Health visitors in Peterborough may be axed from the community and moved into a private "Social Enterprise" organisation.
Health trade union, Unite is worried that proposals to remove 75 health visitors will affect thousands of families with young children in the area.
Peterborough PCT are currently in the midst of a three-month consultation to review a number of options, which also include health visitors working for the city council or becoming attached to the local NHS hospital trust.
Unite has warned that health visitors working for "social enterprise" organisations will not be covered by current NHS pay and pension conditions.
They say that Peterborough PCT has not provided health visitors with enough information to make "considered judgments" about their future employment.
"This move, if it goes ahead, could also have grave implications for families in Peterborough," said Unite Regional Officer Tony Ellingford.
"A 'Social Enterprise' firm may have a very tight contract with the PCT in the future which says health visitors will only provide certain services to the families that could be far less than what is currently provided.
"This would be a retrograde step and undermine the government's public health goals – and there are a number of deprived areas in Peterborugh which could lose out severely."
The final decision is expected to be made this autumn.
Your comments: (Terms and conditions apply)
"We had a great HV in my last practice but she was taken away to fulfill a new role in a re-organisation. We rarley saw an HV again. One lady comitted suicide & took baby with her, our old HV would have spotted that long before this tragedy. I am now in a new practice where HV & DNs are attatched staff. It is so much better, we work as a team, just the way it always used to be" - Anne, ANP practice nurse, Kidderminster
"Health visitors are essential for public health" - Name and address supplied
"As a health visitor trained in 1980 I am convinced from my experience of working in three differrent areas in England, including the Ortons in Peterborough, that health visitors offer a unique service to children and families. The support they provide, along with the identification of health needs and risks, and working in a multiagency setting to reduce those risks and make things better for children and families, reduces the risk of children sufferring from abuse. Facing the Future, a review of the role of health visitors, seeks to focus health visitors skills on where they can make the greatest impact - in early intervention with children and families, and in tackling the "difficult" issues in vulnerable families and communities within a public health context. Gordon Brown, a fellow Scot, in his speech on policy in the past few weeks is championing the nurture of children in our society. Let's hope that someone holding the purse strings in health wakes up to the realisation that health visitors are the unsung champions of children and families" - Eileen Tilbury, senior nurse child protection, Dundee
"I am sorry that I see health visiting changing so much over the last few years that it is no longer the job I set out to do. We are now pushed to such an extent that it is no longer a universal service because the only way to cope with the workload is to not look too hard for needs. If they are not brought to your attention you don't look too hard. What a sad state of affairs for health visiting that we disregard one of the tenents of our role, how appalling for families" - Name and address supplied
"As a HV who has many years of experience and having worked as a school nurse, practice nurse and a smoking specialist nurse, I despair at where health visiting is going. It is a vital service in the community but is also a soft option when considering finacial cutbacks. Our work cannot be audited at times, but the GPs I work for are very appreciative of the work I do within the practice, which includes organising and giving imms to the under-5s. HVs must diversify, I have run asthma clinics, have got my asthma and allergy diplomas and have been a nurse on asthma and eczema holidays run by the societies. As I near the end of my varied career, I hope health visiting will not die 'on the vine'."- Anne Evans, West Sussex
"As a school nurse I am horrified about these plans for health visitors in Peterborough. We rely on the HVs having knowledge of families who are 'at risk' and passing on their concerns as the children enter school. The PCT I work for plans to move us into the schools and we are already concerned about the lack of liaison opportunities with HVs. This move sounds absolutely disastrous for parents and children" - Name and address supplied
"Health visitors do play an important part in the community but they need to target their work more to reach the needs of those children whose lives are blighted by their impoversihed socioecomonic circumstances and they need to increase their skills in community development and in integrated working with all partners in all areas of child and family support" - Name and address supplied
"I agree with the comments already made, but must add this. Perhaps I'm nitpicking - but why does the picture for this article show a pregnant woman apparently being examined by a health visitor? This is the role of the midwife. Health visitors work with parents and children, and much or our role involves discussion with clients, not physical examination. The implication here is that NIP does not understand our role. What hope for non-nurses?" - Name and address supplied
"Of course health visitors play an essential role in the community. We become confidants of families. Families come to us for advice before consulting a GP. Most of us have a wealth experience, in child protection, domestic violence, sexual abuse as well as all aspects of childcare. The introduction of Hall four has caused problems for health visitors. Most of us feel we are not doing the job we were trained for. I have had my first 'victim' of Hall four and attended my first case conference in 10 years. It is unfortunate that the onus is now on the parents to alert us if they have a problem with their child. If things had been left the way they were, we would be using our expertise, judgment and instinct when getting to know a family. Hall four in my opinion is the beginning of the end for health visitors" - Marie Garrity, Glasgow
"Of course they do (play an essential role in the community). Have we forgotten the Making a Difference document. Where are our senior nurses/chief nurse in all this? When will we as a nursing profession get some 'good' nurse leaders who can speak out for nursing rather than tow the party line whatever that may be. Perhaps the next research question should be: Does the chief nurse role make a difference to the health of the population? I think we can second guess the answer!" - Name and address supplied
"As a health visitor in Scotland, I wait, with saddened interest, to see the repercussions of this action should it bear fruition. For some time now, there has been debate as to 'what health visitors actually do in the community?'. Do we have to wait for a serious incident involving children and their families before our 'worth' in the community is finally realised? I hope no child or their family suffers if this change comes about because someone will have to live with making this decision" - Name and address supplied
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