Wednesday, 17 August 2011

Health Visitors - Help or Hindrance?

"Health visitors give advice, they don't judge, they help out." – David Cameron.

“A health visitor is someone who would have liked to be a paediatrician, but for whatever reason, decided that she likes being out and about in the community, offering pearls of wisdom to as many poor, unsuspecting mothers as possible.” – Mumsnet Mum.

Before I begin this article I would like to offer a disclaimer. There are many knowledgeable, non-judgemental health visitors operating contemporary, however the growing trend is sadly that health visiting is attracting more complaints from mothers than ever before (Poulton. B). This article unearths the emerging reality behind the profession. I will tackle the following questions: How do you become a health visitor? How much do health visitors earn? Why does advice differ so dramatically between health visitors? And perhaps most importantly, what are my rights and how do I complain when a health visitor oversteps the mark?

Job Description

A health visitor is a qualified nurse or midwife who has undertaken further training in child health, health promotion, public health and education. They work as part of a primary health care team assessing the health needs of individuals, families and the wider community. In theory, health visitors aim to promote health and prevent illness by offering practical help and advice. The service is distinctive from other health services in that it is supply rather than demand-driven so health visitors will contact clients whether requested or not (Heritage. J). The origins of the health visiting service lay in the sanitation movement of the nineteenth and early twentieth centuries. Strongly interventionist and targeted at working class homes, inspections of sanitation were carried out to “direct the attention of those they visit to the evils of bad smells, want of fresh air and impurities of all kinds” (The rule book of the Manchester and Salford Sanitary Association c1880).

Contemporary UK law does not recognise health visiting as a profession. Its status as a profession was removed from law ten years ago. The occupation has no legal standing and its title has no official meaning. This, argues Nursery World, “puts the public at risk” (Nursery World 2010). The legal change has made it easier for primary care trusts to cut back on health visitors and employ less qualified staff. In theory, anyone can describe themselves as a health visitor. This is legally acceptable.


In order to become a health visitor, a person should first be a qualified and registered nurse or midwife. To train as a nurse, a person will need to complete a degree or diploma. Five GCSEs (or equivalent) are required for entry onto a diploma course, and two A-levels/Highers (or equivalent) are required for degree programmes. A degree in certain subjects may allow a person to take a shortened training course.

Then the candidate should take a one year health visiting course at degree level. Courses may be completed in a shorter period where credit is given for prior experience. The requirements for entry to the course are very flexible and there is no minimum experience requirement; thus, someone who has not long worked as a nurse/midwife can become a health visitor.


Health visitors are paid on Band 6 of the NHS pay scale – i.e. newly qualified entrants normally start at £24,831, rising to £33,436 with seniority. Team managers and health visitor specialists can earn up to £39,273 per year on Band 7 of the NHS pay scale.

The sinister side of health visiting

Health visiting is an oxymoronic dichotomy. That’s just my fancy way of saying that the values of health visiting are in conflict with each other. On one hand, health visitors are required to give support to new mothers. This is the common reputation enjoyed by health visitors. Yet on the other hand they are required to place the same mothers under automatic suspicion of child abuse, erring on the side of caution at all times. Yes – child abuse. This is serious business. Commonly thought to be the exclusive domain of social services and the NSPCC, a central role of health visitors is to sniff out potential child abusers. Your friendly neighbourhood health visitor likes to do a James Bond and collect covert information on unsuspecting parents.

One example is the assessment for postnatal depression (PND). A diagnosis of PND used to be rare however now health visitors are required to screen all mothers for it using the (non-validated) screening tool: the Edinburgh postnatal depression scale (Cox et al). Developed in 1987, this rigid instrument emphasises the significance of professional lead, instead of client participation (Mitcheson. J). It consists of 10 statements, such as "I have felt sad and miserable" or "I have felt scared and panicky". Common feelings for new mums adjusting to the hormonal, emotional and practical changes a new baby can bring, are often pathologised. This means that more new mums than ever before are having the PND label stamped in their records. Rather than this leading to greater support, it has “more to do with problematising parents and their relationships with children” (The Guardian). The consensus amongst health visitors is that a depressed parent can pose a risk to a child. An overwhelming number of mothers are aware of the association between a diagnosis of depression and assumptions of parenting incompetence. “Always put mascara on before the health visitor is due to visit. That way, she’ll think you’re coping and leave you alone” one journalist mother advised (The Wiltshire Gazette and Herald).

Also don’t go thinking that because you’re mentally sane you can limbo under the radar. Even if there is no depression or other ‘problems’ health visitors screen all new parents for any likely risk of child abuse. In some areas, they even visit mothers before the birth to do so. Intentionally vague and probing questions are rattled off, such as "How loving do you feel towards your baby/child?" and "How confident do you feel being a parent?" Such questions are designed to catch mothers off guard and although some health visitors attempt to distance themselves from the procedure by attributing it to a higher authority, the questioning creates an unnecessary climate of judgement (The Guardian).

“The screening looks at risk factors such as the mother's age, marital status, education and whether the baby was premature or in special care. Many of these 'risk factors' are related to poverty, so just being poor makes labelling more likely” (Robinson. J). Mothers with physical problems are additionally picked up by the radar, so having a disability also makes labelling more likely. “Alternative lifestyles or 'non-compliance' of any kind may be regarded with suspicion - including breastfeeding toddlers, use of alternative practitioners and rejection of immunisation” (Robinson. J). These crunchy mothers undermine and challenge a health visitor’s authority, as that authority is derived from their mainstream textbook training.

Furthermore, health visitors purposely obscure their agenda from those they visit (Cowley S et al. Structuring health needs assessments: the medicalisation of health visiting). Vague smokescreen justifications are given for visits, such as “we want to get to know you before the baby arrives” and “we only want to know the depth of your problems so we can help”. The purpose of the interview is disguised. As well as the Edinburgh scale and interviews health visitors utilise cold calling (dropping in unannounced) and even more subtle techniques such as asking to use the bathroom so that they can snoop around. (Crap. I knew I should have removed the cat hairs from the sink).

Risk-assessment measures are increasingly used to pass judgments, and exploited retrospectively to justify past decisions and actions (Goddard C et al. Structured risk assessment procedures: Instruments of abuse? Child Abuse Rev; Openmarket). This increasing involvement in child protection threatens the ethical basis of health visiting (Taylor. S and Tilley. N). Is it ethical for health visitors to seek out and identify risks that they cannot effectively treat? “We cannot ask our Health and Social Services to act as a kind of anti-abuse intelligence service, smelling out the bad parents long before they have committed any crime” (Barker W. Practical and ethical doubts about screening for child abuse). The paradox is that when a mother is threatened with Social Services for “refusing” help, they are then seen as a risk when they “accept” help.

What is more, the Government’s campaign for disallowing aggression towards NHS staff has encouraged staff to label clients as "aggressive" when they have felt threatened, despite what constitutes aggression and threat being highly subjective. You don’t have to issue a bitch slap for your behaviour to be interpreted as aggressive. Vehemently disagreeing with your health visitor could also constitute aggression. A mother who receives a label of “aggressive” is seen as posing a risk of future child abuse. Health visitors’ tendency towards oversensitivity in this way is partly explained by their training background. If they trained as a nurse their approach can be excessively dogmatic.

Once a mum is labelled as suspicious by a health visitor, her label is transferred, via her records, to all the other Primary Care Trust staff that she may come into contact with during the entire course of her mothering experience. Like garlic breath, the label will follow her everywhere and infect her interactions with: midwives, GPs, paediatricians, nursery nurses, Sure Start centre staff, other health visitors and baby clinic staff.

In my opinion new parents should be seen as potentially vulnerable, rather than potentially abusive, and the aim of visits should be to strengthen the parent-child relationship. Yet instead mothers' are disappointed that health visitors are largely there for the baby, not for them.

This climate of surveillance rather than support often makes mothers reluctant to request advice for fear that adverse judgements may be made about their knowledge or competence as a parent. These fears are justified by studies which have shown that health visitors show little effort in acknowledging mothers’ competencies and capacity for personal decision-making (Heritage. J). In situations where mothers assert their knowledge or competence, their assertions receive no acknowledgement or quasi-acknowledgement and, in a number of cases, are positively resisted (Kendall. S). Woe betide you mention opening a book or a laptop every once in a while.

Unsolicited advice

Perhaps the most common way health visitors undermine mothers’ competence is by forcing unsolicited advice upon them. As is the case with mothers in law, the majority of advice given by health visitors is uninvited (Heritage. J ). Unlike mothers in law however, you can’t tell a health visitor that their advice is bollocks because due to their status as childcare professionals, their advice is commonly perceived as effectively unchallengeable.

The tendency of health visitors’ to trot out unrequested advice like an audio-wikipedia may be explained, again, by their nursing background. This training inclines them towards “an identification, diagnosis and treatment” approach to mothers rather than one in which mothers are encouraged to take the lead in defining their needs (Heritage. J).

As health visitors are lone workers and home visits are hidden from public view the health visitor has little fear of scrutiny. Foster and Mayall have observed that health visitors are confident in the superiority of their own knowledge base regardless of whether its origins are lay or professional in character. It is not uncommon for health visitors to dish out patronising, outdated and sometimes hazardous advice. Their excessively authoritarian attitude leads to mothers’ confidence being undermined on the rare occasions that they have some. One only needs to Google “health visitors” to read innumerable complaints from mothers about disparaging comments regarding delaying weaning until 6 months, about whether their babies are getting enough while only breastfeeding, whether mothers should/shouldn't put their babies on a routine and a whole host of developmental issues where mothers have been happy with their choices prior to the visit but discouraged and undermined afterwards. Then, just when a mother assumes all her choices are ‘wrong’, she hears from friends that the same health visiting team is undermining her friends’ completely different choices.

Inaccurate and inconsistent advice damages trust and makes mothers reluctant to ask questions or act on advice given. These experiences and their repercussions are particularly alarming when one considers the fact that health visitors act distinctly different during home visits when the mother is alone than when third parties (husbands, grandmothers, friends) are present (Heritage. J).


There is perhaps no greater example of a health visitor’s potential for giving worryingly damaging advice than the area of breastfeeding. If you ask a first time mum with a newborn where she should go for breastfeeding advice, the little lamb’s first answer is likely to be “health visitor”. However the most common complaints the Association for Improvements in the Maternity Services receive are regarding health visitors’ ignorance and misinformation about breastfeeding – “and it's getting worse” (Robinson. J).

The role of health visitors in facilitating successful breastfeeding relationships should not be underestimated. Studies have shown that “infants being breastfed at the first health visit were significantly more likely to be fed formula at the second visit if their health visitors had had no breastfeeding training in the previous two years” (Tappin et al).

Organisations such as UNICEF have found that the training health visitors receive in breastfeeding is woefully inadequate (No shit Sherlock?) Training is likely to be brief, and is often given by professionals from bottle feeding industries who have a vested interest in promoting their products (The Guardian).

When a breastfeeding problem is encountered, no matter how small, the overwhelming response from health visitors is – yes you guessed it – “top up with formula” (The Guardian). This strategy is used by health visitors in an effort to increase the agreeable appearance of the baby’s weight chart – and to cover their own backs. The weight chart is given preference over the holistic health of the baby. This botched order of priorities has been recognised by academics and commentators including renowned paediatrician Dr Jay Gordon (Look at the Baby, Not the Scale). He argues that “if someone were to ask you what weight a 33 year old man should be, you would laugh. The range of possibilities varies according to height, bone structure, ethnicity and many other factors. Yet babies are expected to fit onto charts distributed throughout the country with no regard to genetics, feeding choice or almost anything else.”

If there are breastfeeding problems, the first answer should never be supplementation as this will sabotage the nursing relationship by reducing milk supply and also damage your baby’s fragile virgin gut. Instead the correct advice would be to find the most knowledgeable support available; and herein lays the problem. Many health visitors see referral to appropriate specialist as a weakness in themselves. Rather than recognise their limitations, they obscure their ignorance by giving questionable advice. This situation is exacerbated by articles in childcare books, baby magazines and online, the majority of which prescribe “if you are having breastfeeding difficulties contact your health visitor”. Is it any wonder that the UK rate of breastfeeding drops dramatically after the first week as new mums follow the ignorant, often conflicting, advice of various health visitors?

It’s not only breastfeeding which is jeopardised, health visitors often dish out advice which is at odds with government guidelines on a range of topics, including weaning (The Guardian), sleep training (Naturally Nurturing), vaccinations (Redsell et al) and toilet training (Netmums).

Your rights

Despite the power imbalance between mother and health visitor, there is much legal arsenal the mother can utilise to protect and withhold her rights. Firstly, a mother is not obliged to use the services of a health visitor and can refuse them at any time. A health visitor has no right of access to your home. Dingwall (Journal of Adv Nurs. Community nursing and civil liberty) has noted that “although health visitors have no legal right of entry, they do not make a habit of pointing this out to clients”. Health visitors have no legal power - it is social workers who have that.

Furthermore, there is no legal requirement to get your baby weighed. It is a service that is made available and advertised, but parents are not obliged to use it.

What if your health visitor has issued incorrect advice, breached confidentiality, undermined your confidence, acted discourteously or committed other misdemeanours? By making a formal complaint you can protect other families from such misconduct and improve the overall conduct of health visitors on a broader scale. You can make a complaint about your health visitor through several channels. Firstly, you should send a written or emailed complaint to your Primary Care Trust (to find your local PCT click here).

Secondly, you can send your complaint to the NHS's Patient Advice and Liaison Services (Click here to find your local PALS).

If you need assistance with making your complaint The Independent Complaints Advocacy Service is a national service that supports people who wish to make a complaint about their NHS care or treatment (Click here to find your local ICAS).

If you're not satisfied with the way the NHS deals with your complaint you can take your complaint to the independent Parliamentary and Health Service Ombudsman.

Another channel of complaint is the Nursing and Midwifery Council. This Council can investigate complaints from individuals who feel a health visitor, midwife or nurse has mistreated them. The Nursing and Midwifery Council has the power to remove or caution any practitioner who is found guilty of professional misconduct.

The address for the NMC is:

Nursing and Midwifery Council
23 Portland Place
London W1N 4JT
Tel: 020 7333 6541

You are also legally entitled to use The Data Protection Act to obtain any record that is compiled about you by the health visitor. First submit a written or emailed request to your health visitor’s Primary Care Trust (their employer). This is called a “Subject Access Request”. A small fee may be charged to process your request, usually around ten pounds sterling. You will need to send some documentation showing proof of your identity (photocopy of passport page) and proof of your residence (a utility bill). It should take about a month for the Trust to process your application.

If your request under the Data Protection Act is declined you may appeal the decision. To do this, send a written or emailed complaint to “The Head of Service” at the Primary Care Trust. Your appeal should be processed within one month.

As well as appealing internally you can also complain directly to the Information Commissioner. They are professionals appointed by the Crown to enforce information laws. The Information Commissioner can force the Primary Care Trust to disclose your data.

You also have the right to send The Primary Care Trust a notice within a reasonable time period asking them to stop processing your information. This is called a “data subject notice”. The notice must specify that the processing of personal information “is causing or likely to cause you or another person substantial, unwarranted damage or distress” and give reasons why.

Another legal right is the Right of Rectification. If you believe that the data recorded about you or your family was inaccurate, you can write to The Primary Care Trust and request the data be rectified. If you do not receive a satisfactory response from the Trust you can apply to the court for an order, or to the Information Commissioner for an enforcement notice, either of which may require that the inaccurate data, and any expression of opinion based on it, is rectified, blocked, erased or destroyed.

And finally, word of mouth is an excellent tool for disgruntled mothers. Discuss your experience with other parents and you may find that they have similar concerns. There is strength in numbers. Plus of course, you may ask for a different health visitor.

I wrote this article for the lovely ladies over at Free Your Parenting.


s said...

Very fascinating post. I live in the United States where it's hard to get any type of health care support, let alone having random health support people just show up!

Common Sense said...

Wow, what a small minded, uneducated, ill-informed article. If you have issues with your health visitor, then that is understandable, but no need to tar all HV's with the same brush. You sound very stuck up, let me guess, married, with one child, possibly two, of which are very young, no older than 18 months...yet you think you know it all? Seriously, you have SO much to learn!

Alpha Parent said...

I welcome all feedback. Good and bad :)

"Common Sense" feel free to tell me why you think my article is ill-informed. said...

Hi, Alpha. Have come back over to try posting again after earlier fail. I just thought, after expressing myself in a half-arsed manner on the MN thread, I ought to comment properly here.

This article still makes me uncomfortable. I am not a HV, nor involved with any HVs these days (had 2 in the past with my babies, pretty neutral experiences, fortunately). I think it's just that it sounds so harsh, it's hard to take it on board in a neutral manner. I know you aim for controversy up to a point but for me, in this post the tone undermines the value of the advice you're offering.

I'd be worried, too, that characterizing some mothers as "chavs and low-lifes", even in jest, might be perceived as really nasty towards some of the people who could be most in need of advice on these matters. Also unsure about Makaton as "Mickey Mouse"; I know little about it, admittedly, but surely it's regarded as invaluable by many parents with SEN kids? I dunno. I am not the best judge of these subjects and I may be having a sense of humour fail today, but there you go. Feedback but not, I hope, a flame (which I don't think helps anyone). said...

Can I just add, in case there is any confusion by other people reading: I am *not* the same person who posted as "Common Sense" above!

Alpha Parent said...


I appreciate your comments re: what I call my 'unique' sense of humour. I use words such as "chav" in jest. You're not the first to pick up on it.

This is after all a blog about "the snobby side of parenting". That's my niche. This blog is my outlet for saying what's on my mind, and a lot of the time that's un-sugar-coated. Some of my favourite blogs take a PC 'toe the line' approach to important topics, being careful not to offend readers, but that's not my personal style. I think the nature of self-publishing is that offending some people is inevitable. I encourage readers to take what they find useful and leave the rest.

Thanks for your feedback. I'm always interested to hear peoples interpretations of my work.

Milk Bubbles said...

I'm in the USA and this is one of the things I'm very afraid will happen if our healthcare becomes socialized. Health visitors byvrequest are one thing, we had that option in one state I lived in,, but even they were pushy and thrived on making mom feel incompetent, but to have them automatically show up or make cold calls is awful. When this "benefit" was discussed as part of the national healthcare plan our gov is trying to force on us my husband and I agreed that only over our dead bodies would a gov worker/health visitor come into our home. Just because medical care is available it doesn't mean that the providers are competent.

We are in charge of our healthcare and no one else. I hope your article impresses on all of your readers in both the UK and USA that they do have the right to refuse this service! Thanks for putting it out there. said...

Thanks for replying, Alpha.

Alpha Parent said...

"Just because medical care is available it doesn't mean that the providers are competent".

Never a truer word spoken. It's unfortunate.

Alpha Parent said...

Hi everyone. After evaluating all the feedback I have received about this article I have decided to remove the list of “everyday activities”. A lot of critique has maintained that the list was overly-satirical and devalues the important information elsewhere in the article.

babimama said...

I agree with everything in this article,my HV has been a complete nightmare & actually gave me advice that was harming my baby, she didn't like being challenged about her so called good advice and labelled me as a risk to my baby when i refused to accept her very very bad advice,HV are nothing more than individuals that like to undermine good parenting & then destroy your life when you abject to their practices, more mums need to be fully aware of the practices of bad HV and the law,my HV refused me access to my child's file and i now have to fight to get it, so yes this article is very well informed and mum's need to know what their rights are.

breakingnews said...
This comment has been removed by the author.
breakingnews said...

I have an interview next week for a health visitor training post and was researching information around the subject when I came across this 'article'. I approached it with an open mind, although found myself questioning some of the presumptuous and subjective views of the disgruntled writer eg health visitors ask to use the bathroom so they can 'snoop around'. I read as far as the 'author' calling new mothers 'little lambs', and the view that health visitors breast feeding training is inadequate, where the author commented, 'no shit sherlock'. That was enough for me! In my opinion if you are unhappy with your health visitor, or any aspect of their role in your life, report them. The NMC are the governing body for all nurses, and health visitors fall into this group. Not so much an 'article' on health visitors, more suitably a diary entry of an unintelligent, inarticulate, disgruntled mother.

JG said...

Sadly, the article above is a true reflection of what is happening on the ground. My mum was a hv, so I had positive associations with them, until recently. Just had my 3rd baby. He gained weight slowly and my hv told me to top up.
Having bf my previous two babies, I knew that this one was perfectly normal and behaving in the same way as the other two.
I independently gained advice from two lactation experts, who said not to top up and to pump and express, take fenugreek etc. Baby gained 1lb in two weeks. Next thing I know, my GP is calling me DAILY to see the baby. Not content that the baby has gained weight, we have been asked to do a urine sample, see a paediatrician and it goes on...more GP appts. We have been labelled as 'at risk' all because I have researched bf and refused to top up. Hv power and advice really is quite worrying and I don't understand why ALL hv don't have in depth bf training.

Dorris the Loris said...

I think part of the problem is that they type of approach that might work with one mum could completely alienate another mum.

Almost everyone I knew warned me about my first HV, but to me she was an absolute godsend, reassuring me and getting me the extra help I needed but in a very straight down the line way. This was perfect for me. In contrast, my second HV seems to be more popular with my other parent friends and acquaintances, but I personally found her a bit fluffy and vague so not particularly helpful.

I think there is an issue about needing to keep track of advice given out about feeding etc sometimes though - a couple of HVs at the weighing clinic would persistently give out advice against the recommended guidelines but when challenged would not acknowledge this. If they want to offer alternatives then that's up to them, but I think they should say first 'this is the recommended way, so you follow weaning plan x at your own risk.'

Craigean Frog said...

Yes we have so much to learn as a young parent... And what's wrong if we want to learn by ourselves then ? I'm french, living in UK for one year and this is the first time I'm pregnant. I totally disagree with this kind of h/v visits. That's my opinion. Who are you to judge this woman and say thats she is "married with one child, no older than 18 month" ? A h/v probably. Some people should understand that a h/v visit could sounds a wee bit intrusive. Just have a look on the forums, there is so many girls complaining about h/v visits. The worst thing for me is that h/v can leave bad comments on your record, but thats the problem for ALL the health UK system. Least but not last I think this article is quite educated and full of very interesting ressources.

Amanda Ketch said...

The health visiting profession is designed to support new parents and to provide the family with the best available support. If you have a new child and have signs of postnatal depression (just as an example) leaving these feelings can leave you to become very unhappy and not enjoy the wonderful thing which motherhood is. If you pretend everything is fine 'slap a coat of mascara on'-as your article suggests. How can the health visitor help you. Yes, HELP. They dont automatically tarnish you with a risk to your child they can provide you support and actually refer you to apporiarate services such as counselling. This article portrays health visitors as judgemental individuals designed to just recognise abuse and label people as bad mothers. This could not be further from the truth, the advice I give to all mothers is to meet your own health visitor and to make up YOUR mind, this article is written by someone who clearly had a bad experience with THEIR health visitor. The advice health visitors give to new parents is based on the BEST upto date evidence, and taking into acount the mother/fathers wishes to come to the best decision for the FAMILY. They are not superior dictator like individuals, its your human right to decide the best choice for you I.e breast milk vs formula. If any of you are still in doubt of how the health visitor can help you these are a few things this biased article doesnt mention. Referring your child to speech and language specialist if they need help with therr talking/speech development. If your baby is being constantly sick from formula milk for eg prescribe lactose free formula milk. If your baby has a cleft pallet help arrange specialised bottles. Help advise on benefits and financial support for your family, contraception. Believe me I could be all day listing these important things the health visitor can help you with. I hope all you new parents make you own decision and please dont auffer in silence if you need help, dont be afraid health visitors are just going to label you as a bad parent as this couldn't be further frpm the truth. X

confusedcroydondad said...

my hv is a complete bitch she is like a miss hitler/obrien her words are gospel I questioned her opinion once and she threatened me saying "IF YOU DONT DO WHAT I TELL YOU I WILL MAKE YOUR LIFE VERY DIFFICULT"
how is this helping me to be a good parent when I have advice that goes against everything I believe to be best for my child now .
now I have to see many different child specialists putting my child through a lot of discomfort with blood tests ?? how does a blood test check a childs development and speech anyway???
I have been reffered to speech therapy , been discharged by speech therapy with no concerns, yet the hv refers me straight back again to supposedly help with development.
we have been accused of child abuse but this has been dismissed as a mollitous attempt at causing me as a loving parent as much harassment as she possibly can .
I have had the police family liason officers round to check our home , social services have been involved all with no further action .


Ummi Jan said...

I came across this article whilst searching for evidence of a parents legal right to refuse a health visitors service. It is very hard to find any direct legislative evidence that states that HV services are optional or that I can deny/refuse HV services at any time dispite it being 'common knowledge' amongst peers.
My HV seemed nice at first but has attemped to undermine my authority as parent to my child (a healthy, happy, well-developed baby) and considers us 'at risk' purely because I am not doing things the way she WANTS me too. We are trying very hard to cease any HV involvement but have been threatened with SS every time. I am of half a mind to say "go ahead and send the SS, they'll not thank you for wasting their time and resources. Resources that could be used to save a child who is actually in need of help."
I often wonder if new parents truly lack confidence or if people like my HV (please note I said MY HV and not EVERY HV) that undermine their confidence without cause.

jayne milwain said...

Unfortunately Alpha parent, you must have had a poor experience of health visiting. It is small minded of you to believe that all health visitors are the same. Child development has not changed over many years, however, the training of health visitors has. Because we are a research based profession we need to update our professional knowledge and therefore if health visitors are acting in a correct manner they should all be singing from the latest research guidelines. In any profession you are going to get exceptions to the rule, but health visitors are there to be a "sounding board" for parents, to access their support if required. We have no legal right to enter your home and you have every right to deny a health visitor access. You also do not have to accept any of their advice. However, health visitors do have a legal obligation to safeguard children as does any other professional working with young families. As you may be aware there have been some very significant child abuse cases recently. One cannot assume that every parent is able to parent effectively. Health visitors work alongside other departments within the multidisciplinary team to ensure that parents are offered the support they need to ensure children have the best start in life. We are experienced in being able to identify any risks and have a legal obligation to inform the authorities if we have any concerns. There is a wealth of research which states that health visitors who visits families antenatally can benefit the professional relationship between parent and professional. We are available to empower mothers and help them solve their own problems in their own way. As for the post natal depression scale, this is only a tool which health visitors use alongside their own professional judgement to assess whether a mother may be suffering from post natal depression. I agree that all mothers will suffer some sort of emotional upset following the birth of their baby, however, it is when this is prolonged that we may be concerned that help is required, as a depressed mum can affect the emotional growth of a child significantly. I think that your article is extremely damning against the wonderful work which some health visitors do, and I think that you obviously have had a difficult time of things and maybe future pregnancies will facilitate a more effective support structure. As for breast feeding we all have to be trained in breastfeeding management and support and no well trained health visitor would suggest offering formula as a supplement so I am not sure where you got that from. We are not all the same and I think you need to apologise for the poor light you are giving health visitors. The government (david cameron), has had first hand experience of the valuable support health visitors give and has thus initiated a drive to employ more of them. I feel pity for you having had a poor experience, but this is NOT the same experience which all mothers face. Remember child abuse crosses all boundaries and creeds and cultures and lifestyles so it is important that we screen everybody to ensure we do not miss any vulnerable families, however remember that there are certain triggers which need to be followed up. Essex Health Visitor

twinklestar said...

I found this 'article' whilst researching public perception of the Health Visitor's role. It is precisely this type of judgemental/ soap box ranting that gives Health Visitors a bad reputation. I am the first to acknowledge that SOME health visitors may be authoritarian rather than authoritative and seek to impose their opinions onto other people but I feel that to tarnish all Health Visitors with the same brush (unless you have experienced the services provided by every single Health Visitor in Great Britain) is both unnecessary and totally hypocritical as you are doing exactly what you are slating the Health visitors for - imposing your opinions onto other people. Whilst there is no law in having your own opinions i think it is unfair to taint the views of mothers instead of letting them make their own views. I trained for three years as a childrens nurse and was constantly being told to remain non-judgemental and to act in a non-discriminatory way at all times not allowing my personal feelings or perceptions cloud my professional judgement. I would implore all mothers to extent this courtesy to their Health Visitor. After all if you don't like the advice the Health visitor is offering you can either request to change Heath visitor or simply ignore it, The choice is ultimately yours.
Suffolk Student Health Visitor

Little Jen said...

Yes some health visitors are judgmental, but I feel this article is just damaging and extremely disrespectful to those health visitors that are nothing like what you have described above.

In terms of postnatal depression, it is not about labeling and it certainly does not make you a bad mother. Health visitors ask because it has been shown that early interventions (which could be anything from a local support group, classes like baby massage, listening visits, counselling or in extreme cases medication) helps the mother and the baby. No mental illness should be about labeling but equally it should never be ignored.

In terms of child abuse I doubt any Health Visitor goes into a home looking for it. That is ridiculous. But if there is any indication that a child is at risk, ANY healthcare professional who comes into contact with a child (so that's the GP, dentist, nurses, health visitors etc.) have a duty of care to that child to report any concerns. Some concerns turn out to be nothing, some are something but a plan is put into place to help the family and in extreme circumstances the child is removed. This need to report any concern is due to serious case reviews, such as Baby P. It is not to say Health Visitors think all parents are monsters! It's to protect children, and stop the extreme, but nevertheless very true cases where children are seriously harmed or died. I think any human being, let alone parent can see that is of benefit.

In terms of the Health Visiting service, it is an opt out system.

Fair Minded said...

No one has commented on the incompetence of some GPs who very often give out advice on childcare & in particular breast feeding which is totally inappropriate & in lots of cases detrimental to the continuation of successful breast feeding.
I agree that there are many health visitors who give out non scientific based advice but for every one of those there are many extremely competent and hard working individuals.
It is extremely irresponsible to disregard the effectiveness of the whole profession.

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