us and have no place alongside us. We all demand police action immediately. I wish your guest luck in her pursuit of justice.

Thank you very much, Noel. To the subject of business and running a business at the moment, Fiona says, I thought that was really sad. These women had dreams and the courage to start up their businesses, sending much love to you all. Robin, on the other hand, says this has been a very unbalanced item with absolutely no argument for the other side that posits there should be a harder lockdown to stop the virus. You should speak to those who live in fear of catching Covid or those who care for their elderly or ill relatives. Why do we need public house regulars? We need nurses, we need carers, we need teachers, but we don't need regulars. Examine how this

mini measure of doing a halfway house pleases no one and how the UK is directionless and compromised. Well, I thought actually Hannah, our landlady in Nottingham, did make the point that being in this halfway house position for her wasn't the easiest actually. And Robin, we've done plenty of conversations and items about caring at this time and at lots of other times. This was an item about what it's like to be running a business, as many of our female listeners do. Wendy says, I'm really angry about the decision to include gyms in the tier three closures. I know the lengths my own gym has gone to to keep COVID secure, and we all feel completely safe. I can sit in McDonald's and stuff my face

with rubbish surrounded by people in relatively close proximity, doing nothing to improve my general health and fitness, but I can't go to my local gym, which has few people in at once, all separated and minding their own business, all armed with sprays and hand sanitiser. Thank you for that, Wendy. Thanks to everybody who took part today. Sangeeta Maisker is here tomorrow. She's going to be talking amongst other people too. Carla Bruni, who just seems one of those

impossibly sleek, sophisticated French women. She's a songstress, of course. She's got a new album out. She has topped the charts in France. She's much more than the wife of Nicolas Sarkozy, but I've just mentioned that she is the wife of Nicolas Sarkozy. But I've just mentioned that she is the wife of Nicolas Sarkozy. So no doubt that will crop up tomorrow in that conversation. I'm back

on Thursday. Have a good couple of days. I'm Sarah Treleaven. And for over a year, I've been working on one of the most complex stories I've ever covered. There was somebody out there who's faking pregnancies. I started like warning everybody. Every doula that I know. It was fake. No pregnancy. And the deeper I dig, the more questions I unearth.

How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby. It's a long story, settle in. Available now.