Tuesday, 23 October 2018

Health Visitors

A report by the Office of the Children’s Commissioner into vulnerable babies in England has recently been published. 

It pulls together some recent statistics in a helpful way but concludes that much of the data is missing and that only best estimates can be given of the numbers of babies living in high-risk households. The report notes that “.. very little data is collected or collated about vulnerable babies, and that the data which does exist is often reported for children in age brackets (0-4) and not broken down for babies under a year old.”

That having been said the report produces an estimate of around 15,800 babies in England under one year of age considered by local authorities to be vulnerable or highly vulnerable and still living at home on 31 March 2017. The report also estimates that there are around 100,000 young children aged 0-5 living in high risk households who are not recognised as ‘children in need’ including 14,000 babies under the age of 1. 

The report urges the government to address urgently the under resourcing of local authority children’s services departments. It notes that Health Visitors may be the only professionals to see a baby regularly in the vulnerable early months. It recommends increasing the number of mandatory health visitor visits for families where known risk factors are present, improved referral pathways from health visitors to health children’s social care services. It suggests that there needs to be “close monitoring of the adequacy of provision of health visitors now that funding for them has transferred to local authorities”.

The report is very right to recognise the importance of Health Visitors. But it is far from clear that the government does! In fact it appears that the government is presiding over swingeing cuts in services. A report by the Royal College of Nursing has found that the health visiting workforce fell from 10,309 to 8,275 between October 2015 and January 2018 and there are concerns that the future arrangements for local authority funding will see an accelerated decline in spending.  

Research suggests that Health Visitors, who were once considered essential members of every primary health care team, have now become detached and their falling numbers mean that in many areas there is only patchy contact between them and other health professionals.

Anybody who is serious about early intervention has to accept that high quality and well-resourced child health monitoring services have to be provided, especially during the first year of life and extending throughout the pre-school period. 

A government that allows such services to wither on the vine is neglecting its responsibilities to very young children, which is a disgrace.

Breaking Point

“There is compelling evidence that the services and support that children and young people rely on are at breaking point.” 

So say the heads of 120 voluntary and statutory organisations providing children’s health, education and social care services in a joint open letter to the Prime Minister and the Chancellor of the Exchequer. 

Anna Feuchtwang,  Chair of End Child Poverty and Chief Executive of the National Children’s Bureau, who is one of the signatories, is quoted in the Guardian as saying that services once taken for granted, such as family support, children’s centres and respite care for families with disabled children, have become “the privilege of the few” and that essential lifelines have been “cut to the bone”. 
It is hard to argue with such a wide range of informed and expert opinion. The Prime Minister and the Chancellor need to take this letter very seriously. Children’s services are at breaking point. If they are allowed to collapse, the consequences for many children and young people will be dire. 

Any politicians who allow that to happen will not be easily forgiven.