Category: Blog

The blue badge parking scheme – did the reforms go too far?

Written by Madeleine Speed, the Pelvic Partnership. May 2015

Since the reform of the Blue badge parking scheme there are far fewer badges issued to applicants – an amazing 130,000 fewer than before the scheme was reformed in 2012 (according to BBC 4 Radio Programme ‘You and Yours’ which went out on 30th January). So is the scheme letting down people with disabilities?

If PGP symptoms have meant that you cannot walk more than a few minutes without difficulty and pain, you will know firsthand how difficult it can be to pick up medicines, food or just to call in on friends. The Blue badge parking scheme is a topic that we have visited a number of times over the last decade but it comes up regularly and it isn’t surprising that women with severe PGP hope the scheme may help increase their quality of life.

The scheme is designed to help people with mobility problems to park close to shops and amenities where drivers without the badge would not be allowed to park. In some areas, including Oxfordshire, there was a scheme for providing temporary permits, which was very helpful to women with PGP. However, it is very unusual for women to receive a blue badge now, unless they have a very long-standing problem.

Before the reforms took place, it was possible for GPs to decide whether or not a patient’s mobility problems warranted a blue badge. Some critics felt that this system was flawed because there were no set criteria that GPs had to use and the approach wasn’t thought to be uniform across the UK. However, the biggest problem with the scheme seems to have been the level of corruption it introduced, with blue badges changing hands for breathtaking amounts of money! As a result, the scheme was reviewed in 2012 and a new system was rolled out.

Following the review, it seems much harder to obtain a badge and the scheme has also been criticised for the way it assesses eligibility. The first (and probably biggest issue in terms of Pelvic Partnership members), is that one aspect of eligibility is the need to ‘have a permanent and substantial disability’ which means ‘you cannot walk, or have very considerable difficulty walking’. A core belief at the Pelvic Partnership is that PGP is fundamentally a biomechanical problem of stiff or stuck pelvic joints. With manual therapy from an experienced physiotherapist or similar professional, the symptoms can usually be overcome. This makes it much harder to argue that the disability caused by PGP is ‘permanent’.

Is there really a need for an applicant to show they have a ‘permanent’ disability if each recipient of a badge is reviewed after three years? If mobility did improve considerably (as we hope it would), couldn’t the badge just be returned because its job had been done?

Another frustration with the current system is that although the review tried to introduce criteria that were set and applicable across the UK (so everyone is asked the same questions and rated identically). Sadly, the playing field appears to be anything but level. The charity Disabled Motoring UK has learnt that the independent assessors who have been going through the criteria with individuals are not necessarily trained to carry out this function instead some have been admin staff. The Government’s Driving and Transport Department has confirmed that the assessments must be carried out by an independent assessor who should be suitably trained e.g. a physiotherapist or occupational health professional. Such a professional is vital for carrying out a proper assessment of the applicant and it seems that not all local authorities are employing healthcare professionals to carry out the assessments.

The Government’s website suggests that you can apply online (see https://www.gov.uk/apply-blue-badge). In theory this is great – no need to go into a department in person and get a particular hard copy. However, it’s not clear whether the initial application is followed up by an individual assessment; if not, it may suggest that no independent assessor is being used to give the applicant a fair appraisal. If this is the case it may be even easier for a local authority to turn down the application.

Critics also argue that where a local authority refuses to award a badge, the applicant who appeals should have their case reviewed fairly regardless of where they live and which authority they come under. However, consistency does seem suspect because, for instance, Swansea is an area where an appeal is three more times likely to be refused than anywhere else in the country.

It seems that there is sufficient concern about the new Blue badge parking system that another review may be on the cards. What do you think? Are there any readers who used to have a Blue badge but haven’t been awarded one recently? Do you think people with a disability that isn’t permanent and may be overcome (such as for severe PGP symptoms or a broken limb that should mend, etc) should be eligible for a Blue badge for a period until they make a recovery? Please contact us via the website and let us know what you think. Ideally, please contact your local MP to ask for a review of the Blue badge system because you are aware that the criteria are not being used consistently across the UK and that assessors are not always qualified physios or Occupational health staff. Most importantly, you may want to say that the scheme should not penalize a woman with PGP who may overcome symptoms given the right treatment of good manual therapy.

Let us know what you think by sending us an email to contact@pelvicpartnership.org.uk

Thanks!

Where can women choose to have their babies?

Written by Madeleine Speed, the Pelvic Partnership. April 2015  

New guidelines from the National Institute for Health and Care Excellence (NICE) suggest that the labour ward of a hospital may not be the best choice for women at low risk of complications.

Recent healthcare guidance from NICE reveals that traditional labour wards in hospitals are no longer the best option for women giving birth following straightforward, low-risk pregnancies. The new guidance states that it is just as safe for women to give birth in midwife-led units or at home and, in some cases, may be even safer.

NICE which advises the NHS, wants healthcare professionals such as GPs and midwives to encourage women with straightforward pregnancies to give birth in midwife-led units or at home. These are women who have previously given birth and who are expected to have low-risk pregnancies and the reason for this advice is that these options are safer for them than giving birth in hospital. There should be four options offered to all women who have had uncomplicated pregnancies and who are expecting an uncomplicated birth: home, a freestanding midwifery unit (separate from the hospital), an alongside midwifery unit, or an obstetric unit (the traditional labour ward or delivery suite).

The new guidance is based on evidence showing that the rate of interventions (e.g. the use of an epidural or forceps or caesarean birth) is lower and the outcome for the baby is no different when compared with a hospital labour ward.

About 45 per cent of women have a low risk of developing complications during the course of their pregnancy. A risk of complications can be attributed to factors such as being over 35, being over-weight or obese, having high blood pressure and bleeding after 24 weeks of pregnancy.

Home births, the guidance outlines, are also equally safe as those within a midwife-led unit and traditional hospital for babies of low-risk pregnant women, the exception being for first-time mothers. In a midwife-led unit or hospital ward, a baby born with serious complications might occur in 5 out of every 1,000 births but this rises to 9 in every 1,000 births for first-time mothers. However, women can still choose to give birth at home, as the risk to the baby, though slightly higher than other settings, remains a small one, and the advantages (in terms of better outcomes for women) remain the same as for other out-of-hospital settings.

The guidance suggests that all women in labour should have access to an obstetric service if they request an epidural or need to be taken to hospital for medical reasons.

The Pelvic Partnership welcomes these findings. As a charity that helps to support and provide information to women with pregnancy-related pelvic girdle pain, we are keen to encourage greater women-centred health care. It seems really important that women should be given information to enable them to make their own decisions about where they have their babies.

Professor Mark Baker, the Clinical Practice Director at NICE, acknowledges that women at low risk of complications should be able to give birth “in an environment in which they feel most comfortable.”
Professor Mark Baker, goes on to say that the “updated guideline will encourage greater choice in these decisions and ensure the best outcomes for both mother and baby.”

Giving women greater choice about where they have their babies has to be a good thing. However, at the moment in England and Wales, nine out of 10 babies are born within traditional labour wards within hospitals. So if the new guidelines encourage a greater interest in home births and midwife-led units from women with straightforward pregnancies, it will be a significant change in provision of maternity care for some organisations, although some already offer all four options to women.

In its article about the new guidelines, the Independent spoke to Cathy Warwick, general secretary of the Royal College of Midwives and who welcomed the new guidance, but pointed out that the NHS in England was still short of 3,200 midwives. Such a shortage in midwives currently means that in reality many women are not currently getting a real choice between hospital, midwife-led units or home birth. The worry is that if demand for a hospital birth is outstripped by the other alternatives, real choice may be even harder for women to exercise if there are not sufficient numbers of midwives to attend home births and midwife-led units. However, if women and babies experience more normal births, and are fit and well as a result, over time this should reduce the risks for future births, as fewer women will need long hospital stays and repeated c-sections, and babies will also need less extra care.

This guidance supports more women to give birth in comfortable, low-risk surroundings, supported by a midwife who is an expert on normal birth, and should improve the outcomes for mothers and babies in the future.

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The Pelvic Partnership consists of volunteers who have had pelvic girdle pain (PGP) and wish to support other women. We aim to pass on information based on both research and the experience of other women with PGP. We are not medical professionals and cannot offer medical advice and the information we provide should not take the place of advice and guidance from your own health-care providers. Material on this site is provided for information and support purposes only.

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