It would be “absolute madness” to allow public health spending cuts to hamper hard-won increases in the number of health visitors, a leading member of the profession has told Nursing Times.
Health visiting services could struggle to deliver the most basic care if numbers drop back down, warned Dame Sarah Cowley, emeritus professor at King’s College London and trustee of the Institute of Health Visiting.
“We don’t know which will take priority – the funding formula or balancing the books”
Her comments to Nursing Times follow a joint letter penned by a range of nursing and child health organisations, including the institute and the Community Practitioners’ and Health Visitors’ Association, noting fears about the situation. They say they are “gravely concerned” at the potential impact of £200m in public health funding cuts on health visiting jobs.
The letter – also signed by the Royal College of Nursing, Royal College of Midwives, Royal College of Paediatrics and Child Health, UK Faculty of Public Health – appeared in a national newspaper days after it emerged the government had narrowly missed its target to recruit an extra 4,200 health visitors by the end of the March this year.
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“We were delighted to see the previous government’s support for a 4,200 increase in health visitor numbers and welcomed the commitment in the Conservative party manifesto to strengthen the health visiting programme for new mothers,” said the letter in The Observer.
“We are now extremely concerned as to how this commitment is to be reconciled with local authority health budgets being reduced by £200m, given that health visiting is likely to be a service under review,” it said.
Dame Sarah told Nursing Times the significant increase in health visitor numbers so far achieved was “fantastic news” but warned that public health directors and health visiting teams were now gripped by uncertainty.
“Two hundred million doesn’t sound much to the NHS, but when you look at the very much smaller budget for public health in local government then it’s a huge amount – something like a million pounds for each local authority,” she said.
“It’s as if [chancellor] George Osborne doesn’t know people working in local government in public health are frontline NHS staff, like health visitors, who are supposed to be protected,” she added.
Councils have been told they must ensure there is one health visitor per 300 children when they take over the commissioning of health visiting and other child public health services in October
“We don’t know what will happen,” said Dame Sarah. “All we know is the money has to be found by local government and we don’t know which will take priority – the funding formula or balancing the books.”
“Rumours and suspicion continues. The recent announcement about the £200bn savings has not helped”
If funding for health visiting was ring-fenced in some way, she said public health managers would still face impossible decisions, with vital services like school nurses, sexual health advisors and breastfeeding services all under threat.
Obi Amadi, lead professional officer for the Community Practitioners’ and Health Visitors’ Association, which is part of the Unite union, said shifting commissioning to local authorities had created “a lot of anxiety that we are all trying to manage”.
She noted that the government and Public Health England had “worked hard to ensure a safe a transition as they think is possible”, but she warned that “rumours and suspicion continues”.
Ms Amadi added the recent announcement about the £200m savings “has not helped”.