PRACTICE-based health visitor services are a vital part of the GP services provided in local communities and I am dismayed that Greater Glasgow and Clyde NHS Board is ploughing ahead with its review of community nursing despite the widespread concerns of GPs, nurses and patients ('Changes to health visitor service threaten "massive problems for middle-class"', July 13).
Health visitors are integral to the primary healthcare team but, under the plans being implemented by the NHS board, they will be removed from the practice and re-housed in geographical centres aligned with social work services – against the advice o
f local GPs.
It is hard to see why the board is so committed to pursuing this plan when the losses clearly outweigh the benefits. In general practices, health visitors have a unique relationship with mothers and young children. This relationship is such that they are able to spot early stages of postnatal depression and provide the necessary support to help them cope. And regular contact with children can mean that health visitors are able to identify any concerns at an early stage. Removing health visitors from the practice removes much of the opportunity for them to engage with their patients and fractures the close relationship with the GPs they work alongside.
Co-locating health visitors and social work is often advocated as a way of addressing some of the communication problems that exist on issues of child protection, but there is no evidence that this will improve services.
The opportunities to support young families and the elderly are being thrown aside in an attempt to implement a non-evidence-based solution to resolve past failures in communication. But there are better ways to do this and the NHS board must work in partnership with the professions to identify a way forward that doesn't leave patients at a disadvantage.
Dr Dean Marshall, chairman, Scottish General Practitioners Committee, EdinburghNO ONE could argue that health visitors do not have a key role to play in identifying babies and young children at the centre of child protection issues. So improving the support that health visitors provide for such families is right. However, health visitors provide an invaluable service to all mothers and babies that should remain universal.
In February of this year, the Labour group in the Scottish Parliament launched a consultation, 'A Positive Start For Every Child', to look at what services best supported children and their parents. Throughout the consultation, whether from professionals or parents themselves, the responses highlighted the importance of health visitors.
Instead of reducing health visitor services, health boards would do well to increase and improve them. Health visitors should be increasing the support they offer to vulnerable families, particularly where there is substance abuse. They should be providing a universal service to all babies and parents so as to identify early challenges. Finally the health visitors service should be extended to cover the life of a child until they enter school.
This will of course mean we need more health visitors, as they are already overworked. The Scottish Government should set targets and provide resources to increase their number. If we are serious about early intervention to provide a better life for our children and support parents let us improve a service we already know can make a difference.
Mary Mulligan, MSPAS A practice manager of a busy GP practice in a deprived area of Glasgow, I feel compelled to say that these changes will affect mostly the ordinary families who are currently able to access their health visitor via the surgery. Our health visitor is well known to most of our families and, along with their GP, is a trusted professional. Families who become vulnerable may not be picked up at all resulting in these children at risk disappearing off the health visitor's radar. The chain of communications round vulnerable families will become far inferior to the present system.
We strongly believe that our health visitor's skills are best utilised within the primary care team where families can easily access them. Due to its universal nature there is no stigma attached to the service enabling mothers from all backgrounds to easily engage with us.
Secondly, this unwelcome development in health visitor services has been created without prior consultation with the professionals who will be affected most. Who does a worried mother contact when she has concerns with her baby? It is certainly not her social worker. The GPs are first point of contact in primary care and as such should have been instrumental in discussions of any proposed changes.
The implementation of these changes must be halted immediately and a fresh start made to move forward by including all involved, doctors, health visitors and patients to ensure the children of Glasgow receive the service they deserve.
Margaret Beggs, practice manager, Yellow Practice, Govan Health CentreThe full article contains 816 words and appears in Scotland On Sunday newspaper.
