Susan Hill recalls how much she relied on her health visitor and bemoans the decline of this once-universal service: the victim of bureaucratic ‘targeting’ and government ignorance
You can be sure of one thing about government. If it ain’t broke, they will fix it and don’t worry about the breaking bit, they will do that for themselves. Rewind 15 years to the health visitor system which was so ‘not broke’ it was a model for best practice throughout the world. HVs originally looked after patients ‘from cradle to grave’, advising and supporting anyone who needed them, including the elderly, the chronically or terminally ill and the disabled, but gradually their remit narrowed to new mothers and babies and the under-fives.
They were qualified nurses who trained on the job before being attached to GP practices, as part of a mixed-skills team with their own caseload, visiting pregnant and new mothers. They did routine checks and advised on maternity and neonatal problems while learning about family and home circumstances. Even mothers in prosperous circumstances have troubles over their post-natal health, breast-feeding, crying or non-sleeping babies, but everyone had a health visitor and with no stigma attached to her visits. If the HV was worried about a mother or baby’s health and welfare, she was perfectly placed to alert her surgery team. She was on the lookout for postnatal depression, developmental problems and tuned to possible domestic violence, child neglect or abuse. She had access to patient notes and could add her own for the surgery team. Many a crisis has been nipped in the bud by an HV having a quiet word with the GP as they passed in the surgery corridor. Meanwhile, trust was built. Mothers could talk to their HV about things they found it difficult to express to family or even doctors.
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Jean Waterworth
November 14th, 2008 11:17am Report this commentI fully endorse Susan Hill's views. As a retired health visitor I'm saddened by what's happening. I can't think of a time when society needs the skills of a HV more than it does now.
Anon
November 14th, 2008 1:49pm Report this commentThank you for this excellent article. As the mum of a toddler I've often wished there was somewhere to turn for a bit of advice without feeling that I would end up on some kind of register of bad mothers.
As soon as the HV issued the sinister Red Book I felt that behind the smile, her job was to catch me out, so I've avoided any contact other than immunisations.
I was also in desperate need of extra support during pregnancy after 4 miscarriages, but there was nothing other than the internet - great for those of us who can afford it.
D Short
November 14th, 2008 9:59pm Report this commentPerhaps the author misdirected this article. It was surely meant for the New Statesman.
Shelby
November 15th, 2008 1:02am Report this commentEven 10 or so years ago I found the quality of health visitor services to be very much the luck of the draw.
One of the HVs attached to our GP practice was a gem. The other was a professional busybody with limited useful information to share. Her knowledge of breastfeeding was abysmal (favourite recommendation when a baby was around 3 months of age: "a nice big bottle of formula at 10pm to encourage him to start sleeping through the night") and she was extremely intrusive unless one was actively assertive. From my conversations with other parents, this experience with HVs was not unique.
So I have always viewed HVs as a mixed blessing - great if you happen to get a good one, but hopeless otherwise. Personally I found more support through the NCT.
DR MARY E NICHOLS
November 15th, 2008 8:50am Report this commentThank you Susan for summarising the problem so well, as a rural GP I see the problem spiralling out of control-One day there will be an enquiry and they'll reinvent the original service but give it a fancy title and employ 10 people in the place of our one friendly health visitor.Saying that , they'll probably do a health and safety review and say it's not safe for them to do home visits!In the mean time-would welcome your views on what the Government wants to do to GPs!
Susan Hill
November 15th, 2008 5:10pm Report this commentTHE NEW STATESMAN !!! I wouldn`t give that leftie journal house room.What do you take me for ?
anonymous
November 18th, 2008 11:13pm Report this commentThank you so much for this article. As a health visitor myself, I am finding that many of my colleagues are leaving the profession because we are horrified and embarrassed by the wholly inadequate and dangerous service we are expected to now provide. I fear that what happened to baby P is inevitably going to happen again.
anonymous
November 21st, 2008 5:52pm Report this commentI can't tell you how relieved I am that this is now out in the open and perhaps someone somewhere will sit up and take notice. For so long now health visitors have been forced to work reactively and defensively and against their better judgement not in the best interests of safe-guarding children but merely to safeguard themselves. I would be very interested to know just how many NHS managers are sitting on letters from health visitors telling them exactly this. Staff morale is at rock bottom and from within the organisation it would seem the profession no longer has a voice that anyone hears or listens to. If you highlight concerns expect to be called 'old fashioned' or ' unable to cope with change' and more terrifyingly, just how many health visitors have on their huge caseloads more cases like that of Baby P just waiting to happen?
Anonymous
November 24th, 2008 9:14pm Report this commentThank you so much for writing this article. I am a Health Visitor who qualified back in the early eighties, left the profession and has recently returned to practice. My current colleagues and I all feel exactly the same - we know that we are qualified to offer a much better, more comprehensive service, but we are being forced into working in a targetted way which, as you appreciate, leads to stigmatising and lack of trust. We are grateful that you have noticed and very grateful for the support. We will keep working for what we believe to be right, please keep our plight in the media!
Christine Meredith
November 30th, 2008 3:31pm Report this commentThere are 'bad apples' in every basket but my experience of the health visiting service was someone who was non judgemental and able to give me informed relevant information and support when reguired. Without the timely intervention and tactful assessment of my needs my children would have lost a mother who would have taken her life due to severe Post Natal depression.
susan field
December 5th, 2008 9:48pm Report this commentI can only agree with this article. As a Health Visitor of 34years I feel the skills of Health Visiting have never been needed more and sadly in more danger of being lost
Kirsteen McDonagh
December 8th, 2008 2:09pm Report this commentHaving just read your article I feel obliged to let you know that as a Community Nursery Nurse, working as part of a health visiting team in a very busy London Borough I am offended to be labeled as 'very low'. I am not only qualified up to level three in Early Years Childcare and Education but also hold a BA Hons. My team hold the work I do with families in high esteem and value my years of experience working with children and families. The role of the HV has changed over the years but rather than looking down on the new staff who have come into the teams you should acknowledge and appreciate the knowledge and skills they have to contribute to the team and the difference they make to the families they work with.
Kirsteen McDonagh
December 23rd, 2008 2:50pm Report this commentNo response Susan? Im disappointed. Merry Christmas though.
m cook
January 8th, 2009 10:28pm Report this commentan excellent overview of the past and present situation. the move to targeted services for the most vulnerable isnt working ,overstressed overworked health visitors are unable to cope with rising the tide of need where social support is barely existent
Miriam Heaney
April 18th, 2009 11:22pm Report this commentWhat refreshing truth, let's hope the powers that be also read your article.
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