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Health visiting could end as specialist career

Health visiting could end as a specialist career in England if Department of Health plans are adopted, say Unite and CPHVA.

Unite/CPHVA fear that the Department of Health's consultation document plans will dilute the specialist professions that are currently covered by post graduate education.

The proposals rely on a "pick and mix" system of skills and competencies, they say, not a well structured evidence-based course.

A Unite/CPHVA spokesperson said: "The proposed framework does not provide a career pathway for the nurse who wishes to progress his/her career in terms of specialist practice whether this be a health visitor, district nurse, school nurse or community children's nurse."

Rita Newland a Unite/CPHVA professional officer added: "What this will mean in every day terms is that families and communities may not receive the level of specialist community nursing care they currently enjoy in the future.

"In years to come, the work of health visitors and other community nurse specialist may be carried out by nurses who are not so well qualified, and this should be a matter that concerns the public. And we are flagging up these concerns in our response to government."


Do you agree that the DH's plans spell the end of health visiting as a specialist career? How do you feel about this? Please supply your comment, name and location. Your details will not be published if you so request. Terms and conditions apply

"Couldn't agree more - think HVs have brought this on themselves by continuing to be "precious" about what they see as their role. They couldn't even do baby imms at the two surgeries I worked in, as a practice nurse I could. But then as a Practice Nurse I am open to learning and see my role as flexible." - Name and address supplied

"I think health visitors have got so much experience, it will be a great shame to lose it. The powers-that-be are always coming up with these bright ideas. They never seem to learn. The matrons were gotten rid of, and then they decided to bring them back as though they were still around and waiting in the wings to come back when needed. They were well-respected special people. Can they be replaced by just using the name? I don't think so. Things have a way of going round in circles. In a few years time when things have gone very wrong it will be "bring the health visitors back", as though they too will be waiting in the wings. Has any one bothered to go to the packed clinics to ask mums what they want? It will be like other issues in the health service. It's never the people who are involved who get their say, or if they do, it is ignored." - Hazel Manning, Practice Nurse, Chingford

"Not only health visiting but district nursing. I was fortunate to get on the specialist degree this year, but there were only two secondment places for Derby City. The numbers have slowly gone down - it is worrying when you look at the proposed outlines on how district nursing will fit in" - Graham Coates, Derby

"Health visitors have been their own worst enemy in diluting this service. They have been reluctant to move with the times and modernise the service to meet the ever-changing population and society we live in" - Name and address supplied

"Yes, it is happening in my area too" - Name and address supplied

"I do have some sympathy with health visitors on this issue. It isn't palatable to find your job dispensable. Health visiting started in a climate of poor housing with little social or medical support for lower classes. Lower social classes still exist and have their own needs but times are now very much different and I feel that HVs has not moved with the times. Instead they have dictated what is or isn't their job according to their 'professionalism' rather than society's changing needs and EBP. It's interesting that they don't mention practice nurses as a specialist practice which I feel may signify their outdated attitude and be at the heart of their problem. Practice nursing arose out of need for nursing care in general practice, which was not catered for by other community nurses. For all the criticisms levelled at practice nurses by their other community nurse colleagues, it is they, practice nurses, who are at the moment standing the test of time. We should all stop being so protective about what we do. If we all worked 24 hours a day there would still be more to be done. So we need to worry about having a job but we do need to be critical about what we do and the benefits of our care. Healthcare is expensive and each one of us pays for it, so let's open our minds and be more critical about what we do" - Name and address supplied

"I am sure most nurses are able to carry out the tasks that health visitors and community nurses do. I don't know of anything special they do except for child health" - Name and address supplied

"I don't agree with the opinion that health visiting should be a specialist career because the job they are doing now does reflect on nursing job profession. It does not involve going deep into medical/surgical conditions and that is why nursery nurses, healthcare assistant do their job. Most health visitors behave and act as if they did not pass through general nursing training at all" - Name and address supplied

"Totally agree with the above comments. It is happening in Glasgow, taking HVs out of GP attachment (and immunisations), into geographical teams with social work colleagues. The bulk of the work is to be done by staff nurses and health support workers. HVs have to focus on child protection. Firefighting not prevention! Care will be fragmented, to the detriment of families and young children. We work intensely with families that need the input and prioritise on a daily basis. Situations change and HVs are best placed to identify and target vulnerable and hard-to-reach children and families. However, the powers-that-be are not listening and we are battle weary. I have real concerns for the future. Get more social workers!" - Name and address supplied