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‘Short-term cuts will damage public health in the long run’

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A health visitor I met at a recent Nursing Times Careers Live event told me she was looking for a new job because cuts in her local area meant she was about to her lose her current position. 

She wasn’t going to look for another job in health visiting because, although she loved it, she felt it was too insecure and unstable. She wanted a more certain future and so she was looking for other nursing work.

It is only just 18 months since the Department of Health’s five-year Health Visitor Implementation Plan ended, having increased the number of health visitors by just under 4,000. It seems to me criminal – and I don’t use that word lightly – that the country struggles to recruit nursing talent and yet once it has recruited, trained and nurtured that experience and given it clinical experience, their jobs are taken away.

That health visitor’s experience is not isolated – this is happening up and down the country, according to health visitors attending the Community Practitioners and Health Visitors Association annual conference last week (read the story here), as recent reports in Nursing Times also testify.

As cash-strapped local government authorities take over commissioning health visiting and school nursing posts, they are integrating the roles at best, or losing them altogether in some cases.

The NHS is in dire financial straits, and essential to its success is a population that has a good start in life to give people the best chance to lead healthy lives. There is much evidence to support public health nurses and the contribution they can make to keeping the population well, and therefore needing fewer costly NHS interventions later in their lives.

It seems to me that cuts like this are implemented to make a short-term gain that will result in significant losses in the not too distant future. Unfortunately, having a health service managed by a government with only a guaranteed maximum of five years in power means decisions are made to balance the books in the short term that will cost us dear in the medium to long term.

Public health nurses’ contribution to care may not be as visible as other groups of nurses – as is always the case with those involved in prevention. Their role is to keep the nation well by preventing ill health, rather than curing the sick, and the latter is always easier to measure. It’s true what they say – you don’t know what you’ve got until it’s gone. And I fear, that will be a saying that rings truer than ever about health visitors and their public health colleagues.


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