Health Visitor turned up after I declined appointment

[AliceBeazley]

So, the Health Visitor. I understand it can be a valuable service to some, and it's good we have this available to us if we need it.

That said, I've never really felt the need myself. I had a visit from one once or twice after my first son was born, and she was very nice but it wasn't especially useful and just took up my time when I would rather have been doing something else.

Whenever I've been sent an appointment, I've gone through the checklist and never had any concerns. I've also got various books on child development in the early years and am proactive about checking whether milestones are being met. I've therefore cancelled all HV appointments that have been sent, and other than the office staff seeming a little puzzled, I've never had an issue doing this.

Roll on to baby number 2. I declined the checks from the start, other than arranging for the HV to come and weigh him when he was a few weeks old. When the 1 year check appointment came through I called the office and cancelled again. The woman said she would pass the message on to the HV.

The HV called and left a message to say she had my message and that's fine, but she could come and do another weigh if I wanted to, yada yada yada.

Feeling the matter was resolved, I forgot about it.

This morning the HV turned up at the door for the 9-12 month check. I explained it had been cancelled, and she sort of made noises as if that was a surprise. I said hang on, did you say your name was "Emma", wasn't it you who left a message for me to acknowledge I'd cancelled. She then said "Yes but as I said, it would be nice to meet you both". I said "Well there's lots of people it would be nice to meet, but you can't just turn up at people's doors uninvited". It was this point she obviously could tell I was annoyed at her intrusion and decides to scuttle off again.

I'm pretty annoyed by this to be honest. She knew I wasn't interested but she tried to disregard my wishes and try and come in anyway. I know a lot of people think HV appointments are mandatory and they don't do anything to point out the contrary. I feel like she just wanted to railroad me into letting her in whether I wanted to see her or not. This tactic probably works on some. I have to say I find it quite disturbing that someone acting on behalf of a government funded organisation can decide to turn up at your house and ask to see your children and intrude upon your privacy without any mandate or justification. As if the state knows better than me and I am unable to opt out.

Am I being unreasonable? I feel like complaining about this as its a complete overstep. I've no idea who to complain to or if it would even do any good. I'd appreciate other's thoughts on it. TIA.

I don’t disagree that confidentiality is paramount in the nursing profession. I just find it sad that HV haters on Mumsnet are so active with their anecdotal criticisms. You talk about stats, yet seem very happy to believe anything written on the internet.

Nursing effectiveness is notoriously hard to measure in figures. How do you quantify something like comforting a mother who had a stillborn child? All you can do is record how many visits you did. The same applies to visiting a mother with PND.

As for safeguarding, figures are gathered on how many referrals are made to social workers, how many HV visits are carried out for safeguarding, how many families are discussed at safeguarding supervision, how many safeguarding case conferences you prepare reports for and attend, how many drug and alcohol abusers you have on your caseload, how many cases of domestic violence you have, how much deprivation there is in your area, etc. As for asking did you play a part in preventing child abuse, then I can say yes I did as I’ve had children taken into care, following referrals for neglect, physical abuse, sexual abuse and emotional abuse.

I’m not expecting you to come back and say, anything positive. I’m sure you and the other haters will come up with more bile.

I don’t appreciate being called names @dollymuchymuchness especially inaccurate ones. Saying you don’t think a service is helpful and would like to see it behave more transparently and to understand what it aims to do and if it achieves that in a desirable way is not being a “hater”. Nor is recounting my own lived experience. I don’t understand your choice of language or your inability to provide any facts and the name calling is hardly professional. Why do you think those who didn’t benefit from the input should be shut down? I’ve never come across this attitude before. In fact most healthcare providers are interested in their user’s experience and in explaining clearly why and how they operate.

Predictable response.

Predicable non-response.

This is why we have a Health Visiting team, to try to lower the number of Serious case reviews
www.theguardian.com/commentisfree/2022/apr/24/observer-view-failures-of-child-proection-system?CMP=Share_iOSApp_Other

Well they're not trying very hard as there seems to be incident after incident that could have been prevented by someone, somewhere, doing their job even halfway properly. Or not trying to cover things up. From social workers to the incident with the black girl being strip-searched in school in London to the maternity crises. All preventable with someone not looking the other way.

@user1493559472 but all bar one of those children were too old for HV and I think under ss? It’s heartbreaking but my question really is are HV effective safeguarding and do they “catch” cases that would otherwise be missed. Is there a better way to achieve the safeguarding?

It’s not fair to say “they are not doing a good job”. How many more cases have they averted? We don’t know as that’s confidential. It’s like goalkeeping. People don’t notice the ones you stop.

How many more cases have they averted? We don’t know as that’s confidential I think we should know, surely numbers aren’t confidential unless they’re very very small.

@5zeds surely that is how long is a piece of string. Obviously if a HV sees something seriously amiss then they may stop something even more horrendous happening. But they may also see something that isn’t so bad, and could just be a mum struggling a bit and no harm yet to DC, but with some advice mum can feel better and nothing escalates.

I expect figures can be found for how many children are taken into care. Done to protect them.

I don’t think it is that hard to judge the effectiveness of a service. Surely you look at which services were involved without action, which with and what the outcomes were? All departments/professionals/services should be scrutinised. It leads to improved service and reduces waste.

I get why you're annoyed OP. You made it clear you didn't want the visit and they attended anyway.

I agree with others that these visits are crucial for safeguarding, but I think I understand why it bothers you: if the visits ARE mandatory, then this should be clear. They should be upfront and honest about this, that HVs need by law to see children and if they don't it will be passed along to social services to make sure everything's okay. But they portray is as optional, and then try to come anyway without your consent. Which is it?

Health visitors are the lead professionals in delivering the Healthy Child Programme which is commissioned by local authorities and will have key performance indicators that are monitored.
Safeguarding data, for example number of referrals to children’s services, and numbers taken into care is also collected by the local authority and published in annual reports.

Seriously, those of you saying how many cases have they averted need to give your heads a wobble. Of course we won’t know the figures, HVs are supposed to help mums and babies, we won’t know if cases would escalate without them. It’s a bit like sliding doors.

What they do is compare incidence rates with and without a service. So for example compare areas with lots of provision to those without or between countries which have different models (Eg England and Scotland). We really don’t and shouldn’t just commission a service and assume it helps. It should be evidence based.
it isn’t really pertinent if the service is voluntary as in OP’s case. All that had to happen was the HV explain she would come round regardless and then OP could have chosen how she responded.

But visits aren’t mandatory. There is no law that requires an HV to see children nor a law that requires mothers to allow HVs access. If HVs pass details along to social services when a mother turns down the service that is entirely a made up policy by either the individual HV or the service she is working with, it isn’t a government or legal requirement. And Social Services are highly unlikely to do anything with a report that simply says a mother has turned down HV visits. Even if they did decide to look into it, in the absence of a court order (good luck getting that simply because someone has turned down an optional service) social services don’t have a right to insist on seeing a child. Only the police have powers to insist on entering a home and they need reasonable grounds to suspect life or limb to be at risk - and turning down HV services would not constitute reasonable grounds to suspect that.

You are at liberty to refuse them.

Those saying ,oh but it’s a safety concern ! Well it shouldn’t be ! Mother’s see doctors and midwifes throughout the pregnancy. So simply assuming there is some sort of safeguards to check on someone who just had a baby is absolutely nonsense and not based on fact .
I go as further at saying the services are mostly not needed in a well run health service . No other country seems to have HV and their child mortality is not worse than the U.K.
money spend in Hv could probably be more helpful in another setting within the nhs .
and yes this is just my own opinion but is based on meninges mum of 3 and an extra 2 surrogate births , as well as a solicitor that had to deal with clinical negligence and family law for quite few years .HV services have massive e flaws abd are ineffective and inefficient.

Those saying ,oh but it’s a safety concern ! Well it shouldn’t be ! Mother’s see doctors and midwifes throughout the pregnancy. So simply assuming there is some sort of safeguards to check on someone who just had a baby is absolutely nonsense and not based on fact .
I go as further at saying the services are mostly not needed in a well run health service . No other country seems to have HV and their child mortality is not worse than the U.K.
money spend in Hv could probably be more helpful in another setting within the nhs .
and yes this is just my own opinion but is based on my experience as a mum of 3 and an extra 2 surrogate births , as well as a solicitor that had to deal with clinical negligence and family law for quite few years .HV services have massive e flaws abd are ineffective and inefficient.

It is mandatory for the health visiting service to offer contact to families as part of the Healthy Child programme.
It isn’t mandatory for parents to accept, but in the UK it is a no cost opportunity for parents/ carers to discuss their children’s health and development, so most people see it as that, without viewing it through the lens of suspicion of State interference.

Mfsf
Services similar to health visiting are found in many other countries, but may have a different title eg Public Health Nurse, Child Health Nurse, Child and Family Health Nurse, Social Nurse.

And in those countries, like in mine, you go to them at a centre, they don't intrude into your home. So it makes a big difference.

How does that work for the vulnerable women who most need help and are least likely to be proactive in asking for it?

@NotaHV you have spectacularly missed the point that NHS services are free only at the point of delivery in the UK. Money does not change hands. This brings an air of receiver as grateful supplicant into the equation and in my opinion is a significant reason for the often poor behaviour towards women from midwives/hvs etc.

I find I get far better quality services when I pay. GP, dentist, consultant, independent schools etc.

Let's also not forget that the HV service has its roots in support for the deprived and was provided by women from higher classes than its recipients. It's never really shaken that mantle off entirely with the head of the HV service declaring in the Times in 1996 that the role if the HV was to teach ignorant women the three Cs. Cooking, cleaning and communication.