David Cameron plans more health visitors and a minimum number of health visits...

[Habbibu]

...so I'm guessing he hadn't read much of MN before he came on here! Apparently he wants more visits by trained staff "who really know what they're doing". Oh, don't we all, dearie.

I know, I know, there are lots of great HVs out there - but there are lots of rubbish ones too - and he's talking about a minimum of 6hrs pw for the first two weeks. I think I'd have poked my eyes out...

i can assure you that the fifteen i saw looked after neither the mother or the baby.
and i have no problem with people who say 'i'm no expert, i'm just filling in forms and looking for developmental delays/PND'. but that was not my experience. fifteen bfing experts, i met. especially the ones who said there was no point in bfing and i should just give formula. they seemed to think they were very expert indeed.
unless...

...are they targeted to produce women with PND cos they very nearly broke me.

Aitch I agree your experience sounds horrendous and we are hearing it all the time and perhaps there are some managers who visit here who can now defend the money-saving move to corporate caseloads which may be partly responsible for the problems you had.
Also to clarify, my personal experience is mine, no one else's and I don't use it in the way that you suggest, but I still know what it's like and that's what I remember when someone's telling me that they want to exclusively breast feed but the baby's screaming. It's not an essential requirement for the job but I've been there too and hopefully understand, but our job is to give you the evidence-based information and allow you to make an informed choice, not make the decision or the choices for you. Good practical breast feeding support is a high priority for me and is something I and my team devote a lot of time too and I would use local expertise too if we only had it, but we have very little. I use peer group support where I can. I work in a huge and isolated rural area so the service is very different from inner city and we have to be innovative and creative about how we work.
There has been no money for training updates or study days for at least the last three years, my PCT was 22 million in deficit and the crunch has come at coalface level,vacancy freezes and not even allowed to drive to meetings because of the cost of mileage.But we have worked very hard to cover the work and keep ourselves updated and would be professionally negligent if we didn't. This has all been hopelessly demoralising and is something that must never be allowed to happen again.
But none of this is what matters to all of you and I make no excuses, nor am I defending bad practice, it should be exposed and people should complain. Yes it all needs a good shake up but a shake up by people who understand what they are shaking up and how best to do it. If you all have your say on here then perhaps this time they'll get it right

I don't understand how they look after the mother. I didn't get looked after, I got pressurised to give up breastfeeding and mithered about average weight gain charts which bore no relation to my non-average dd. Then a couple of boxes got ticked. If that's being looked after, I'd rather be neglected.

oh i did complain, loudly, believe me. they had a peer review thing and got their arses kicked, but if what you say about funding is true then i bet it changed nothing...

i hope you get your shake-up and i hope it's one that acts in your favour. and mine.

I'd rather they put the money into proper BF support tbh.

Then HV's wouldn't need to bother about it, they could let trained BF counsellors deal with it. BF support shouldn't really be part of HV's work at all imo, because they aren't trained for it and if they were it would take up all their time.

Really,they aren't expected to be experts in those areas at all. I work very closely with HVs (am a SALT) and a large part of their work is screening and referring on.

It's not too much to ask an HV to have a rudimentary training in b/feeding and nutrition though,which so many obviously don't have.

Reallytired,you are right and the list goes on and of course none of us can do any of that properly or signpost families to people who can if there aren't enough of us. There's nothing worse than knowing what you could offer but only being able to offer a fraction.
I wonder about the quasi-audiologist bit because we do the newborn hearing screening now and refer on from that if there is no clear response, beyond that test all referrals go direct to audiology and I thought that was national now? Perhaps I'm wrong and there are still health visitors out there whispering in baby's ears?

My first health visitor was briliant and the most important thing she did was give me confidnece in myself as a Mum. The one I got with 2nd DS was hopeless, no kids of her own and no bloody idea. She turned up 45 minutes early for an appointment in the morning when I had a 10 day old baby and a 17 month old toddler and couldn't see that I might see this as a problem. I actually had worked with her as a nurse prior to her becoming a HV and felt quite comfortable in telling her not to bother coming back until she had to for developmental checks. She dressed for work in very fitted clothes, which is fine but is it suitable for a HV. Much later on the NHS grapevine I did hear that another HV eventually told her that new mothers did not always want a glamorous HV coming throught the door at a point in their lives when they felt far from glam and that toning down her work wardrobe may be appropriate. Like I said the girl had no bloody idea.

dinosaurouttograss,

My son is six years old and we have had no contact with the health visitor since he was 20 months old. I am sure a lot has changed in four years.

Prehaps there needs to be research to decide what should tested at development reviews.

For example I think the distraction test that my son had at 8 months which involved two health visitors, one whisphering and the other monitoring was a bit of a waste of time. A lot of children had false negatives and my son had a false positive! (He now has hearing aids at he age of six years old!) I don't blame the health visitors for failing to pick up my son's hearing loss in at all. It is hard to check the hearing of a baby.

However I think that a health visitor could test children for glue ear quite easily. Or possibly test the hearing of a child over the age of three. (Just like school nurses check the hearing of reception children)

It might seen silly employing a health visitor to be a jack of all trades, but sometimes health visitors will spot that the mother is suffering postnatal depression when the mother comes to ask about a baby's weight.

As I really don't want to see a Tory government elected I was rather hopeful that this latest idea would deter a few women voting for them.

I'd like to see more money put into the overall services offered so that health visitors can get up to date training and be there to see women in a way which suits them. My HV tended to make appointments for me to go and see her rather than visit me, though she did come here too, but tbh, that sort of suited me for several reasons. Sometimes I needed the push to get out of the house, the health centre is very very close to home anyway, and there were days when I didn't want the state of my house judged.

The HVs I saw were all really nice people and generally they tried to make me feel better not worse about things but I had real issues about being judged as a new mum by then. My experience was an 8 day stay in hospital with my son as the patient where I was supported as a breastfeeding mother with various resources but had very little support from genuine breastfeeding experts, and a feeling that I was constantly being judged and found wanting as a mum. I don't see any way in which I would have felt anything other than being checked up on by 6 hours a week of HV visits.

I'd like to see adequately resourced and really joined up services for new mums and babies, provided by hospitals and health authorities that aren't either struggling from crisis to crisis or putting together a bid to be a Foundation Trust. How are maternity services going to improve if hospitals or primary care trusts are being "fined" for not meeting xyz targets? Including perhaps this HV one?

I apologise for starting a thread and the running away for the weekend - initially I just thought it was a funny juxtaposition as DC had just had a live webchat on MN, but had not perhaps been informed about MNer's favourite rant topics! And I really didn't intend to offend HVs - didn't have great experience from mine, who advised controlled crying from 6 weeks, and early weaning because dd was big. That said, there's a lovely HV who's one of the mothers at our toddler group, and if I have another one I shall beg her to add me to her caseload.

What did bug me about DC's proposal was the very lazy one-size-fits-all thing. I didn't need (and would have hated) 6hrs per week from my HV, even had she been good - we were lucky and got on fine with dd. So for us it would have been a waste of resources, and as ReallyTired pointed out, they have to be too much of a jack-of-all-trades, whereas what new mothers may need is specialised help. I found it soundbite-y, lazy and especially irritating given he's just been on MN and exposed to all the complexities thereon.