to expect the health service to ask to see a child between the ages of 2.5 and 5?

[wolveschick]

This week I got a letter from my health service to say that they will no longer send a 3 year check appointment, to bring a child to the clinic for assessment but instead I have been sent a questionnaire to drop into the clinic instead. In the light of baby P and other tragic recent cases is it unreasonable to let a child go potentially unseen by health visitors from the age of 2 (the last official check we had) to when they start school at 5. I hardly imagine an abusive parent will fill this fact in on the questionnaire will they? I am usually the first person to moan about the state playing big brother and keeping stats but in this case I feel really strongly about them cancelling this check. AIBU or do other health authorities do the same?

I got a letter yesterday from HV detailing the vaccinations ds has had to date, and saying he won't be seen til he starts school. He's not been seen since his MMR at 13 months or so and is 2 next month.

I think its shocking in a way, and don't agree health problems would necessarily be picked up in other ways, certainly not in any timely way. There's something a bit if they have an assumption that health problems will be picked up via social services..as if certain health problems only happen in "problem" families that are known to ss already.

If they HV services were properly funded surely they wouldn't be dropping these health checks.

Last time the HV saw my daughter (now just over 2 years) was at 5 months, I got a leaflet for her first and second year check-ups.

I agree with the OP if she didn't go to child care and I didn't take her to toddler groups or mix with other mums & kids no-one would know how she was.

Also other that the occasional 10 min Dr appointment there has been no support to my parenting with regards to health - I could (and may well be) making a complete balls up of things.

I find it worrying too. A lot can change in a year or two, separation, bereavement, depression etc can all have an effect on the parents mental state. The current system assumes that if you are coping fine when the baby is born, then everything will be hunky dory for the next few years, which I find bizzare. I can completely understand how a child could easily slip off the radar, which is disturbing. Some people dont have a support network or close family and friends, so how would ss (or anyone) know if anything was wrong if they just assume things. I personally wish more checks were done on my dd, for my own peace of mind, as wierd as it sounds! We recently moved house and phoned our doctors to notify them of our change of address. I asked if they would be doing a home visit and was told, no, they dont do that. dd is only one and has not been seen by a hv since her 3 month jabs. As I said a lot can change in a year, I could have been moving in a drug den for all they cared! They also still send letters to my previous address so if I hadnt called again, they would have basically had a child on their books who could be anywhere and nobody official would know.

Judging the parent's mental state is only a small part of the job anyway. I was in fine mental health when dd was a toddler, perfectly pleased with my parenting and our bonding and my happy home. Would never have occurred to me to seek help because I didn't know that anything was wrong. It was just that dd was showing early signs of disability.

Not apparent to me due to my lack of experience. And if I didn't see it, you wouldn't expect someone at a toddler group to see it either.

Ds (22 months) saw the health visitor for his jabs and his MMR, a 6 week check, and he also had a rough check over at about 8 months, but it wasn't anything detailed.

I took him to the health centre recently because I was concerned about his weight, and was told that he receives no other checks. My siblings all received 2 yr and pre-school checks, for developmental and social stuff - I can't understand why they are scrapping these checks. What happens to children who have problems but who don't attend nursery and never go to the health centre? It's a bit strange I think.

It's not necessarily about money. My PCT had big problems recruiting HVs (and even worse ones for school nurses).
Regarding the six month/two years checks the evidence suggests that most of the routine checks just aren't very effective in picking up problems, and that it is more useful to have a service that is easy to access when as a parent you have concerns. That way the service is not clogged up with lots of parents and babies who are doing fine, but feel that they need to do the whole weighing regularly thing. What then happens is that the HV service is concentrated on mums and babies where there are already concerns. Not usually picked up through SS type concerns, but usually defined by social deprivation or other risk factors. This works very well when services talk to each other ie a mum presenting with mental health or drug/alcohol issues should be flagged in the HV service if they have young children, but people are still very very worried about doing this because of data protection, and also sometimes just don't think beyond their own specialty.

Unfortunately though community services are always the most squeezed when the health service is short of cash because they are almost totally hidden. Lots of targets for hospitals and GPS, and pretty much none for community services, so waits get focused on at A&E/GP appointments and for operations but not for OT or SALT assessments. Also in the past community services had terrible IT systems (often in fact no IT systems at all) so they couldn't even easily say who had been seen or not.

Having said that I was personally very happy not to visit my HV clinic more than once or twice for each child, but I did have access to lots of child development specialist at work.

My DS hasn't been seen by a health visitor since he was 6 months old. We moved area when he was one and there has been no interest in him whatsover, despite us trying to contact the health visitors by phone. He's 2 and a half now. I don't know why I'm bothered really since HVs are so rubbish, but I figure that I want the service I'm paying my taxes for.

Tumtumtetum - I'm sure I read that a large proportion of children who die or are injured at the hands of family are not on the at risk register.

To the people wo suggest that things might be picked up at toddler group:

I am a toddler group leader, and had to design a child protection policy. but.. I received absolutely no formation on the subject. The council did invite us to a meeting to listen to our concernes about child protection/fisrt aid issues, they took our names and contact numbers to send us invites to a course taylored for us, it was over a year ago and we still have not had any news about that course.

I would be totally unable to pick up on child abuse unless it was really obvious (bruised face and dirty clothes + maybe drunk mum...)nor would I pick up slow developpement as I pretty much feel like Cory felt.

Please, do not rely on toddlers group for that, we are not trained for it!

HVs are still out there - just not as many. They are so incredibly busy with child protection work, as well as working with new mums and babies, children with special needs and supporting mums with PND and social isolation. They don't have time to do routine exams and assessments for children now.

Also routine checks are notoriously bad at detecting problems as they are just a half hour snapshot of that child - far better for parents to seek medical help as and when they need it. Parents know their child much better than a stranger. If a parent has concerns about that child then it is far better for them to see their GP than to wait to bring it up at a 2 year check.

I agree that not being able to contact a HV at all is poor, but why wait for them to come and find you? Pick up the phone and call them - your child, your priority, your responsibility.

TBH I don't think that health visitors are sufficiently qualfied to judge serious child development issues. I found with my son the health visitor was well meaning but to put politely fairly clueless.

It is hard for anyone to be sufficiently knowledgable in all the fields that health visitor is expected to be knowledgable. Either everything from child development, child protection, maternal health, social worker etc.

The health visitor was pre occupied with me suffering severe postnatal depression that she did not even listen to my concerns about my son's development. I think she did her best but she was human.

My son's developemnt problems were sorted when he was refered to the child development centre by our GP and saw the community paediatrian. The community paediatrian was able to tell us exactly what was wrong and get us the correct practical help.

My son had 18 months of nhs physio to learn to walk properly and the paediatrian picked up on my son's deafness. He is now enjoying life and doing well at school at the age of seven.

I saw a HV twice - both times before my son was four weeks old and that was it. They obviously thought that I was coping and then used their time supporting others who they felt needed more attention.
I have the option to take him to be checked at the local children's centre but I haven't really seen the point of that - he's fine. If there's anything wrong with him I'd rather take him to the G.P. - luckily only had to do this one in 17 months.
Only worry is that I think it's difficult to see if someone who is coping at four weeks are still coping at 26 etc. They could very easily be missed...

Well you don't actually have to have a child seen by a health practitioner at all ever if they are not ill.Routine health screening is entirely optional at any age
My GP seemed very suspicious when I took my DS aged 13 recently as they had no record of having seen him since he was 2 ! he has had the usual round of colds flu sickness bugs etc but nothing requiring a doctors attention.