Last update 8th. January 2005


David Hobbs

Director of Corporate Development

North Central London Strategic Health Authority

170 Tottenham Court Road

London W1T 7HA

23rd September 2004

Dear Mr Hobbs

I am writing to thank you for taking the time to talk to me the other day. You were very helpful. I really appreciated the effort you made to help me understand the bureaucracy.

I have made initial enquiries to both Camden and Islington Primary Care Trusts. Mr Paul Fox is the Chairman of the Inequalities Group, Interim General Manager and Head of Health Partnership at Camden. Sarah Price is The Director of Public Health for Islington and is responsible directly for tackling inequalities in Health. I will send copies of this letter to them.

I would like to put forward a suggestion relating to the physical welfare of mothers after giving birth.

In this country a midwife visits at home for ten days after the birth. She apparently teaches pelvic floor exercises. In my experience I was told of them but not taught. There is a post natal check up after 6 weeks. In France however the health system is insurance--based, the state picking up 80% of the tab. This means that doctors can prescribe alternative and fitness treatments from the private and public sector. The physical welfare of the mother is treated with respect and understanding.

Post Natal physical care for women does not exist in this country. We are left to our own devices find 'alternative' physical therapy for pain and damage caused by childbirth. This lack of physical care for women is not only potentially damaging to the mothers future health but also can damage the relationship between mother and child. The children suffer.

I'd like to put forward a case for change in social policy for the physical welfare of women who are suffering pain and fatigue whilst caring for their babies and children. To put an end to inconsistency in medical advice and treatment. I said to a health worker within my GP's baby care clinic. 'I am in so much pain and I am so exhausted', she replied "Would I like to see a psychiatrist?" This 'clinical medical' approach to the treatment of pain, stems from The Royal College of Physicians discriminatory service considerations policy for Rheumatology, on the treatment of soft tissue injury, osteoarthritis, back and neck pain, chronic musculoskeletal pain [chronic pain syndrome post viral fatigue syndrome etc and sports injuries]. The policy says 'These are often dealt with on a 'one stop' basis.'

I mentioned to you that I had attended the Fibromyalgia Associations Conference at Imperial College recently. Within this country there are estimated 1,000,000 people with Fibromyalgia and CFS, over 90% are women. It is recognized by the Government to potentially disabling. The two main causes of this progressively disabling physical illness are childbirth and surgery.

We need to introduce specialist clinics in Physical Medicine that bypass the lengthy and expensive consultations with G P`s, pain management clinics and consultants, leading to an efficient use of funds and effective treatment. What is needed is 'Clinical Excellence' not just 'best practice'. A 'Sports Medicine and Sports Injury Clinic', specialising in Physical Medicine, specifically for the post natal treatment and fitness of mothers. An autonomous clinic within the hospital. Sports Medicine is a clinical mainstream Rhuematalogieal discipline and is only prescribed to the select few. A clinic where mothers know that the treatment they receive will treat the origin of their pain, not the point of pain or be merely palliative. As an example, Carpal Tunnel Syndrome is in the upper. The origin of Carpal Tunnel Syndrome is in the upper spine, treatment for this within Clinical Medical practice, is acupuncture at the point of pain, in the wrists. If the pain does not go away, surgery is given. Surgery is out of the question whilst a mother is still using her hands to pick up a child. Surgery is expensive and wholly unnecessary. A few sessions of 'hands on' physical therapy, coupled with knowledge and empowerment will get rid of the problem.

Conceiving may be a sporting activity, but being a mother, in pain, is not much fun.

Once again thank you for talking to me. I hope that what I have to say is of interest to you and that given that women and babies no longer require as much space, time and expertise that you will give my proposal some consideration.

Yours sincerely,

Jane Barratt

23 Courthope Road

London NW3

0207 482 6090

cc Sarah Price

Paul Fox