Saturday, 24 September 2011

Health Visitors: Will New Government Plans Provide Solutions?

In April I wrote a post about Health Visitors, setting out some of my concerns and asking you to get in touch with me with yours. Your feedback was invaluable, and helped me to build up a picture of what is being got wrong, and right, nationwide in the UK.  Everyone was agreed, Health Visitors are a powerful influence on new mothers. Sometimes this power is used to great effect and they are an invaluable help at what can be a difficult time of transition and change.  However, you also told many stories of negative experiences and advice given that appeared to be anything but 'evidence based'. Problems seemed to be centred in three main areas:
  • Advice given could undermine breastfeeding, for example being told to top up with formula.
  • Advice given could undermine attachment, for example being discouraged from picking up baby every time she cried.
  • Advice given was not evidence based; rather it seemed to be rooted in outdated parenting approaches, some speculated from the Health Visitors personal experience of motherhood.       
I took the step of contacting my MP, David Heath, with these concerns.  Due to some technical difficulties in getting in touch with him via his website, it has taken a while for him to respond to me, and therefore for me to write this follow up post. However, I'm pleased to say I have now had a reply from him, and there is some good news - it seems that the Government are trying to address current problems in the health visiting service with their Health Visitor Implementation Plan 2011-15.  And there's more good news - I've read it so you don't have to!  

Essentially the plan, which describes itself as 'a call to action to expand and strengthen health visiting services',  will increase the numbers of Health Visitors - the Government has made a commitment to an extra 4200 of them by 2015. Most of the plan is focused on how this increase in the workforce will be achieved, and there is plenty of civil service lingo in there to baffle and anaesthetise you. However I did perk up considerably when I read this paragraph:
The start of life is especially important in laying the foundations of good health and well being in later years.  The period from prenatal development to age 3 is associated with rapid cognitive language, social, emotional and motor development. A child’s early experience and environment influence their brain development during these early years, when warm, positive parenting helps create a strong foundation for the future. New evidence about neurological development and child development highlights just how important prenatal development and the first months and years of life are for every child’s future.
It was really heartening to see these words in a government document, as so often it has seemed to me that policy makers do fail to see that the solution for so many current social issues lies in giving focus to the first few years of life. The Implementation Plan makes it clear from the outset that the current government realises the power of the Health Visitor in supporting parents to give their children the best possible start, and the important long term impact, on both individuals and society, that this can have.

According to the Plan, the new health visiting service will help families via four main elements:

  • Your Community: a range of services including some Sure Start services and the services families and communities provide for themselves. Health visitors will be responsible for developing these and making sure you know about them.
  • Universal Services: providing the Healthy Child Programme, offering support for parents and services such as info about immunisations, health and development checks.
  • Universal Plus: a rapid response from your HV team when you need specific expert help.
  • Universal Partnership: ongoing support from your HV team plus a range of local services working together and with you, to deal with more complex issues over a period of time. 
The fact that the Government have come up with this plan is encouraging, and seems a direct acknowledgement that the current system is not helping new mothers as well as it could or should.  However, it did leave me with two main questions:
  • The main focus of the plan seems to be on Quantity as opposed to Quality.  Although there is some mention of extra training for existing HV's, there is no specific detail about this.  What is going to be done to ensure that existing and new HV's are offering up-to-the-minute, evidence based advice on subjects such as breastfeeding, weaning and infant sleep?
  • Health Visitors have to first be trained as nurses or midwives. But given that the NHS is already suffering from nurse and midwife shortages, isn't it going to be difficult to recruit new HV's without worsening the current shortages?
My MP has told me to get back to him, if, after reading the Implementation Plan, there is anything further I wish him to raise directly with the Department of Health. So, it's over to you again.  Please get in touch with me with your comments and thoughts, either via my facebook page, by sending me an email, or by leaving a comment on this post.  I look forward to hearing your views.

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