So what is the point of Health Visitors?

[wonderstuff]

I've seen 3 so far, they all seem very nice, but really not very useful.

Today lovely lady came by, did PND questionnaire, weighed my baby. Talked about weaning - advised that some babies (especially boys) are ready for weaning at 4 months, to be aware of him taking interest in us eating couldn't give any advise about BLW as no reseach has been done and she doesn't want to get sued - fair enough, but seemed strange that on the weaning age she was willing to contradict research evidence. She also warned of 'missing weaning window at 6 months' I didn't ask what would happen - will I end up bfeeding forever, Little Britain style? Told me breastfeeding was tiring (there was me thinking it was the lack of sleep that was knackering but presumbably if I bottle fed I'd have much more energy?) She stayed for half an hour.

Really what is the point - could money be better spend on Midwifery or Social care?

Did you register when you moved and go along to their weekly clinic so they knew who you were? I haven't seen your other thread, but suspect that unless you make yourself known and on their list as it were, there's every chance you'd get lost amongst the numbers. (That aside, I'm very sorry to hear about your PND).

Tbh gaelic the chances are the HVs did not even know you were there. I come across it all the time as a HV. Unless the Mum rings us we often don't know they are there.

As faot not seeing babies for months on end - we do look at the whole picture when we do initial visits and more or less risk assess. Some we know we have to keep an eye on either from past history or from what we find when we visit. I personally could not visit every single baby on my caseload though as I HAVE to focus on the need rather than the want. I have families I would give my eye teeth to visit weekly but who are so normal I cannot justify it so I visit the 15 year old Mum, the 17 year old parents who are struggling due to dad's cannabis use, drug abusers, the families where children are subject to child protection plans and child in need plans.

I take your point that any child could be subject to abuse at any time and things CAN change but given current resources I have to prioritise my workload on probabilities.
Even WITH weekly visiting and lots of support abuse can happen - some years ago I worked with a family who were struggling because of depression (Mum). They appeared to be doing well in all other respects and their children were georgeous and well cared for. Then between one visit and the next booked visit the baby was taken to hospital with all the symptoms of shaken baby syndrome and Dad subsequently went to prison. So even with intensive visiting we will not prevent abuse if it is going to occur.

I have just read the OP again though and could rage about it.... some HVs are just NOT up to the job. Perhaps we shouldn't be needed - would the money be better spent going into other services?

...and suchprospects I see what you are saying but am just not sure how we get round these ethics. At present we have no other way of doing things apart from to offer a blanket service to all.
The main reason for me visitng a new mother is to offer a service (albeit this may be fairly limited to phone contact and baby clinic) and NOT to make sure she is fit to parent her baby. However, if problems become apparent at that first visit then I would be negligent not to do anything about it.

If there are problems - emotional health etc then I can often offer support and I do. This is not about child protection but about supporting a mother to see she is doing a fabulous job and giving her 45 mins of time to talk about the difficulties she is facing. In some cases it's also about trying to get appropriate support.

The bulk of my work IS child protection but that should not be the focus of my work which SHOULD be family health. The resources are such though that Child Protection is what I have to concentrate on.

Anyhow - must get ready for work.

If HV's were part of anyone's household budget or the budget of a small company how long do you really think they would last Ghostly Pirate no individual or small private company would allow the leakage of resources in the manner of the HV service. No published objectives, no mission statement, no short, medium or long term strategy about to improve effectiveness. And it was a joke that I had to go to the CEO of the Health Authority to get a definition of what HVs are supposed to do and even that was non specific. When from reading threads on here 1 in 3 at best and possible 1 in 2 are not capable of providing an acceptable standard of service do you not agree as a Health Visitor the current situation is completely unacceptable and needs to be addressed as a matter of urgency.

So when a child is registered with a new GP the HV records don't follow the medical records?! That is very surprising.

My experience in the first area was requesting to be seen (for the 2 year check that everyone got but we didn't) and it being refused. Then in this current area, where HV didn't know DS existed, it turns out the team in the previous area - who had been expressly contacted by me and had refused to see DS - had never got DS's records from the previous place we lived.

Obviously everything is fine here (we're staying put now), but families moving around must sometimes be an indicator of an unstable home life. And of course the child at risk will be the one whose parents don't contact the HV.

greenbeanie and ghostlypirate thank you for replying. I understand there is a good deal of training needed to become a HV in the 1st place, but I think what seems to be missing, unless I am missing it!, is the CPD aspect - WHY do they not get up-to-date training inputs on eg BLW, bf-ing etc? Bf-ing initial peer supporter courses are 1 day events at weekends etc, HVs should be on them! I'm sure you get updates, as I do, when for example there are changes in child protection legislation - so why not on weaning advice etc?

When I had stopped being angry at mine for trying to force me to stop bf-ing, I did have a wry laugh at the fact that she told me how to go about formula feeding in completely the wrong way in terms of the new guidelines on heating the water etc.

i had a fantastic HV - not only was she great with all my dc but last year when i had been suffering from depression and had been hospitalised, when i came home she would come and visit me once a week just for a chat and to make sure i was coping alright even though dc were at school - i have been so lucky.

The main problem I remember with my HV for DD1 was trying to get any concrete information out of them. I had no idea about babies before I had mine and I remember asking just how long they were supposed to sleep during the day. I got all sorts of waffle about all babies being different and to be led by your baby etc, when what I wanted to know was should it be 10 minutes or 5 hours? They really don't like to commit themselves. It was only when I said my newborn DD1 was maybe having half an hour or so in total over a few catnaps that I got any kind of useful info - in the end I had to resort to the Gina Ford book for an estimate of a normal total sleep time - no wonder DD1 screamed the whole time, I thought they just slept when they were tired, didn't realise you needed to actually put them to bed .

So the upshot seems to be that actually HV's are there for those who are at risk and offering the service universally means they can identify who is at risk. I can buy that (with difficulty) if the quid pro quo is an excellent mother and child centred service which provides excellent advice based on evidence based research offered in a kindly and thoughtful way. Is that what mothers who aren't at risk are getting? I didn't get it 15 years ago and don't see any positive changes since.

Surely if HV's want the blanket access they have to give something that's worth having in return do they not? Was confused 15 years ago, continue to be confused now.

Come on HV's was it right that 15 years ago the chair of the Health Visiting Association gave an interview in the national press, think it was The Times, stating the role of the HV was to teach ignorant mothers the 3 C's, Cooking, Cleaning and Communication.

Very respectful to most mothers or what. Sorry but am I really supposed to have an iota of respect in those circumstances especially bearing the mind the wholly inadequate and insolent service I received.

I was treated as though I was ignorant mother. It was wholly unacceptable then and remains wholly unacceptable now.

Absorb it into social services and have done with it unless the service can be significantly improved. If it can't be honest about what can be expected from it.

No it wasnt right the service you received 15 yrs ago and things are changing at speed for the health visiting service.

We will be commisioned for safeguarding and seeing new babies following the midives visits,we then have to work out who has a targetted service.All other parents are offered phone advise and dropin clinics.

All the preventative work we used to do with families is supposed to be in Childrens centres by their workers. Probably wont be commisioned for supporting mums with PND,bereavement,disabled children.

You cant compare a child health service with companies. Child protection is expensive and the only end product you hope is a live healthy child. Bad economics when they die look at the cost of Baby P and Climbe inquiry millions.

I appreciate the argument that if HVs only visited "at risk" families then there would be a stigma attached and it would be less likely that the people who really needed them would let them in. I also agree that it's a good idea to do an occasional check on everybody because PND and other problems can crop up in any home, but the service for "normal", coping-well-enough families seems to be frequently worse than useless.

Perhaps the answer is a sort of two-tier HV service: Somebody properly trained in the basics - feeding (BF AND FF), sleeping, weaning (all methods), normal child development - all the stuff a not-at-risk family would find useful - would visit every family. They would also be trained to spot problems and refer the mums on as necessary to a second tier of HV who could make full use of their specialist training to work with at-risk families, or they could refer mums to BF support workers if that's what is needed, or any more specialist help a mum may need, or just keep contact to the minimum if that's what is appropriate.

What am I talking about? There are horrible cuts - nothing is going to get any better any time soon

Watch what happens to the service, there has been no investment into HV training over past decade. We are being commissioned to deliver a stat service mainly on safeguarding. Its unlikely that "non at risk "families will receive a service and that HVs will be brought into Childrens services to work alongside social workers.

Well there was investment two decades ago and they still weren't providing an acceptable service then. Sorry Jaffa but I really think things have to change. Feel tempted to ring up the Health Authority and tell them I'll reconsider a non exec directorship after all this!!

Health visitor comment on mums net Oct 2010

My experience of HV was awful ? and dangerous. My DS?s weight dropped from the 75th centile at birth to just above the 2nd centile in week 7.

I never saw the same HV in a row.

Although the HVs said they were concerned about DS?s weight they just kept telling me to go to a breast feeding clinic ? ergo I was feeding him incorrectly.

On an occasion when my ?named? health visitor did have contact with me she saw my DS bring most of his feed up (as normal) and she said, ?There must be plenty going in if there is plenty coming out.? How WRONG she was. My son has reflux and thank God I know a paediatric doctor who I rang in desperation. Within 2 days she had diagnosed (him over the phone) and we saw his weight increase dramatically. :)

A good friend watched as her health visitor who was on the phone write information in the red book about her DS that the HV could NOT have known if it was true or not.

In my experience, HV are appalling.

...but littlefish and onceamai - can you at least accept that we are not all appalling?

Most HVs have NO training in feeding/weaning at all apart from "on the job". It's not great and tbh I know what I do because I keep up to date. There will not be a universal service for much longer I doubt - we are all being told that we will work with "needy" families and not universally in the future.

And what the HV woman said in The Times 15 years ago is hideous. I certainly do not see that as MY role. More like looking at health needs and trying to find resources to meet these needs.

Quite honestly though after the day I have had today I might just resign anyway and donate my salary elsewhere. M+S must be looking for Xmas staff .

I am surprised there are not more of these threads but honestly can some of you not realise that you cannot tar a whole profession by your experiences of a few.

It IS disheartening to read "All HVs are crap" written on the experience of 3 contacts - especially after the day I have had today.

And will hide this thread as it's starting to annoy me immensely. Those of you who think we are useless just refuse the bloody service - it's NOT complulsory.

And if there were no HVs I can tell you that the GP appointment system would collapse under the weight unless they employ many more GPs who are infinitely more expensive than HVs.

Bye bye - thread hidden as of now.

hostly pirate lets give up we cant defend ourselves anymore we surrender!
Honestly noone relly understands what working with difficult families is like unless they are in family law or social services.
Lets stop banging the drum and go job searching ! Take care

I hope that enough people have said that they are not all useless!! It is just the same as every other profession, goodies and baddies, but this is a parenting forum so we've all had experience of HVs. I have no doubt there are truly appalling accountants out there, but I've never used an accountant!

fwiw I'm a teacher and a fair few of them are crap!

But the stakes are so high I guess with what the HVs have to deal with - that is why being unprofessional and poorly trained (again not you guys personally) is unnacceptable!!

I am sad to say I didn't encounter a single decent HV in the last 13 months. One came after the midwives signed off on us (they did the home checks after my DS was born). She sat on the sofa and told me that my (seriously underweight, premature) DS should be fed every four hours, not three, as otherwise he'd never get used to feeling hungry.

Then there was the one who didn't know how to measure him when we had our first check-up at the clinic, so his length was never recorded. Then there was the one who wanted to refer us to a nutritionist after the lovely GP had reassured a very anxious me that my DS was healthy, just 'a slender child'. And how was a nutritionist supposed to help a breastfed-on-demand baby who was just very energetic and had been a low birthweight? She made me cry all the way home. She made her pronouncement based on looking at the chart in his red book, by the way - she didn't actually look at him once. Not even at his face.

Then there were the four HVs who did a session on weaning for mothers of 16-week-olds, none of whom knew what BPA-free meant, none of whom could advise anyone on stopping breastfeeding and none of whom seemed to know anything about babies. Four of them. One would have done for a room with ten babies/parents. I still recall them saying, 'BPA-free is just a manufacturer's gimmick'. And I get that they are supposed to encouraged breastfeeding, but badly prepared formula can make babies very ill indeed.

I have met nine or ten HVs through the local practice, a very large one in a baby-filled area of London. Some of them were perfectly nice people, but I have yet to receive any advice that was even sane, let alone helpful. And I have heard some shocking advice that was given to other mothers I know.

Why would anyone want to be a HV? And what do you need to do to qualify? Being a busybody shouldn't be enough.

Definitely useless in my experience. If you asked anything that wasn't in the text book they didn't have a clue.

Haven't seen one for DS since he was 5 days old (he was 1 yesterday). They "forgot" to give me the results of his heel prick test and sent them when he was about 4 months old.

Had a standard letter from them a couple of weeks ago basically saying "read the attached and get in touch if you think there's a problem". Marvellous! Oh and they also advised me that my child should be weighed at 1 year (get yourself down to the clinic to do this). WHY? It'll be for no-one's benefit except mine! They seem to be called the Public Health Team around here now, except they don't seem to see much of the public!

As withorwithoutyou said, think they are there to check you don't need reporting to social services and perhaps to help if you're having trouble coping. But they'd never know if, as in my case, they haven't seen you since your baby was 5 days old... Relying on the parent to get in touch if they fall into one of the above is a bit of a risky strategy, it seems to me.

Just wanted to add that I hadn't read the whole thread when I posted and having done so, I can see there are good ones out there working hard. I did encounter some shockers, though. But I do know what it's like to be broadly categorised as useless when you work bloody hard for small enough reward, and I feel sorry for the HVs who are worth triple their salaries. Working with The Public is a tough job sometimes. We, The Public, don't always see it that way.

I really cannot praise my HV highly enough. I was on the at risk watch list for PND (I am bi-polar and was taking a reduced level of meds for my illness to minimise addictive nature of the drugs on the baby) and she visited before, and many times after. It never felt forced or judgemental. I knew that I was at risk and I knew I wouldn't notice. She was fabulous with practical advice about formula (couldn't BF due to addictive drugs I have to take). I think her support (and that of the other HV's in our area later on when I attended the weigh in clinics weekly) was one of the reasons I didn't get PND. However NCT friends from different areas travelled to weigh ins in my area as their own HV's were similar to the bad ones being described above.

Unfortunately it's one of those services where a bad experience/bad service can have a really severe impact on us at a very vulnerable time.

the hv that visited me was nice enough but have found since going to clinic my self that they all tell me totally different thongs about the same issue i had with bf - they seem to just go with their own views.

that said at least there are people there to talk to - my midwives were absolutely useless - any issue i asked them about on their helpline ended in "if you're worried go to a&e" with no other help!

My HV only visited twice; once a week after DS was born, and again 5 weeks later. She didn't even recognise me when I bumped into her at the clinic.

I'd have liked her to visit more frequently, I could have done with better advice about DS sleeping on his own than 'just make sure all his needs are met for now'.

I don't expect it's such a 'lovely' job when they come across children in real need of protection though.

Ghostly I hope you're still here to read this; I don't think HVs are useless. And the HVs at my clinic appeared to be very well-trained and up to date in their knowledge of BF/BLW and weaning in general. I just wish one could have visited me more.

Quite frequently the less a mother needs an HV, the more dismissive they're going to be of their value. Same as any caring profession unfortunately.