Numerous studies have confirmed that of all health spending, that spent on mothers and young children gives the greatest return. {Why-Health-Visitors-Matter.pdf]. Maternity and Early Years care is one of the greatest examples of prevention before treatment.
Which is why it is so disappointing that since 2015 the number of Health Visitors has plunged from 11,000 to 6,500 – a drop of around 40%! Their budgets were shifted out of the NHS into local authorities and…guess what…cuts, cuts, cuts.
Health Visitors are not only affected by the under-staffing caused by austerity; they also see first had the devastation it has caused in working class communities – the families being brought up in poverty; homes with no carpets, no beds, no blankets; women preyed on by abusive men; and children fed from food banks. They see the things normally hidden behind closed doors.
Each Health Visitor’s caseload should sit at about 250 children; less in areas of deprivation. But because of all those cuts they routinely sit at 500, 600 or even more. More than 70% of Health Visitors surveyed recently said that staff shortages had affected their ability to help children. But that is not just a problem for Health Visitors, young mothers or their children. The lack of prevention triggers all sorts of problems in the later lives of those children. Problems that could have been dealt with early, nipped in the bud, prevented.
Under twos are big users of A&E, along with the very old. [ADULT SOCIAL CARE: too big to be ignored, too expensive to fix? – Left-Horizons}. Children are taken there with fevers and temperatures, viral infections, rashes and breathing difficulties. Regular contact with a universal health visiting service could reassure worried parents, could deal with the commonest but least serious symptoms, and make evidence-based escalations.
Health Visitors are key in vaccination campaigns, perhaps the most fundamental element of preventative medicine.
And Health Visitors are the first line of defence against child abuse. As it is a service open to everyone, there is no stigma to using it. On regular visits Health Visitors can look out for the hidden signs – maternal depression, coercion and control by partners, alcohol and drugs, or plain neglect and not coping. Enquiry after enquiry finds that the other statutory services miss these signs as they are all looking at their little bit.
Adverse Childhood Experience (ACE) is shown to link to heart disease, diabetes, and mental illness in later life. Preventing, or even just reducing ACE, gives population health benefits for decades after.
And yet politicians like Wes Streeting prefer to announce shiny new Health Hubs – even if funded by PFI-type schemes [A return to public-private partnerships? Getting the NHS back on track | Mills & Reeve], or to invest in complex algorithms to triage A&E and patient discharge, whilst tolerating a hollowed-out Health Visiting service. It does not make sense.
Unite has a good membership amongst Health Visitors, but our reps often struggle for facility time in the face of under-funding and under-staffing. Sadly, there are whole Trusts with members and union recognition, but no reps. The union is even running a Healthy Visitors strike in South Wales [Health visitors crank up pressure on Cwm Taf health board with eight more weeks of strikes], but strikes can only take us so far. What is needed is sustained investment in the grass roots, nurturing of new reps, and regularly bringing reps together to solve each other’s, and their own, problems.
You must be logged in to post a comment.