Health visitor postcode lottery continues

How often a child sees a health visitor is still a postcode lottery, according to new research which reveals the ratio of health visitors to children under five in England. Figures released in May by the Family and Parenting Institute show that there are huge variations in the number of health visitors up and down the country – County Durham PCT has one health visitor for every 165 children whereas some London PCTs have as few as one health visitor for 800 children.  The findings come ahead of the Department of Health (DH) and the CPHVA/Unite’s summit on health visitors taking place on 5 May and follows Lord Laming’s recommendation that the number of health visitors needs to be increased*.

Mary MacLeod, Chief Executive of the Family and Parenting Institute said: “The value of health visitors is unquestionable. Parents tell us they are a lifeline. Having a baby is a great joy but also a huge change for any family, especially first time round as you deal with sleepless nights and new demands, Mums and Dads are eager for good advice. And a well-trained health visitor can make all the difference. Health visitors respond to parents’ worries and concerns, and their unique relationship and position of visiting families in their home means that they can detect problems that parents may not talk about – such as post natal depression, domestic violence or child abuse. They really are the frontline, able to pick problems early before matters get out of hand. This postcode lottery is unacceptable. We need a universal health visitor service so that all parents can have the support they want and need and children’s wellbeing can be safeguarded.”

The Family and Parenting Institute has been campaigning for more health visitors since 2007. It is calling for:

• a universal health visitor service with an intensive service for parents who will benefit most;
• a preventative health visitors service – the key to unlocking support for vulnerable families who are still missing out;
• and a well-trained health visitor service with a clearly defined role and a better career structure.

The health visitor table shows a clear North-South divide in the service. The top three performing PCTs, when it comes to health visitors, in England were County Durham, Darlington and Bournemouth. Of the ten PCTs with the lowest number of health visitors, eight of them were in London. There was also disparity in PCTs’ budgets for health visiting. The biggest spender, Wirral PCT allocated over £386 per child under five (in the financial year 08/09). South West Essex Teaching PCT has much shorter pockets for its health visiting budget spending just over £60 per child.

CPHVA/Unite which represents health visitors recommends that health visitors should have a case load of no more than 250 children – only 15 of the 136 respondents meet this target.

The Family and Parenting Institute has also compared the number of health visitors each PCT had in 2006 with how many they have now. The findings show that some PCTs (including some who had the lowest number of health visitors in our last survey), have dramatically increased numbers, while in other Trusts numbers have dropped significantly over the last two years. Lambeth’s health visitors caseload has nearly doubled (88% increase). At the other end of the spectrum Darlington has gone from having 17 health visitors to 29 for 5,300 children.