to ask the health visitor why she's here

[womblesofwestminster]

Recently I got a letter from the health visiting team. It was informing me that an appointment had been made for a home visit for my DS because he has just turned 2.

DS is not a PFB. There's been no concerns with his development or health. No missed vaccinations or GP appointments. Nothing. So why the need for the visit?

I phoned and cancelled the appointment saying I had no concerns with my DS. They phoned back a few days later to say another appointment had been arranged. WTF? I thought this service was optional not mandatory?!

I was actually after links to hard evidence, near, but I know to stop asking when I know the information is not going to be forthcoming.

While what you went through sounds horrible, it exemplifies exactly what I mean when I said you are generalising. You have taken your own experience and extrapolated it to the entire service and justified it because some posters on this one thread have also had poor experience of the service.

And you admit yourself that your experience was 19 years ago, so perhaps as a start, you could accept that things may have changed since then?

In fact, near, the government's own data state that there are around 10,500 HVs as at February 2013. Even allowing for a salary of £30,000, which is above the starting salary for a HV, and adding your 25% (evidence for choosing that figure is ....?), you are very far from the billions you quote.

2 year checks aren't offered where I live - due to "shortages". We were given a piece of A4 with a list of what the 'average' 2 year old should be able to do, and told to contact HV if we had concerns.

Rhonda it seems to me that although Near is generalising, she's not wrong about the obfuscation around the HV service.

E.g.: I choose not to have smear tests at my GP's normally. They write offering me one. I decline. They may ask if I want to reschedule, but if I say no, it's no issue. It's an optional service and I can actually decline it.

With HVs, it's so murky! 'We like to see all women.' 'Well, you can decline, but obviously we'll have to report that.' 'You might get a red flag next to your name if you ever take DC for emergency treatment.'

I have also seen a lot of women on here saying that HVs ask about their relationships with their husbands and their sex lives (use of contraception). Why, if it's about the child?

Those are the kinds of messages I (as a layperson) get about the HV service. It's also not clear to me what it's for. Is it for child health? Is it for child protection? Maternal health? Is it for both parents? There seem to be mixed messages.

I think it would be much better if HV visits were either made compulsory or non-obligatory and this was clearly flagged to all new mothers. The remit should also be made clear. Either it's about the child's health in which case ideally both new parents should be in attendance, and it can take place at a clinic.

I disagree. I think there should be more.

My DS is on a later schedule of vaccinations for family history reasons, but this was discussed with his doctor but not noted as the doctor didn't think it was worth noting for whatever reason. He hasn't been to see the doctor in bloody ages because he's not been poorly; when he has it's been obvious what it is (chicken pox/d&v bug) and I've not taken him in to prevent infection. His 2 year check was postponed due to a bug he had, and tbh I never chased it up as I was getting back to work at the time. My own absent mindedness is to blame, I know.

Whatever; no one is bothered that they haven't seen him in probably the best part of a year. My friend is the same; her DS had the MMR at 13 months and he's only now been called for his pre school jabs. He hasn't been to the doctors either since then because he's the youngest of 3, so his mum has seen it all before and knows how to treat it.

I think that is worse, and no one is checking or seems bothered in the slightest.

I think near was expecting too much from her HV - she says the HV was the one person who should have been there for her. For many people, it's their partner or family or friends. I wouldn't have expected my HV to fill that role. And if the HV had truly said those awful judgemental things about BFing, why on earth didn't near report her for being unprofessional? Why come on here, 19 years after the event, claiming it's evidence that the whole HV service has gone to hell in a hand cart?

I actually think parents should be made to do a 'parenting theory test' like the dvla. It should ask questions like if your baby cries what would u do, etc etc bla. And fathers should do it as well. It is important that there is a catchall system. A test would flag up those in more need of support. Is that a really stupid idea? Do I sound like Michael Gove? Oh dear.

Imagine having the luxury of complaining about a free health check for your child? I'm speechless.

Actually you remind me of my DSIS and DBIL bitching about the nhs keeping them prisoner overnight because the hospital wouldn't discharge their sick newborn baby. Peoe should be thanking their lucky stars that they leave in a state that cares about the welfare of its children. And yes public health isn't perfect and there are a lot of inadequate HV, but systems are put in place that work for the whe if society not for individuals.

Excuse typos

It is possible to feel that you personally, for whatever reasons (mine are above) do not want to use the HV service or some aspects of it, and yet still think it is a good thing and should continue.

Personally I am concerned that my local service has been reduced to one that I believe is no longer doing the basics. A good, accessible
HV is something all women and children should have available to them.

I understand that there are massive funding problems, hence the reduced service. I understand these funding problems have a knock on effect to quality of advice due to fewer opportunities for training and professional development. It must be bloody awful trying to do a good job when you are constantly working at full capacity and still not getting everything done. I can see how some of the solutions were reached; service needs to see all babies for one year check but we have 20% fewer HV than we need and not enough clinic spaces (clinics are regularly cancelled) so we will introduce group appointments and see 6 babies in the time we would previously have seen one.

The other problem is that some of these solutions do not work. The other problem is that when a HV is working in somebody's home and says something slightly incorrect like "if your 3.5yo child doesn't have his preschool booster [given between 3-5yo] now, he could give the baby whooping cough and children have died of this! Hopefully it's not too late." There is no peer or supervisor to over hear it and say "erm, that may have been a bit much Jan, the child is well within the schedule window and extremely unlikely to have whooping cough never mind pass it on to the baby". More training opportunities help reduce this risk but that isn't always possible due to understaffing.

I have never felt that my decision to decline some development checks has created red flags. This may be because it is not uncommon for parents where I live to go private including private GPs.

Completely agree K8middleton. Further suburban to point out, I had the full and complet supposrt of my partner and family - they just weren't experts or professionally qualified in relation to breastfeeding and I think it is reasonable to expect someone who tells you 100pct you must do ut to be expert enough to help you.

The luxury of complaint about free services. The NHS is not free, it is free at the point of delivery. If a servuixe provider turns up on my doorstep I expect to know the clear parameters of what is being provided. I can give birth privately, I can see a private GP, I can educate my children privately. I would have been happy to hire a private HV with checked credentils - I couldn't it was a state dictated service. Therefore, when I am dictated to I expect that service to be a lot better than good and if it isn't I don't expeect to engage with it.

No way id accept. Hvs here are useless. I've two dds and our hvs are dumb. I'd happily rock up at a GP. But wouldn't for hv.

I quite liked my HV. When "PFB" son was born I took him up for his weekly weigh ins until I went back to work and was perfectly happy for her to visit the house every day for the first few days. By the time his 2 year and 3 year checks arrived, however, I was back at work and it meant wasting taking a days holiday for someone to spend 15 minutes telling me there were no concerns. When I phoned to cancel I got the whole, "oh but it's so important, you really need to have it done etc." Being naive with "PFB" -and being a foreigner and not knowing how things work here-- I felt I had to keep the appointments. I wised up by the time I had DD and declined her 2 year check.

Imagine having the luxury of complaining about a free health check for your child? I'm speechless.

This.

There are a lot of people on this thread that need to get the fuck over themselves.

I wouldn't just engage any old accountant or solicitor or even estate agent and I feel quite strongly that women should have more choice in relation to their HV and should be able to check out their local reputations before engaging with them.

Hear hear!!

CompareTheHealthVisitor.com someone needs to create this website.

Maybe the HVs need their own website:

SpotTheArseyClientBeforeYouWasteYourVisit.com

Yes, revoltingpeasant you can decline any check, as an adult.
But your child is not declining the check. You are declining it on their behalf. The reason for the "chasing up" is that the child does not have any say in accessing health services.
It's fine to refuse a health check as an adult. Children have no choice. Hence the following up from child health services.

OP here. Someone was asking for evidence, here some:

Health Visitors or Health Police?

This is about the child not you.

Amanda, that is fine. But then it should be made clear. It evidently isn't to a lot of women on this thread.

What should be made clear?
A 2 year check can surely only be for a child. When's the lack of clarity?

Also, someone mentioned tha they wouldn't engage "any old accountant or solicitor..." we'll, no. Neither would most people. But you're not engaging he HV. You're certainly not paying a private hourly fee.
I agree that hcpvs should be good at their job and I can see that it's a great shame some ppl have had negative experiences, but the comparison just doesn't stand up, you are not engaging the HV. They are offering a public service.

An optional public service...

And if they offer a public service and pretend it is mandatory the powers that be who spend our money on it need to make sure the service is homogenous, competent and transparent. With respect to the check being for the child, if the child needs an operation the parent has to sign consent formas and the surgeon cnnot wield the knife without parental consent or a court order.

With hindsight I went wrong with mine from the very beginning. She turned up rather discourteously at 9.10am expecting me to be available to spend 45 minutes with her. In that time I was in my nightie too embarassed to feed my baby, who helpfully went back to sleep when I stuck my little finger in his mouth. I don't usuallt strike up "rrelationships" in my nightie. Least of all whenn the stranger hasn't had sufficient courtesy to telephone and make a mutually convenient appointment.

What I should have done of course is to have said "no you can't come in, you haven't made an appointment and I am not ready to talk to you let alone let you, a total stranger, into my home. Somehow one doesn't think on one's feet with a 10 to 12 day old baby.

OP, it was I who asked for evidence, but I wasn't just asking for evidence that some people have had bad experiences with HVs. There's plenty of that of this thread.

I was asking near for specific evidence to support her claims that (a) substandard services are more prevalent in the public sector than in the private sector and that problems are less likely to be addressed in public sector services and (b) that the HV service costs "billions of pounds" and the most women find it inadequate for their needs.

So far, none of this evidence has been forthcoming but I certainly don't expect you to provide it because you didn't make the original claims.