The loss of health visitors is a true scandal

Susan Hill recalls how much she relied on her health visitor and bemoans the decline of this once-universal service: the victim of bureaucratic ‘targeting’ and government ignorance

You can be sure of one thing about government. If it ain’t broke, they will fix it and don’t worry about the breaking bit, they will do that for themselves. Rewind 15 years to the health visitor system which was so ‘not broke’ it was a model for best practice throughout the world. HVs originally looked after patients ‘from cradle to grave’, advising and supporting anyone who needed them, including the elderly, the chronically or terminally ill and the disabled, but gradually their remit narrowed to new mothers and babies and the under-fives.

They were qualified nurses who trained on the job before being attached to GP practices, as part of a mixed-skills team with their own caseload, visiting pregnant and new mothers. They did routine checks and advised on maternity and neonatal problems while learning about family and home circumstances. Even mothers in prosperous circumstances have troubles over their post-natal health, breast-feeding, crying or non-sleeping babies, but everyone had a health visitor and with no stigma attached to her visits. If the HV was worried about a mother or baby’s health and welfare, she was perfectly placed to alert her surgery team. She was on the lookout for postnatal depression, developmental problems and tuned to possible domestic violence, child neglect or abuse. She had access to patient notes and could add her own for the surgery team. Many a crisis has been nipped in the bud by an HV having a quiet word with the GP as they passed in the surgery corridor. Meanwhile, trust was built. Mothers could talk to their HV about things they found it difficult to express to family or even doctors.