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Public health reforms risk 'division' of children's nursing services

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The government’s public health reforms risk creating a “dysfunctional division” among children’s nursing services, with a gulf developing between health visiting and school nursing, MPs are warning.

These services need to be coordinated, but each is due to be the responsibility of a different public body, the House of Commons health select committee says today in a wide-ranging report into the government’s public health reforms.

Under current government plans, public health services for children under the age of five – including health visiting and the Family Nurse Partnership – will initially be the responsibility of the NHS Commissioning Board, the new national body being set up to carry out the day to day running of the health service.

From 2015, this responsibility will pass to local authorities. However, councils will, from the outset, commission services for children aged between five and 19, including the Healthy Child Programme for school-age children.

Maternity care, meanwhile, will now be undertaken by the new GP-led clinical commissioning groups being set up round the country, which will take on much of the current work of primary care trusts. It was originally intended that maternity care would be undertaken by the NHS Commissioning Board. The board will, however, still be responsible for specialist neonatal services.

The government has said the initial split in responsibility between councils and the board is to help achieve its plans to increase the health visiting workforce by 4,200. It wants the commissioning board to lead this process nationally.

But the committee warns that the involvement of different organisations “risks creating a “dysfunctional division between services which need to be coordinated”.

It recommends that the government reviews its current plans for children’s public health services to avoid them becoming fragmented.

During one of a series of hearings that provided evidence to the committee for its report, councillor David Rogers, the Local Government Association’s social care spokesman, had told MPs the initial split in commissioning children’s public health services “doesn’t make sense”.

He told the committee: “There is obviously a serious risk of a gap developing around the age of five, and it doesn’t make sense for school nursing to be in one place and health visiting to be in another. We would argue […] that much of this can be done at local level.”

The committee adds that it also heard from directors of public health in the South West who said the plans risked “incoherent services” and it was unclear how the safeguarding of children would be commissioned.

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