Every mother needs a health visitor for every baby, no matter her age, occupation or income, says Polly Toynbee
Every mother remembers her health visitor with warmth and affection. My first was wonderful Miss McCurdy in Lambeth in the 1970s, an older woman, small, wiry and wise, like someone from Call the Midwife, she’d seem now. The very sight of her in the old church hall behind a screen where she held her baby clinic was reassurance itself. For the last of my four children, 15 years later in a crisp, modern health clinic, there was Bea - it was Christian names by this time - robust, wise and comforting too, who held up my son and pronounced him the finest fellow. That’s what mothers need to hear.
Every mother needs a health visitor for every baby, no matter her age, occupation or income, no matter whether she’s fragile or strong, tired, depressed or coping well. One good thing David Cameron did was to keep his promise to increase health visitor numbers by 4,200, after years when their numbers had dropped.
“I will do all I can to promote the importance of health visitors, community practitioners, nursery nurses and school nurses”
The Labour government created Sure Start children’s centres, at last bringing in the missing cradle in the “cradle-to-grave” welfare state. However, hiring more nursery nurses and early years staff didn’t mean there was any less need for health visitors. Even with the extra numbers, from what I hear talking to health visitors, caseloads in many areas are still far too high with a fast-rising birth rate. At the same time, health visitors are on the front line for the many more families under pressure, struggling to get by and in need of all the help they can get.
I am thrilled to be appointed as president of Unite/Community Practitioners’ and Health Visitors’ Association and I will do all I can to promote the importance of health visitors, community practitioners, nursery nurses and school nurses - each with their own issues of concern. I have been writing about the health service ever since I wrote a book on the Royal London Hospital back in the mid-1970s. I have worked in hospitals, taking jobs for my research. Later, for many years, I was the BBC’s social affairs editor, covering the NHS going through one its many periodic “reforms”. I have seen - and sometimes despaired at - the endless structural reorganisations imposed by governments when they get their hands on the NHS levers. The latest has been by far the most disruptive, with 90,000 staff changing jobs.
Now is the time to raise the profile of community health services of every kind. The latest mantra from all the political parties is the need to move care out of acute hospitals into the community, in the hope that early prevention can prevent people from developing acute needs. All too often, this looks like a cover for closing down hospital units before building up the community services that are supposed to replace them.
Meanwhile, school nurses are in danger of being forgotten in the new contracting system. Some have caseloads that mean they have no chance of reaching out to all the children who might need their help in, say, 10 schools under their care. They have a unique role in school life - trusted and caring, outside the normal school regime yet part of that environment. Young people will say things to nurses they might not confide to teachers - but for that to happen, nurses need to be on hand, familiar and available, the vital link to other services. They really can catch problems before they develop, with long delays for CAMs referrals in many areas.
I look forward to spending time with practitioners in CPHVA, observing them at work, hearing the challenges they confront every day and doing all I can to promote the value of the work they do.
Polly Toynbee is a columnist for The Guardian and president of Unite/Community Practitioners’ and Health Visitors’ Association