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Recruit more health visitors now to help keep children safe

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The furore that surrounded the tragic case of Baby P has focused, understandably enough, on the role of social workers in child protection. The government and the opposition have both expressed in the strongest possible terms that ‘things must change’.

But the crucial role of health visitors in ensuring that children grow up healthy and safe seems to have been lost among the hand-wringing and finger-pointing. This is a dangerous omission for – to state the obvious – health visitors with a workload of 500-plus under-fives is deeply worrying.

What is more, it is in precisely those areas, where other health and social care professionals find themselves groaning under their own crippling workloads, that health visitors are in the shortest supply.

For perhaps a generation, health visiting has been slipping to the margins and into something approaching crisis. While most other branches of nursing have benefited in both numbers and expanded roles during the last decade, health visitors have struggled with ever-increasing workloads and question marks over where they fit into new models of community services.

Who is to blame for this situation? The government, for failing to get the message across as to how and where health visitors should best be employed? The PCTs, who reacted to this vacuum by disinvesting in health visiting services and turning their attention to more fashionable community nursing solutions? The profession, which responded defensively to the developments promoted in 2007’s Facing the Future and focused on rows over banding, while the world changed around them?

As ever, the truth is that all are at fault – just as the solution can only be found if all work together.

There also needs to be a consensus about health visiting, in terms of its role, its status and its future. Whatever the conclusion, the essential job that health visitors do, will still need to be done, if prevention is going to be a key part of child protection policy.

The Department of Health is developing a tool to help better determine the need for health visitors. This will be useful, but
PCTs should not wait for its introduction – the shortages are obvious now. Recruitment must be stepped up significantly – and speedily – if health visitor workloads are to be reduced to reasonable levels.

Alastair McLellan, editor, Nursing Times

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