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Dear Jean

Excellent..I will be taking this up with my MP.

Thanks for drafting such a comprehensive and

clear letter.

Chris

Letter to MP

I enclose the letter that I have sent to my MP if it is any help to

anyone thinking of doing likewise.

Dear Ann Keen

I write to you again about health visiting as my fears have been

justified.

The health visiting profession is to be de-regulated and the health

visitors' professional register will disappear in April 2004. (The

Nursing and Midwifery Order 2001 (Consequential Amendments) Order 2002)

The only registers that will be in existence will be for nurses and

midwives, which, in effect, denote the demise of the health visiting

profession. What is more disturbing is that the Nursing & Midwifery

Council had accepted the Requirements for Pre-registration Health

Visitor programmes in August 2002 and were widely accepted by the

profession and other agencies. The proposed competency framework for

Specialist Community Public Health Nurses (third register) is out for

consultation. The framework and the competencies themselves are narrowly

defined as a biomedical model in their focus and wording. There is no

purpose described for Specialist Practice in Public Health Nursing.

Health visiting is not mentioned in the document, except to state that

the framework is drawn from the principles of health visiting, which

they do not. The briefing note from the Nursing & Midwifery Council

indicates that future courses will be based on knowledge and skills of

nursing and midwifery models, not a social model of health that was the

basis and principles for health visiting. It will be nurses who will

develop public health nursing courses and outcomes for professional

practice.

I had been assured in your letter to me in June 2001 along with

information from Lord Hunt, that health visitors would have a separate

register, protection of their title and that professional regulation of

health visitors was therefore fully preserved. In reality because it is

a Nurses and Midwives Order, this cannot be allowed as health visitors

are not named in it.

The outcome of the legislation is that by de-regulating of the

profession, anyone can call himself or herself a health visitor after

April 2004. How are the to be public protected? Unfortunately, whether

we like it or not, the public know what health visitors are and what

they do. Will families know that the person knocking on their door may

be anyone who calls himself or herself a health visitor, are competent

safe practitioners? This could equally apply to commercial companies who

would wish to use the name health visitor to ensure that their products

reach the mothers e.g. infant/children's food companies and others who

are in the business of baby/children's products.

It would appear that health visitors themselves are unaware that they

are being de-regulated as they had been assured that their profession

and title would be protected. Having recently alerted a lot of people

and a Professor in Child and Family Law, they seem totally be unaware

that this is happening and are very likewise very concerned.

This all seems very much at odds with the government agenda and policies

that mention health visitors' role in the context of health and social

well-being, reduction in health inequalities and social inclusion.

I would really like to be assured that all these issues of concern have

been thoroughly discussed and explained to the practitioners and indeed

the public, but sadly and regrettably I think this has not been so.

Although I am not in practice now but work as an Independent Public

Health Specialist - a very different role and responsibility, my Public

Health Specialist colleagues are also confused about who will be on the

third part of the register and what the practitioners will be competent

to do in practice.

--

Rowe

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Thanks Will adapt and send to my MP too. I have responded as an

individual HV to the NMC consultation but feel a sense of fait accompli

about the whole thing. Ruth

Letter to MP

>

>

> I enclose the letter that I have sent to my MP if it is any help to

> anyone thinking of doing likewise.

>

> Dear Ann Keen

>

> I write to you again about health visiting as my fears have been

> justified.

>

> The health visiting profession is to be de-regulated and the health

> visitors' professional register will disappear in April 2004. (The

> Nursing and Midwifery Order 2001 (Consequential Amendments) Order 2002)

>

> The only registers that will be in existence will be for nurses and

> midwives, which, in effect, denote the demise of the health visiting

> profession. What is more disturbing is that the Nursing & Midwifery

> Council had accepted the Requirements for Pre-registration Health

> Visitor programmes in August 2002 and were widely accepted by the

> profession and other agencies. The proposed competency framework for

> Specialist Community Public Health Nurses (third register) is out for

> consultation. The framework and the competencies themselves are narrowly

> defined as a biomedical model in their focus and wording. There is no

> purpose described for Specialist Practice in Public Health Nursing.

> Health visiting is not mentioned in the document, except to state that

> the framework is drawn from the principles of health visiting, which

> they do not. The briefing note from the Nursing & Midwifery Council

> indicates that future courses will be based on knowledge and skills of

> nursing and midwifery models, not a social model of health that was the

> basis and principles for health visiting. It will be nurses who will

> develop public health nursing courses and outcomes for professional

> practice.

>

> I had been assured in your letter to me in June 2001 along with

> information from Lord Hunt, that health visitors would have a separate

> register, protection of their title and that professional regulation of

> health visitors was therefore fully preserved. In reality because it is

> a Nurses and Midwives Order, this cannot be allowed as health visitors

> are not named in it.

>

> The outcome of the legislation is that by de-regulating of the

> profession, anyone can call himself or herself a health visitor after

> April 2004. How are the to be public protected? Unfortunately, whether

> we like it or not, the public know what health visitors are and what

> they do. Will families know that the person knocking on their door may

> be anyone who calls himself or herself a health visitor, are competent

> safe practitioners? This could equally apply to commercial companies who

> would wish to use the name health visitor to ensure that their products

> reach the mothers e.g. infant/children's food companies and others who

> are in the business of baby/children's products.

> It would appear that health visitors themselves are unaware that they

> are being de-regulated as they had been assured that their profession

> and title would be protected. Having recently alerted a lot of people

> and a Professor in Child and Family Law, they seem totally be unaware

> that this is happening and are very likewise very concerned.

>

> This all seems very much at odds with the government agenda and policies

> that mention health visitors' role in the context of health and social

> well-being, reduction in health inequalities and social inclusion.

>

> I would really like to be assured that all these issues of concern have

> been thoroughly discussed and explained to the practitioners and indeed

> the public, but sadly and regrettably I think this has not been so.

> Although I am not in practice now but work as an Independent Public

> Health Specialist - a very different role and responsibility, my Public

> Health Specialist colleagues are also confused about who will be on the

> third part of the register and what the practitioners will be competent

> to do in practice.

>

>

> --

> Rowe

>

>

>

>

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Jean

Many thanks - I was a bit alarmed when I went onto the faxyourmp sight

and it said please don't send standard letters, express yourself in your

own words so I hope you'll forgive me if I've mixed some of your very

clear points with rhetoric of my own. I have also asked my MP to

consider presenting a paper along the lines of that which seeks to

promote the status of social work and protect the title 'social worker'

but obviously to protect the status and title of 'health visitor'. I

attach a copy of the letter in case anybody wants to draw on the same

argument. If we all keep moving the words around and adding bits, nobody

will ever realise it's the same letter. It looks a bit funny - is it in

some strange format that nobody can open - if it is and you want to

seeit - let me know and I'll cut and paste

The more the merrier!

Lowenhoff

Letter to MP

I enclose the letter that I have sent to my MP if it is any help to

anyone thinking of doing likewise.

Dear Ann Keen

I write to you again about health visiting as my fears have been

justified.

The health visiting profession is to be de-regulated and the health

visitors' professional register will disappear in April 2004. (The

Nursing and Midwifery Order 2001 (Consequential Amendments) Order 2002)

The only registers that will be in existence will be for nurses and

midwives, which, in effect, denote the demise of the health visiting

profession. What is more disturbing is that the Nursing & Midwifery

Council had accepted the Requirements for Pre-registration Health

Visitor programmes in August 2002 and were widely accepted by the

profession and other agencies. The proposed competency framework for

Specialist Community Public Health Nurses (third register) is out for

consultation. The framework and the competencies themselves are narrowly

defined as a biomedical model in their focus and wording. There is no

purpose described for Specialist Practice in Public Health Nursing.

Health visiting is not mentioned in the document, except to state that

the framework is drawn from the principles of health visiting, which

they do not. The briefing note from the Nursing & Midwifery Council

indicates that future courses will be based on knowledge and skills of

nursing and midwifery models, not a social model of health that was the

basis and principles for health visiting. It will be nurses who will

develop public health nursing courses and outcomes for professional

practice.

I had been assured in your letter to me in June 2001 along with

information from Lord Hunt, that health visitors would have a separate

register, protection of their title and that professional regulation of

health visitors was therefore fully preserved. In reality because it is

a Nurses and Midwives Order, this cannot be allowed as health visitors

are not named in it.

The outcome of the legislation is that by de-regulating of the

profession, anyone can call himself or herself a health visitor after

April 2004. How are the to be public protected? Unfortunately, whether

we like it or not, the public know what health visitors are and what

they do. Will families know that the person knocking on their door may

be anyone who calls himself or herself a health visitor, are competent

safe practitioners? This could equally apply to commercial companies who

would wish to use the name health visitor to ensure that their products

reach the mothers e.g. infant/children's food companies and others who

are in the business of baby/children's products.

It would appear that health visitors themselves are unaware that they

are being de-regulated as they had been assured that their profession

and title would be protected. Having recently alerted a lot of people

and a Professor in Child and Family Law, they seem totally be unaware

that this is happening and are very likewise very concerned.

This all seems very much at odds with the government agenda and policies

that mention health visitors' role in the context of health and social

well-being, reduction in health inequalities and social inclusion.

I would really like to be assured that all these issues of concern have

been thoroughly discussed and explained to the practitioners and indeed

the public, but sadly and regrettably I think this has not been so.

Although I am not in practice now but work as an Independent Public

Health Specialist - a very different role and responsibility, my Public

Health Specialist colleagues are also confused about who will be on the

third part of the register and what the practitioners will be competent

to do in practice.

--

Rowe

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Now I've tried opening the attachment, all it is is a photo of my m'p -

I'ma technoheathen I'm afraid - herewith attached is real letter (I

hope!)

Letter to MP

I enclose the letter that I have sent to my MP if it is any help to

anyone thinking of doing likewise.

Dear Ann Keen

I write to you again about health visiting as my fears have been

justified.

The health visiting profession is to be de-regulated and the health

visitors' professional register will disappear in April 2004. (The

Nursing and Midwifery Order 2001 (Consequential Amendments) Order 2002)

The only registers that will be in existence will be for nurses and

midwives, which, in effect, denote the demise of the health visiting

profession. What is more disturbing is that the Nursing & Midwifery

Council had accepted the Requirements for Pre-registration Health

Visitor programmes in August 2002 and were widely accepted by the

profession and other agencies. The proposed competency framework for

Specialist Community Public Health Nurses (third register) is out for

consultation. The framework and the competencies themselves are narrowly

defined as a biomedical model in their focus and wording. There is no

purpose described for Specialist Practice in Public Health Nursing.

Health visiting is not mentioned in the document, except to state that

the framework is drawn from the principles of health visiting, which

they do not. The briefing note from the Nursing & Midwifery Council

indicates that future courses will be based on knowledge and skills of

nursing and midwifery models, not a social model of health that was the

basis and principles for health visiting. It will be nurses who will

develop public health nursing courses and outcomes for professional

practice.

I had been assured in your letter to me in June 2001 along with

information from Lord Hunt, that health visitors would have a separate

register, protection of their title and that professional regulation of

health visitors was therefore fully preserved. In reality because it is

a Nurses and Midwives Order, this cannot be allowed as health visitors

are not named in it.

The outcome of the legislation is that by de-regulating of the

profession, anyone can call himself or herself a health visitor after

April 2004. How are the to be public protected? Unfortunately, whether

we like it or not, the public know what health visitors are and what

they do. Will families know that the person knocking on their door may

be anyone who calls himself or herself a health visitor, are competent

safe practitioners? This could equally apply to commercial companies who

would wish to use the name health visitor to ensure that their products

reach the mothers e.g. infant/children's food companies and others who

are in the business of baby/children's products.

It would appear that health visitors themselves are unaware that they

are being de-regulated as they had been assured that their profession

and title would be protected. Having recently alerted a lot of people

and a Professor in Child and Family Law, they seem totally be unaware

that this is happening and are very likewise very concerned.

This all seems very much at odds with the government agenda and policies

that mention health visitors' role in the context of health and social

well-being, reduction in health inequalities and social inclusion.

I would really like to be assured that all these issues of concern have

been thoroughly discussed and explained to the practitioners and indeed

the public, but sadly and regrettably I think this has not been so.

Although I am not in practice now but work as an Independent Public

Health Specialist - a very different role and responsibility, my Public

Health Specialist colleagues are also confused about who will be on the

third part of the register and what the practitioners will be competent

to do in practice.

--

Rowe

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I just get a dear little photo of a smiley man! Ruth

Letter to MP

>

> I enclose the letter that I have sent to my MP if it is any help to

> anyone thinking of doing likewise.

>

> Dear Ann Keen

>

> I write to you again about health visiting as my fears have been

> justified.

>

> The health visiting profession is to be de-regulated and the health

> visitors' professional register will disappear in April 2004. (The

> Nursing and Midwifery Order 2001 (Consequential Amendments) Order 2002)

>

> The only registers that will be in existence will be for nurses and

> midwives, which, in effect, denote the demise of the health visiting

> profession. What is more disturbing is that the Nursing & Midwifery

> Council had accepted the Requirements for Pre-registration Health

> Visitor programmes in August 2002 and were widely accepted by the

> profession and other agencies. The proposed competency framework for

> Specialist Community Public Health Nurses (third register) is out for

> consultation. The framework and the competencies themselves are narrowly

> defined as a biomedical model in their focus and wording. There is no

> purpose described for Specialist Practice in Public Health Nursing.

> Health visiting is not mentioned in the document, except to state that

> the framework is drawn from the principles of health visiting, which

> they do not. The briefing note from the Nursing & Midwifery Council

> indicates that future courses will be based on knowledge and skills of

> nursing and midwifery models, not a social model of health that was the

> basis and principles for health visiting. It will be nurses who will

> develop public health nursing courses and outcomes for professional

> practice.

>

> I had been assured in your letter to me in June 2001 along with

> information from Lord Hunt, that health visitors would have a separate

> register, protection of their title and that professional regulation of

> health visitors was therefore fully preserved. In reality because it is

> a Nurses and Midwives Order, this cannot be allowed as health visitors

> are not named in it.

>

> The outcome of the legislation is that by de-regulating of the

> profession, anyone can call himself or herself a health visitor after

> April 2004. How are the to be public protected? Unfortunately, whether

> we like it or not, the public know what health visitors are and what

> they do. Will families know that the person knocking on their door may

> be anyone who calls himself or herself a health visitor, are competent

> safe practitioners? This could equally apply to commercial companies who

> would wish to use the name health visitor to ensure that their products

> reach the mothers e.g. infant/children's food companies and others who

> are in the business of baby/children's products.

> It would appear that health visitors themselves are unaware that they

> are being de-regulated as they had been assured that their profession

> and title would be protected. Having recently alerted a lot of people

> and a Professor in Child and Family Law, they seem totally be unaware

> that this is happening and are very likewise very concerned.

>

> This all seems very much at odds with the government agenda and policies

> that mention health visitors' role in the context of health and social

> well-being, reduction in health inequalities and social inclusion.

>

> I would really like to be assured that all these issues of concern have

> been thoroughly discussed and explained to the practitioners and indeed

> the public, but sadly and regrettably I think this has not been so.

> Although I am not in practice now but work as an Independent Public

> Health Specialist - a very different role and responsibility, my Public

> Health Specialist colleagues are also confused about who will be on the

> third part of the register and what the practitioners will be competent

> to do in practice.

>

>

> --

> Rowe

>

>

>

>

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Dear ,

Id very much like to see what you

have written.

Was much inspired by your last posting on

Senate.

Would like to stress again that many HVs

are not aware of what is about to happen. Can we can stop it?

Letter to MP

I enclose the letter that I have sent to my MP if

it is any help to

anyone thinking of doing likewise.

Dear Ann Keen

I write to you again about health visiting as my

fears have been

justified.

The health visiting profession is to be

de-regulated and the health

visitors' professional register will disappear in

April 2004. (The

Nursing and Midwifery Order 2001 (Consequential

Amendments) Order 2002)

The only registers that will be in existence will

be for nurses and

midwives, which, in effect, denote the demise of

the health visiting

profession. What is more disturbing is that

the Nursing & Midwifery

Council had accepted the Requirements for

Pre-registration Health

Visitor programmes in August 2002 and were widely

accepted by the

profession and other agencies. The proposed

competency framework for

Specialist Community Public Health Nurses (third

register) is out for

consultation. The framework and the competencies

themselves are narrowly

defined as a biomedical model in their focus and

wording. There is no

purpose described for Specialist Practice in

Public Health Nursing.

Health visiting is not mentioned in the document,

except to state that

the framework is drawn from the principles of

health visiting, which

they do not. The briefing note from the Nursing

& Midwifery Council

indicates that future courses will be based on

knowledge and skills of

nursing and midwifery models, not a social model

of health that was the

basis and principles for health visiting. It will

be nurses who will

develop public health nursing courses and outcomes

for professional

practice.

I had been assured in your letter to me in June

2001 along with

information from Lord Hunt, that health visitors

would have a separate

register, protection of their title and that

professional regulation of

health visitors was therefore fully preserved. In

reality because it is

a Nurses and Midwives Order, this cannot be

allowed as health visitors

are not named in it.

The outcome of the legislation is that by

de-regulating of the

profession, anyone can call himself or herself a

health visitor after

April 2004. How are the to be public protected?

Unfortunately, whether

we like it or not, the public know what health

visitors are and what

they do. Will families know that the person

knocking on their door may

be anyone who calls himself or herself a health

visitor, are competent

safe practitioners? This could equally apply to

commercial companies who

would wish to use the name health visitor to

ensure that their products

reach the mothers e.g. infant/children's food

companies and others who

are in the business of baby/children's products.

It would appear that health visitors themselves

are unaware that they

are being de-regulated as they had been assured

that their profession

and title would be protected. Having recently

alerted a lot of people

and a Professor in Child and Family Law, they seem

totally be unaware

that this is happening and are very likewise very

concerned.

This all seems very much at odds with the

government agenda and policies

that mention health visitors' role in the context

of health and social

well-being, reduction in health inequalities and

social inclusion.

I would really like to be assured that all these

issues of concern have

been thoroughly discussed and explained to the

practitioners and indeed

the public, but sadly and regrettably I think this

has not been so.

Although I am not in practice now but work as an

Independent Public

Health Specialist - a very different role and

responsibility, my Public

Health Specialist colleagues are also confused

about who will be on the

third part of the register and what the

practitioners will be competent

to do in practice.

--

Rowe

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Dear Mr Tim Yeo,

........imagine

there's no health visitors, it's easy if you try......

I am

writing to you to express my concern about the impending demise of the health

visiting profession.

We feel

that we were very much sold down river when the UKCC

for nursing, midwifery and health visiting was changed to become the NMC, the Nursing and Midwifery Council. However, at the

time, we, the health visiting profession, were assured that health visitors

would have a separate register, that our title would be protected, and the

professional regulation of health visitors preserved.

However

as there are greater numbers of non-health visiting nurses and midwives

contributing to the regulation debate, we find that the social, preventive

model of health which health visitors have sought to uphold for so long is

being subsumed under the broader definition of public health. Amidst the

rhetoric of the developing family-centred public

health role of health visitors there is a subversive but pervasive intent to

eliminate both the family-centred aspect and the

health visitor emphasis from the public health role. Many of the proponents of

the brave new world of public health see the new public health nurses working

with the public ( whatever that means) and focussing on needs-led group and community work and moving

away from preventive interventions focussed on

parents and families. Yet nobody disputes that the breast cancer screening progamme, relying as it does on assessment of indiviuals to detect those at risk, is a public health

intervention or that immunisation

campaigns, that rely on immunising as many of

the vulnerable population as possible, is a public health intervention? Surely

providing a service that seeks to give parents the information, confidence and

support they need to be the best parents they can be whilst at the same time

identifying those relationships and children at risk must reap huge benefits in

public health terms ( and there is the research

evidence to prove it)?

Whilst

the green paper 'Every Child Matters' talks about reducing educational failure,

protecting children at risk of abuse or neglect, reducing the increasing

numbers of children with emotional and behavioural

problems including those with conduct disorder who often go on to cost society

a fortune and, unless they are lucky enough to receive intensive and prolonged

intervention of the sort they need, will become truants, delinquents, drug and

alcohol abusers, early school leavers, premature parents and ultimately perpetuate

the cycle of unhelpful parenting, it fails to recommend the very intervention

that is the root cause of many of these adverse sequelae.

Just as children need access to an emotionally available caregiver to help them

make sense of the world, to learn that they are loved and can love in return so

do parents need access to someone with whom they can build a relationship basd on trust and respect, whom they can rely on for advice

and support and to whom they can turn to in a crisis. This was always the ethos

that underpinned health visiting practice but which has been seriously

undermined of late as the role has been eroded and the workforce diminished.The trouble is that many middle class people

will say that they only saw their health visitor once and she wasn't much help.

That is because the health visitor will have made an assessment of the family

circumstances and levels of need and concluded that additional interventions or

support were not required at that time or that the mother was sufficiently well-supported

and self-sufficient to call the health visitor for help if she needed it. That

is the beauty of a universal service that offers targetted

support. Everybody thinks they are getting the same level of support and nobody

feels stigmatised.

Generally,

the latest policy documents, whilst acknowedging the

burgeoning body of evidence that recognise the merits

of positive parenting during the first three years of life (not just because

its 'nice' to support parents but because the quality of the emotional

environment in the early years actually influences the structure and function

of the infant's developing brain - ask Greenfield in the House of

Lords)and determines their social, emotional and cognitive intelligence for

life, are being very careful to avoid mentioning health visiting by name

wherever possible. As it is, when we are no more, it will be a bit embarrasing because this government gave health visitors

specific mention in many of their early policy documents including ' Saving

Lives' 'Supporting Families',The NHS

Plan, NSF for Mental Health, Women’s mental health strategy. Surely if '

Every Child Matters' then 'Every Parent Matters' and to find every parent that

needs help, we need a universal, non-stigmatising,

familiar, acceptable service. Life is never straightforward for anyone and we

never know when we are going to have to deal with major life events, how we

will respond to them and who will help us get through those difficult times.

Bereavement, Divorce, family reconstitution, domestic violence, overwhelming

debt, harsh and inconsistent parenting, parental mental ill-health, disability,

drug and alcohol abuse, teenage pregnancy although more common, are not just

the province of the disadvantaged. If we focus too much on a targeted service

based on socioeconomic disadvantage, an awful lot of parents and children in

need will slip through the net.

The

Acheson Inquiry stated that of all the 39 steps it recommended

, the interventions most likely to reap the most long-lasting and

beneficial health outcomes for this and future generations are those that are

targeted at children and parents, especially mothers.This

report also specifically alluded to the vital role that health visitors play in

promoting emotional well-being in families and children.

The role

of health visitors in detecting and managing postnatal depression is

specifically mentioned as a cost-effective intervention in the Mental Health

Promotion document that runs alongside the NSF for mental health and the role

of health visitors is again applauded in the NSF for Children.After

struggling to gain political recognition for the work that we do, we thought

that our time had come...!

Many of

the people who cannot understand our concerns think we are just being

protective about our title and resistant to change but when the Nursing and

Midwifery Order comes into effect in April 2004, the health visiting profession

will be de-regulated and the health visitor's professional register will disappear.

Furthermore, the proposed competency framework for Specialist Community Public

Health Nurses ( 3rd part of the register which was

supposed to include a separate register for health visitors)is out for

consultation. The framework and the competencies themselves are narrowly

defined as a biomedical model in their focus and wording. There is no purpose

described for specialist practice in public health nursing. Health visiting is

not mentioned in the document except to state that the framework is drawn from

the principles of health visiting which it is not and the briefing note from

the Nursing and Midwifery Council indicates that future courses will be based

on the knowledge and skills of nursing and midwifery models, not a social model

of health that was the basis and principles for health visiting.

The

outcome of the legislation is that by de-regulating the profession, anyone can

call himself or herself a health visitor after April 2004. How are the public

to be protected? Health visitors have been around for 100 years and although

some people may dispute the fact, the majority of the public, and certainly all

those who are parents, know what health visitors do and will let them into

their homes. All sorts of people can now masquerade as health visitors -

volunteer workers who may have some basic training to support parents,

representatives from Baby Food manufacturers who can call themselves health

visitors expressly to gain the support and trust from the public, anybody who

seeks to gain access to vulnerable mothers and children......

Health

visitors aren't perfect, there is still a lot more we can do and perhaps more

clarity is needed about our roles and responsibilities but it seems somewhat

bizarre to me that just when we seemed to have finally gained government

recognition and acknowledgement for all the work that we do and just as all the

research and longitudinal studies are producing incontrovertible evidence that

what matters most is the quality of nurturing infants receive in the first year

of life(I can supply you with endless references if you wish)and that the most

cost-effective preventive interventions are those that involve support during

the first three years of life, that somebody somewhere has decided to do away

with us.

What

about the public perception of health visitors - with all the focus on user

views and consulting with the public about what they want and need, has anybody

asked them if they are happy with the abolition of the profession? We have had

to fight the sometimes strange perception that we are there to inspect people's

toilets, but if I knocked on your door and said I was a public health nurse,

what would you be expecting me to do I wonder?

I notice

on the CNO's site that there is a paper out for

consultation to promote the status of social work and protect the title of

'social worker' presented by Ladyman and

Margaret Hodge. Can I please urge you and your colleagues to rally round and

propose similar legislation to protect the title of health visitor?

Thank you

for listening. I do hope you can do something to help

Lowenhoff

Health

Visitor Consultant

Letter to MP

I enclose the letter that I have sent to my MP if

it is any help to

anyone thinking of doing likewise.

Dear Ann Keen

I write to you again about health visiting as my

fears have been

justified.

The health visiting profession is to be

de-regulated and the health

visitors' professional register will disappear in

April 2004. (The

Nursing and Midwifery Order 2001 (Consequential

Amendments) Order 2002)

The only registers that will be in existence will

be for nurses and

midwives, which, in effect, denote the demise of

the health visiting

profession. What is more disturbing is that

the Nursing & Midwifery

Council had accepted the Requirements for

Pre-registration Health

Visitor programmes in August 2002 and were widely

accepted by the

profession and other agencies. The proposed

competency framework for

Specialist Community Public Health Nurses (third

register) is out for

consultation. The framework and the competencies

themselves are narrowly

defined as a biomedical model in their focus and

wording. There is no

purpose described for Specialist Practice in Public

Health Nursing.

Health visiting is not mentioned in the document,

except to state that

the framework is drawn from the principles of

health visiting, which

they do not. The briefing note from the Nursing

& Midwifery Council

indicates that future courses will be based on

knowledge and skills of

nursing and midwifery models, not a social model

of health that was the

basis and principles for health visiting. It will

be nurses who will

develop public health nursing courses and outcomes

for professional

practice.

I had been assured in your letter to me in June

2001 along with

information from Lord Hunt, that health visitors

would have a separate

register, protection of their title and that

professional regulation of

health visitors was therefore fully preserved. In

reality because it is

a Nurses and Midwives Order, this cannot be

allowed as health visitors

are not named in it.

The outcome of the legislation is that by

de-regulating of the

profession, anyone can call himself or herself a

health visitor after

April 2004. How are the to be public protected?

Unfortunately, whether

we like it or not, the public know what health

visitors are and what

they do. Will families know that the person

knocking on their door may

be anyone who calls himself or herself a health

visitor, are competent

safe practitioners? This could equally apply to

commercial companies who

would wish to use the name health visitor to

ensure that their products

reach the mothers e.g. infant/children's food

companies and others who

are in the business of baby/children's products.

It would appear that health visitors themselves

are unaware that they

are being de-regulated as they had been assured

that their profession

and title would be protected. Having recently

alerted a lot of people

and a Professor in Child and Family Law, they seem

totally be unaware

that this is happening and are very likewise very

concerned.

This all seems very much at odds with the

government agenda and policies

that mention health visitors' role in the context

of health and social

well-being, reduction in health inequalities and

social inclusion.

I would really like to be assured that all these

issues of concern have

been thoroughly discussed and explained to the

practitioners and indeed

the public, but sadly and regrettably I think this

has not been so.

Although I am not in practice now but work as an

Independent Public

Health Specialist - a very different role and

responsibility, my Public

Health Specialist colleagues are also confused

about who will be on the

third part of the register and what the

practitioners will be competent

to do in practice.

--

Rowe

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Share on other sites

Bravo, Bravo and Bravo! What an excellent letter and here's to all it speaks and stands for.

Fiona McGuinness

From: " lowenhoff " <project@...>

Organization: 's Work

Reply-

Date: Sun, 30 Nov 2003 19:16:25 -0000

< >

Subject: RE: Letter to MP

Dear Mr Tim Yeo,

........imagine there's no health visitors, it's easy if you try......

I am writing to you to express my concern about the impending demise of the health visiting profession.

We feel that we were very much sold down river when the UKCC for nursing, midwifery and health visiting was changed to become the NMC, the Nursing and Midwifery Council. However, at the time, we, the health visiting profession, were assured that health visitors would have a separate register, that our title would be protected, and the professional regulation of health visitors preserved.

However as there are greater numbers of non-health visiting nurses and midwives contributing to the regulation debate, we find that the social, preventive model of health which health visitors have sought to uphold for so long is being subsumed under the broader definition of public health. Amidst the rhetoric of the developing family-centred public health role of health visitors there is a subversive but pervasive intent to eliminate both the family-centred aspect and the health visitor emphasis from the public health role. Many of the proponents of the brave new world of public health see the new public health nurses working with the public ( whatever that means) and focussing on needs-led group and community work and moving away from preventive interventions focussed on parents and families. Yet nobody disputes that the breast cancer screening progamme, relying as it does on assessment of indiviuals to detect those at risk, is a public health intervention or that immunisation campaigns, that rely on immunising as many of the vulnerable population as possible, is a public health intervention? Surely providing a service that seeks to give parents the information, confidence and support they need to be the best parents they can be whilst at the same time identifying those relationships and children at risk must reap huge benefits in public health terms ( and there is the research evidence to prove it)?

Whilst the green paper 'Every Child Matters' talks about reducing educational failure, protecting children at risk of abuse or neglect, reducing the increasing numbers of children with emotional and behavioural problems including those with conduct disorder who often go on to cost society a fortune and, unless they are lucky enough to receive intensive and prolonged intervention of the sort they need, will become truants, delinquents, drug and alcohol abusers, early school leavers, premature parents and ultimately perpetuate the cycle of unhelpful parenting, it fails to recommend the very intervention that is the root cause of many of these adverse sequelae. Just as children need access to an emotionally available caregiver to help them make sense of the world, to learn that they are loved and can love in return so do parents need access to someone with whom they can build a relationship basd on trust and respect, whom they can rely on for advice and support and to whom they can turn to in a crisis. This was always the ethos that underpinned health visiting practice but which has been seriously undermined of late as the role has been eroded and the workforce diminished.The trouble is that many middle class people will say that they only saw their health visitor once and she wasn't much help. That is because the health visitor will have made an assessment of the family circumstances and levels of need and concluded that additional interventions or support were not required at that time or that the mother was sufficiently well-supported and self-sufficient to call the health visitor for help if she needed it. That is the beauty of a universal service that offers targetted support. Everybody thinks they are getting the same level of support and nobody feels stigmatised.

Generally, the latest policy documents, whilst acknowedging the burgeoning body of evidence that recognise the merits of positive parenting during the first three years of life (not just because its 'nice' to support parents but because the quality of the emotional environment in the early years actually influences the structure and function of the infant's developing brain - ask Greenfield in the House of Lords)and determines their social, emotional and cognitive intelligence for life, are being very careful to avoid mentioning health visiting by name wherever possible. As it is, when we are no more, it will be a bit embarrasing because this government gave health visitors specific mention in many of their early policy documents including ' Saving Lives' 'Supporting Families',The NHS Plan, NSF for Mental Health, Women¹s mental health strategy. Surely if ' Every Child Matters' then 'Every Parent Matters' and to find every parent that needs help, we need a universal, non-stigmatising, familiar, acceptable service. Life is never straightforward for anyone and we never know when we are going to have to deal with major life events, how we will respond to them and who will help us get through those difficult times. Bereavement, Divorce, family reconstitution, domestic violence, overwhelming debt, harsh and inconsistent parenting, parental mental ill-health, disability, drug and alcohol abuse, teenage pregnancy although more common, are not just the province of the disadvantaged. If we focus too much on a targeted service based on socioeconomic disadvantage, an awful lot of parents and children in need will slip through the net.

The Acheson Inquiry stated that of all the 39 steps it recommended , the interventions most likely to reap the most long-lasting and beneficial health outcomes for this and future generations are those that are targeted at children and parents, especially mothers.This report also specifically alluded to the vital role that health visitors play in promoting emotional well-being in families and children.

The role of health visitors in detecting and managing postnatal depression is specifically mentioned as a cost-effective intervention in the Mental Health Promotion document that runs alongside the NSF for mental health and the role of health visitors is again applauded in the NSF for Children.After struggling to gain political recognition for the work that we do, we thought that our time had come...!

Many of the people who cannot understand our concerns think we are just being protective about our title and resistant to change but when the Nursing and Midwifery Order comes into effect in April 2004, the health visiting profession will be de-regulated and the health visitor's professional register will disappear. Furthermore, the proposed competency framework for Specialist Community Public Health Nurses ( 3rd part of the register which was supposed to include a separate register for health visitors)is out for consultation. The framework and the competencies themselves are narrowly defined as a biomedical model in their focus and wording. There is no purpose described for specialist practice in public health nursing. Health visiting is not mentioned in the document except to state that the framework is drawn from the principles of health visiting which it is not and the briefing note from the Nursing and Midwifery Council indicates that future courses will be based on the knowledge and skills of nursing and midwifery models, not a social model of health that was the basis and principles for health visiting.

The outcome of the legislation is that by de-regulating the profession, anyone can call himself or herself a health visitor after April 2004. How are the public to be protected? Health visitors have been around for 100 years and although some people may dispute the fact, the majority of the public, and certainly all those who are parents, know what health visitors do and will let them into their homes. All sorts of people can now masquerade as health visitors - volunteer workers who may have some basic training to support parents, representatives from Baby Food manufacturers who can call themselves health visitors expressly to gain the support and trust from the public, anybody who seeks to gain access to vulnerable mothers and children......

Health visitors aren't perfect, there is still a lot more we can do and perhaps more clarity is needed about our roles and responsibilities but it seems somewhat bizarre to me that just when we seemed to have finally gained government recognition and acknowledgement for all the work that we do and just as all the research and longitudinal studies are producing incontrovertible evidence that what matters most is the quality of nurturing infants receive in the first year of life(I can supply you with endless references if you wish)and that the most cost-effective preventive interventions are those that involve support during the first three years of life, that somebody somewhere has decided to do away with us.

What about the public perception of health visitors - with all the focus on user views and consulting with the public about what they want and need, has anybody asked them if they are happy with the abolition of the profession? We have had to fight the sometimes strange perception that we are there to inspect people's toilets, but if I knocked on your door and said I was a public health nurse, what would you be expecting me to do I wonder?

I notice on the CNO's site that there is a paper out for consultation to promote the status of social work and protect the title of 'social worker' presented by Ladyman and Margaret Hodge. Can I please urge you and your colleagues to rally round and propose similar legislation to protect the title of health visitor?

Thank you for listening. I do hope you can do something to help

Lowenhoff

Health Visitor Consultant

Letter to MP

I enclose the letter that I have sent to my MP if it is any help to

anyone thinking of doing likewise.

Dear Ann Keen

I write to you again about health visiting as my fears have been

justified.

The health visiting profession is to be de-regulated and the health

visitors' professional register will disappear in April 2004. (The

Nursing and Midwifery Order 2001 (Consequential Amendments) Order 2002)

The only registers that will be in existence will be for nurses and

midwives, which, in effect, denote the demise of the health visiting

profession. What is more disturbing is that the Nursing & Midwifery

Council had accepted the Requirements for Pre-registration Health

Visitor programmes in August 2002 and were widely accepted by the

profession and other agencies. The proposed competency framework for

Specialist Community Public Health Nurses (third register) is out for

consultation. The framework and the competencies themselves are narrowly

defined as a biomedical model in their focus and wording. There is no

purpose described for Specialist Practice in Public Health Nursing.

Health visiting is not mentioned in the document, except to state that

the framework is drawn from the principles of health visiting, which

they do not. The briefing note from the Nursing & Midwifery Council

indicates that future courses will be based on knowledge and skills of

nursing and midwifery models, not a social model of health that was the

basis and principles for health visiting. It will be nurses who will

develop public health nursing courses and outcomes for professional

practice.

I had been assured in your letter to me in June 2001 along with

information from Lord Hunt, that health visitors would have a separate

register, protection of their title and that professional regulation of

health visitors was therefore fully preserved. In reality because it is

a Nurses and Midwives Order, this cannot be allowed as health visitors

are not named in it.

The outcome of the legislation is that by de-regulating of the

profession, anyone can call himself or herself a health visitor after

April 2004. How are the to be public protected? Unfortunately, whether

we like it or not, the public know what health visitors are and what

they do. Will families know that the person knocking on their door may

be anyone who calls himself or herself a health visitor, are competent

safe practitioners? This could equally apply to commercial companies who

would wish to use the name health visitor to ensure that their products

reach the mothers e.g. infant/children's food companies and others who

are in the business of baby/children's products.

It would appear that health visitors themselves are unaware that they

are being de-regulated as they had been assured that their profession

and title would be protected. Having recently alerted a lot of people

and a Professor in Child and Family Law, they seem totally be unaware

that this is happening and are very likewise very concerned.

This all seems very much at odds with the government agenda and policies

that mention health visitors' role in the context of health and social

well-being, reduction in health inequalities and social inclusion.

I would really like to be assured that all these issues of concern have

been thoroughly discussed and explained to the practitioners and indeed

the public, but sadly and regrettably I think this has not been so.

Although I am not in practice now but work as an Independent Public

Health Specialist - a very different role and responsibility, my Public

Health Specialist colleagues are also confused about who will be on the

third part of the register and what the practitioners will be competent

to do in practice.

--

Rowe

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Share on other sites

Last night, , I sat and read your tirade of some days/weeks ago which was brilliant and said very articulately what I believe. Now I read your letter and would dearly like to adapt it to send to my MP. May I?

Ann

RE: Letter to MP

Dear Mr Tim Yeo,

........imagine there's no health visitors, it's easy if you try......

I am writing to you to express my concern about the impending demise of the health visiting profession.

We feel that we were very much sold down river when the UKCC for nursing, midwifery and health visiting was changed to become the NMC, the Nursing and Midwifery Council. However, at the time, we, the health visiting profession, were assured that health visitors would have a separate register, that our title would be protected, and the professional regulation of health visitors preserved.

However as there are greater numbers of non-health visiting nurses and midwives contributing to the regulation debate, we find that the social, preventive model of health which health visitors have sought to uphold for so long is being subsumed under the broader definition of public health. Amidst the rhetoric of the developing family-centred public health role of health visitors there is a subversive but pervasive intent to eliminate both the family-centred aspect and the health visitor emphasis from the public health role. Many of the proponents of the brave new world of public health see the new public health nurses working with the public ( whatever that means) and focussing on needs-led group and community work and moving away from preventive interventions focussed on parents and families. Yet nobody disputes that the breast cancer screening progamme, relying as it does on assessment of indiviuals to detect those at risk, is a public health intervention or that immunisation campaigns, that rely on immunising as many of the vulnerable population as possible, is a public health intervention? Surely providing a service that seeks to give parents the information, confidence and support they need to be the best parents they can be whilst at the same time identifying those relationships and children at risk must reap huge benefits in public health terms ( and there is the research evidence to prove it)?

Whilst the green paper 'Every Child Matters' talks about reducing educational failure, protecting children at risk of abuse or neglect, reducing the increasing numbers of children with emotional and behavioural problems including those with conduct disorder who often go on to cost society a fortune and, unless they are lucky enough to receive intensive and prolonged intervention of the sort they need, will become truants, delinquents, drug and alcohol abusers, early school leavers, premature parents and ultimately perpetuate the cycle of unhelpful parenting, it fails to recommend the very intervention that is the root cause of many of these adverse sequelae. Just as children need access to an emotionally available caregiver to help them make sense of the world, to learn that they are loved and can love in return so do parents need access to someone with whom they can build a relationship basd on trust and respect, whom they can rely on for advice and support and to whom they can turn to in a crisis. This was always the ethos that underpinned health visiting practice but which has been seriously undermined of late as the role has been eroded and the workforce diminished.The trouble is that many middle class people will say that they only saw their health visitor once and she wasn't much help. That is because the health visitor will have made an assessment of the family circumstances and levels of need and concluded that additional interventions or support were not required at that time or that the mother was sufficiently well-supported and self-sufficient to call the health visitor for help if she needed it. That is the beauty of a universal service that offers targetted support. Everybody thinks they are getting the same level of support and nobody feels stigmatised.

Generally, the latest policy documents, whilst acknowedging the burgeoning body of evidence that recognise the merits of positive parenting during the first three years of life (not just because its 'nice' to support parents but because the quality of the emotional environment in the early years actually influences the structure and function of the infant's developing brain - ask Greenfield in the House of Lords)and determines their social, emotional and cognitive intelligence for life, are being very careful to avoid mentioning health visiting by name wherever possible. As it is, when we are no more, it will be a bit embarrasing because this government gave health visitors specific mention in many of their early policy documents including ' Saving Lives' 'Supporting Families',The NHS Plan, NSF for Mental Health, Women’s mental health strategy. Surely if ' Every Child Matters' then 'Every Parent Matters' and to find every parent that needs help, we need a universal, non-stigmatising, familiar, acceptable service. Life is never straightforward for anyone and we never know when we are going to have to deal with major life events, how we will respond to them and who will help us get through those difficult times. Bereavement, Divorce, family reconstitution, domestic violence, overwhelming debt, harsh and inconsistent parenting, parental mental ill-health, disability, drug and alcohol abuse, teenage pregnancy although more common, are not just the province of the disadvantaged. If we focus too much on a targeted service based on socioeconomic disadvantage, an awful lot of parents and children in need will slip through the net.

The Acheson Inquiry stated that of all the 39 steps it recommended , the interventions most likely to reap the most long-lasting and beneficial health outcomes for this and future generations are those that are targeted at children and parents, especially mothers.This report also specifically alluded to the vital role that health visitors play in promoting emotional well-being in families and children.

The role of health visitors in detecting and managing postnatal depression is specifically mentioned as a cost-effective intervention in the Mental Health Promotion document that runs alongside the NSF for mental health and the role of health visitors is again applauded in the NSF for Children.After struggling to gain political recognition for the work that we do, we thought that our time had come...!

Many of the people who cannot understand our concerns think we are just being protective about our title and resistant to change but when the Nursing and Midwifery Order comes into effect in April 2004, the health visiting profession will be de-regulated and the health visitor's professional register will disappear. Furthermore, the proposed competency framework for Specialist Community Public Health Nurses ( 3rd part of the register which was supposed to include a separate register for health visitors)is out for consultation. The framework and the competencies themselves are narrowly defined as a biomedical model in their focus and wording. There is no purpose described for specialist practice in public health nursing. Health visiting is not mentioned in the document except to state that the framework is drawn from the principles of health visiting which it is not and the briefing note from the Nursing and Midwifery Council indicates that future courses will be based on the knowledge and skills of nursing and midwifery models, not a social model of health that was the basis and principles for health visiting.

The outcome of the legislation is that by de-regulating the profession, anyone can call himself or herself a health visitor after April 2004. How are the public to be protected? Health visitors have been around for 100 years and although some people may dispute the fact, the majority of the public, and certainly all those who are parents, know what health visitors do and will let them into their homes. All sorts of people can now masquerade as health visitors - volunteer workers who may have some basic training to support parents, representatives from Baby Food manufacturers who can call themselves health visitors expressly to gain the support and trust from the public, anybody who seeks to gain access to vulnerable mothers and children......

Health visitors aren't perfect, there is still a lot more we can do and perhaps more clarity is needed about our roles and responsibilities but it seems somewhat bizarre to me that just when we seemed to have finally gained government recognition and acknowledgement for all the work that we do and just as all the research and longitudinal studies are producing incontrovertible evidence that what matters most is the quality of nurturing infants receive in the first year of life(I can supply you with endless references if you wish)and that the most cost-effective preventive interventions are those that involve support during the first three years of life, that somebody somewhere has decided to do away with us.

What about the public perception of health visitors - with all the focus on user views and consulting with the public about what they want and need, has anybody asked them if they are happy with the abolition of the profession? We have had to fight the sometimes strange perception that we are there to inspect people's toilets, but if I knocked on your door and said I was a public health nurse, what would you be expecting me to do I wonder?

I notice on the CNO's site that there is a paper out for consultation to promote the status of social work and protect the title of 'social worker' presented by Ladyman and Margaret Hodge. Can I please urge you and your colleagues to rally round and propose similar legislation to protect the title of health visitor?

Thank you for listening. I do hope you can do something to help

Lowenhoff

Health Visitor Consultant

-----Original Message-----From: Noy [mailto:julianoy@...] Sent: 29 November 2003 13:27 Subject: RE: Letter to MP

Dear ,

Id very much like to see what you have written.

Was much inspired by your last posting on Senate.

Would like to stress again that many HVs are not aware of what is about to happen. Can we can stop it?

-----Original Message-----From: lowenhoff [mailto:project@...] Sent: 24 November 2003 23:54 Subject: RE: Letter to MP

JeanMany thanks - I was a bit alarmed when I went onto the faxyourmp sightand it said please don't send standard letters, express yourself in yourown words so I hope you'll forgive me if I've mixed some of your veryclear points with rhetoric of my own. I have also asked my MP toconsider presenting a paper along the lines of that which seeks topromote the status of social work and protect the title 'social worker'but obviously to protect the status and title of 'health visitor'. Iattach a copy of the letter in case anybody wants to draw on the sameargument. If we all keep moving the words around and adding bits, nobodywill ever realise it's the same letter. It looks a bit funny - is it insome strange format that nobody can open - if it is and you want toseeit - let me know and I'll cut and pasteThe more the merrier! Lowenhoff-----Original Message-----From: Rowe [mailto:jean@...] Sent: 24 November 2003 07:54 Subject: Letter to MPI enclose the letter that I have sent to my MP if it is any help toanyone thinking of doing likewise.Dear Ann KeenI write to you again about health visiting as my fears have beenjustified. The health visiting profession is to be de-regulated and the healthvisitors' professional register will disappear in April 2004. (TheNursing and Midwifery Order 2001 (Consequential Amendments) Order 2002) The only registers that will be in existence will be for nurses andmidwives, which, in effect, denote the demise of the health visitingprofession. What is more disturbing is that the Nursing & MidwiferyCouncil had accepted the Requirements for Pre-registration HealthVisitor programmes in August 2002 and were widely accepted by theprofession and other agencies. The proposed competency framework forSpecialist Community Public Health Nurses (third register) is out forconsultation. The framework and the competencies themselves are narrowlydefined as a biomedical model in their focus and wording. There is nopurpose described for Specialist Practice in Public Health Nursing.Health visiting is not mentioned in the document, except to state thatthe framework is drawn from the principles of health visiting, whichthey do not. The briefing note from the Nursing & Midwifery Councilindicates that future courses will be based on knowledge and skills ofnursing and midwifery models, not a social model of health that was thebasis and principles for health visiting. It will be nurses who willdevelop public health nursing courses and outcomes for professionalpractice. I had been assured in your letter to me in June 2001 along withinformation from Lord Hunt, that health visitors would have a separateregister, protection of their title and that professional regulation ofhealth visitors was therefore fully preserved. In reality because it isa Nurses and Midwives Order, this cannot be allowed as health visitorsare not named in it. The outcome of the legislation is that by de-regulating of theprofession, anyone can call himself or herself a health visitor afterApril 2004. How are the to be public protected? Unfortunately, whetherwe like it or not, the public know what health visitors are and whatthey do. Will families know that the person knocking on their door maybe anyone who calls himself or herself a health visitor, are competentsafe practitioners? This could equally apply to commercial companies whowould wish to use the name health visitor to ensure that their productsreach the mothers e.g. infant/children's food companies and others whoare in the business of baby/children's products. It would appear that health visitors themselves are unaware that theyare being de-regulated as they had been assured that their professionand title would be protected. Having recently alerted a lot of peopleand a Professor in Child and Family Law, they seem totally be unawarethat this is happening and are very likewise very concerned.This all seems very much at odds with the government agenda and policiesthat mention health visitors' role in the context of health and socialwell-being, reduction in health inequalities and social inclusion.I would really like to be assured that all these issues of concern havebeen thoroughly discussed and explained to the practitioners and indeedthe public, but sadly and regrettably I think this has not been so.Although I am not in practice now but work as an Independent PublicHealth Specialist - a very different role and responsibility, my PublicHealth Specialist colleagues are also confused about who will be on thethird part of the register and what the practitioners will be competentto do in practice.-- Rowe

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, excellent,brill.. .... I do hope Tim responds to this. Malcolm

RE: Letter to MP

Dear Mr Tim Yeo,

........imagine there's no health visitors, it's easy if you try......

I am writing to you to express my concern about the impending demise of the health visiting profession.

We feel that we were very much sold down river when the UKCC for nursing, midwifery and health visiting was changed to become the NMC, the Nursing and Midwifery Council. However, at the time, we, the health visiting profession, were assured that health visitors would have a separate register, that our title would be protected, and the professional regulation of health visitors preserved.

However as there are greater numbers of non-health visiting nurses and midwives contributing to the regulation debate, we find that the social, preventive model of health which health visitors have sought to uphold for so long is being subsumed under the broader definition of public health. Amidst the rhetoric of the developing family-centred public health role of health visitors there is a subversive but pervasive intent to eliminate both the family-centred aspect and the health visitor emphasis from the public health role. Many of the proponents of the brave new world of public health see the new public health nurses working with the public ( whatever that means) and focussing on needs-led group and community work and moving away from preventive interventions focussed on parents and families. Yet nobody disputes that the breast cancer screening progamme, relying as it does on assessment of indiviuals to detect those at risk, is a public health intervention or that immunisation campaigns, that rely on immunising as many of the vulnerable population as possible, is a public health intervention? Surely providing a service that seeks to give parents the information, confidence and support they need to be the best parents they can be whilst at the same time identifying those relationships and children at risk must reap huge benefits in public health terms ( and there is the research evidence to prove it)?

Whilst the green paper 'Every Child Matters' talks about reducing educational failure, protecting children at risk of abuse or neglect, reducing the increasing numbers of children with emotional and behavioural problems including those with conduct disorder who often go on to cost society a fortune and, unless they are lucky enough to receive intensive and prolonged intervention of the sort they need, will become truants, delinquents, drug and alcohol abusers, early school leavers, premature parents and ultimately perpetuate the cycle of unhelpful parenting, it fails to recommend the very intervention that is the root cause of many of these adverse sequelae. Just as children need access to an emotionally available caregiver to help them make sense of the world, to learn that they are loved and can love in return so do parents need access to someone with whom they can build a relationship basd on trust and respect, whom they can rely on for advice and support and to whom they can turn to in a crisis. This was always the ethos that underpinned health visiting practice but which has been seriously undermined of late as the role has been eroded and the workforce diminished.The trouble is that many middle class people will say that they only saw their health visitor once and she wasn't much help. That is because the health visitor will have made an assessment of the family circumstances and levels of need and concluded that additional interventions or support were not required at that time or that the mother was sufficiently well-supported and self-sufficient to call the health visitor for help if she needed it. That is the beauty of a universal service that offers targetted support. Everybody thinks they are getting the same level of support and nobody feels stigmatised.

Generally, the latest policy documents, whilst acknowedging the burgeoning body of evidence that recognise the merits of positive parenting during the first three years of life (not just because its 'nice' to support parents but because the quality of the emotional environment in the early years actually influences the structure and function of the infant's developing brain - ask Greenfield in the House of Lords)and determines their social, emotional and cognitive intelligence for life, are being very careful to avoid mentioning health visiting by name wherever possible. As it is, when we are no more, it will be a bit embarrasing because this government gave health visitors specific mention in many of their early policy documents including ' Saving Lives' 'Supporting Families',The NHS Plan, NSF for Mental Health, Women’s mental health strategy. Surely if ' Every Child Matters' then 'Every Parent Matters' and to find every parent that needs help, we need a universal, non-stigmatising, familiar, acceptable service. Life is never straightforward for anyone and we never know when we are going to have to deal with major life events, how we will respond to them and who will help us get through those difficult times. Bereavement, Divorce, family reconstitution, domestic violence, overwhelming debt, harsh and inconsistent parenting, parental mental ill-health, disability, drug and alcohol abuse, teenage pregnancy although more common, are not just the province of the disadvantaged. If we focus too much on a targeted service based on socioeconomic disadvantage, an awful lot of parents and children in need will slip through the net.

The Acheson Inquiry stated that of all the 39 steps it recommended , the interventions most likely to reap the most long-lasting and beneficial health outcomes for this and future generations are those that are targeted at children and parents, especially mothers.This report also specifically alluded to the vital role that health visitors play in promoting emotional well-being in families and children.

The role of health visitors in detecting and managing postnatal depression is specifically mentioned as a cost-effective intervention in the Mental Health Promotion document that runs alongside the NSF for mental health and the role of health visitors is again applauded in the NSF for Children.After struggling to gain political recognition for the work that we do, we thought that our time had come...!

Many of the people who cannot understand our concerns think we are just being protective about our title and resistant to change but when the Nursing and Midwifery Order comes into effect in April 2004, the health visiting profession will be de-regulated and the health visitor's professional register will disappear. Furthermore, the proposed competency framework for Specialist Community Public Health Nurses ( 3rd part of the register which was supposed to include a separate register for health visitors)is out for consultation. The framework and the competencies themselves are narrowly defined as a biomedical model in their focus and wording. There is no purpose described for specialist practice in public health nursing. Health visiting is not mentioned in the document except to state that the framework is drawn from the principles of health visiting which it is not and the briefing note from the Nursing and Midwifery Council indicates that future courses will be based on the knowledge and skills of nursing and midwifery models, not a social model of health that was the basis and principles for health visiting.

The outcome of the legislation is that by de-regulating the profession, anyone can call himself or herself a health visitor after April 2004. How are the public to be protected? Health visitors have been around for 100 years and although some people may dispute the fact, the majority of the public, and certainly all those who are parents, know what health visitors do and will let them into their homes. All sorts of people can now masquerade as health visitors - volunteer workers who may have some basic training to support parents, representatives from Baby Food manufacturers who can call themselves health visitors expressly to gain the support and trust from the public, anybody who seeks to gain access to vulnerable mothers and children......

Health visitors aren't perfect, there is still a lot more we can do and perhaps more clarity is needed about our roles and responsibilities but it seems somewhat bizarre to me that just when we seemed to have finally gained government recognition and acknowledgement for all the work that we do and just as all the research and longitudinal studies are producing incontrovertible evidence that what matters most is the quality of nurturing infants receive in the first year of life(I can supply you with endless references if you wish)and that the most cost-effective preventive interventions are those that involve support during the first three years of life, that somebody somewhere has decided to do away with us.

What about the public perception of health visitors - with all the focus on user views and consulting with the public about what they want and need, has anybody asked them if they are happy with the abolition of the profession? We have had to fight the sometimes strange perception that we are there to inspect people's toilets, but if I knocked on your door and said I was a public health nurse, what would you be expecting me to do I wonder?

I notice on the CNO's site that there is a paper out for consultation to promote the status of social work and protect the title of 'social worker' presented by Ladyman and Margaret Hodge. Can I please urge you and your colleagues to rally round and propose similar legislation to protect the title of health visitor?

Thank you for listening. I do hope you can do something to help

Lowenhoff

Health Visitor Consultant

-----Original Message-----From: Noy [mailto:julianoy@...] Sent: 29 November 2003 13:27 Subject: RE: Letter to MP

Dear ,

Id very much like to see what you have written.

Was much inspired by your last posting on Senate.

Would like to stress again that many HVs are not aware of what is about to happen. Can we can stop it?

-----Original Message-----From: lowenhoff [mailto:project@...] Sent: 24 November 2003 23:54 Subject: RE: Letter to MP

JeanMany thanks - I was a bit alarmed when I went onto the faxyourmp sightand it said please don't send standard letters, express yourself in yourown words so I hope you'll forgive me if I've mixed some of your veryclear points with rhetoric of my own. I have also asked my MP toconsider presenting a paper along the lines of that which seeks topromote the status of social work and protect the title 'social worker'but obviously to protect the status and title of 'health visitor'. Iattach a copy of the letter in case anybody wants to draw on the sameargument. If we all keep moving the words around and adding bits, nobodywill ever realise it's the same letter. It looks a bit funny - is it insome strange format that nobody can open - if it is and you want toseeit - let me know and I'll cut and pasteThe more the merrier! Lowenhoff-----Original Message-----From: Rowe [mailto:jean@...] Sent: 24 November 2003 07:54 Subject: Letter to MPI enclose the letter that I have sent to my MP if it is any help toanyone thinking of doing likewise.Dear Ann KeenI write to you again about health visiting as my fears have beenjustified. The health visiting profession is to be de-regulated and the healthvisitors' professional register will disappear in April 2004. (TheNursing and Midwifery Order 2001 (Consequential Amendments) Order 2002) The only registers that will be in existence will be for nurses andmidwives, which, in effect, denote the demise of the health visitingprofession. What is more disturbing is that the Nursing & MidwiferyCouncil had accepted the Requirements for Pre-registration HealthVisitor programmes in August 2002 and were widely accepted by theprofession and other agencies. The proposed competency framework forSpecialist Community Public Health Nurses (third register) is out forconsultation. The framework and the competencies themselves are narrowlydefined as a biomedical model in their focus and wording. There is nopurpose described for Specialist Practice in Public Health Nursing.Health visiting is not mentioned in the document, except to state thatthe framework is drawn from the principles of health visiting, whichthey do not. The briefing note from the Nursing & Midwifery Councilindicates that future courses will be based on knowledge and skills ofnursing and midwifery models, not a social model of health that was thebasis and principles for health visiting. It will be nurses who willdevelop public health nursing courses and outcomes for professionalpractice. I had been assured in your letter to me in June 2001 along withinformation from Lord Hunt, that health visitors would have a separateregister, protection of their title and that professional regulation ofhealth visitors was therefore fully preserved. In reality because it isa Nurses and Midwives Order, this cannot be allowed as health visitorsare not named in it. The outcome of the legislation is that by de-regulating of theprofession, anyone can call himself or herself a health visitor afterApril 2004. How are the to be public protected? Unfortunately, whetherwe like it or not, the public know what health visitors are and whatthey do. Will families know that the person knocking on their door maybe anyone who calls himself or herself a health visitor, are competentsafe practitioners? This could equally apply to commercial companies whowould wish to use the name health visitor to ensure that their productsreach the mothers e.g. infant/children's food companies and others whoare in the business of baby/children's products. It would appear that health visitors themselves are unaware that theyare being de-regulated as they had been assured that their professionand title would be protected. Having recently alerted a lot of peopleand a Professor in Child and Family Law, they seem totally be unawarethat this is happening and are very likewise very concerned.This all seems very much at odds with the government agenda and policiesthat mention health visitors' role in the context of health and socialwell-being, reduction in health inequalities and social inclusion.I would really like to be assured that all these issues of concern havebeen thoroughly discussed and explained to the practitioners and indeedthe public, but sadly and regrettably I think this has not been so.Although I am not in practice now but work as an Independent PublicHealth Specialist - a very different role and responsibility, my PublicHealth Specialist colleagues are also confused about who will be on thethird part of the register and what the practitioners will be competentto do in practice.-- Rowe

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Feel free, but bear in mind that on faxyourmp it says that they are not interested in standard

letters so you may have to modify it a bit – mine certainly paraphrases

large sections from Jean’s original.

Re: Letter

to MP

Last night, , I sat and read

your tirade of some days/weeks ago which was brilliant and said very

articulately what I believe. Now I read your letter and would dearly like to

adapt it to send to my MP. May I?

Ann

Letter to MP

I enclose the letter that I have sent to my MP if

it is any help to

anyone thinking of doing likewise.

Dear Ann Keen

I write to you again about health visiting as my

fears have been

justified.

The health visiting profession is to be

de-regulated and the health

visitors' professional register will disappear in

April 2004. (The

Nursing and Midwifery Order 2001 (Consequential

Amendments) Order 2002)

The only registers that will be in existence will

be for nurses and

midwives, which, in effect, denote the demise of

the health visiting

profession. What is more disturbing is that

the Nursing & Midwifery

Council had accepted the Requirements for

Pre-registration Health

Visitor programmes in August 2002 and were widely

accepted by the

profession and other agencies. The proposed

competency framework for

Specialist Community Public Health Nurses (third

register) is out for

consultation. The framework and the competencies

themselves are narrowly

defined as a biomedical model in their focus and

wording. There is no

purpose described for Specialist Practice in Public

Health Nursing.

Health visiting is not mentioned in the document,

except to state that

the framework is drawn from the principles of

health visiting, which

they do not. The briefing note from the Nursing

& Midwifery Council

indicates that future courses will be based on

knowledge and skills of

nursing and midwifery models, not a social model

of health that was the

basis and principles for health visiting. It will

be nurses who will

develop public health nursing courses and outcomes

for professional

practice.

I had been assured in your letter to me in June

2001 along with

information from Lord Hunt, that health visitors

would have a separate

register, protection of their title and that

professional regulation of

health visitors was therefore fully preserved. In

reality because it is

a Nurses and Midwives Order, this cannot be

allowed as health visitors

are not named in it.

The outcome of the legislation is that by

de-regulating of the

profession, anyone can call himself or herself a

health visitor after

April 2004. How are the to be public protected?

Unfortunately, whether

we like it or not, the public know what health

visitors are and what

they do. Will families know that the person

knocking on their door may

be anyone who calls himself or herself a health

visitor, are competent

safe practitioners? This could equally apply to

commercial companies who

would wish to use the name health visitor to

ensure that their products

reach the mothers e.g. infant/children's food

companies and others who

are in the business of baby/children's products.

It would appear that health visitors themselves

are unaware that they

are being de-regulated as they had been assured

that their profession

and title would be protected. Having recently

alerted a lot of people

and a Professor in Child and Family Law, they seem

totally be unaware

that this is happening and are very likewise very

concerned.

This all seems very much at odds with the

government agenda and policies

that mention health visitors' role in the context

of health and social

well-being, reduction in health inequalities and

social inclusion.

I would really like to be assured that all these

issues of concern have

been thoroughly discussed and explained to the

practitioners and indeed

the public, but sadly and regrettably I think this

has not been so.

Although I am not in practice now but work as an

Independent Public

Health Specialist - a very different role and

responsibility, my Public

Health Specialist colleagues are also confused

about who will be on the

third part of the register and what the

practitioners will be competent

to do in practice.

--

Rowe

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Share on other sites

,

Very articulate.Please can I have

permission to share with my colleagues then adapt to formulate letter to local MP

?

Many thanks,

Letter to MP

I enclose the letter that I have sent to my MP if

it is any help to

anyone thinking of doing likewise.

Dear Ann Keen

I write to you again about health visiting as my

fears have been

justified.

The health visiting profession is to be

de-regulated and the health

visitors' professional register will disappear in April

2004. (The

Nursing and Midwifery Order 2001 (Consequential

Amendments) Order 2002)

The only registers that will be in existence will

be for nurses and

midwives, which, in effect, denote the demise of

the health visiting

profession. What is more disturbing is that

the Nursing & Midwifery

Council had accepted the Requirements for

Pre-registration Health

Visitor programmes in August 2002 and were widely

accepted by the

profession and other agencies. The proposed

competency framework for

Specialist Community Public Health Nurses (third

register) is out for

consultation. The framework and the competencies

themselves are narrowly

defined as a biomedical model in their focus and

wording. There is no

purpose described for Specialist Practice in

Public Health Nursing.

Health visiting is not mentioned in the document,

except to state that

the framework is drawn from the principles of

health visiting, which

they do not. The briefing note from the Nursing

& Midwifery Council

indicates that future courses will be based on

knowledge and skills of

nursing and midwifery models, not a social model

of health that was the

basis and principles for health visiting. It will

be nurses who will

develop public health nursing courses and outcomes

for professional

practice.

I had been assured in your letter to me in June

2001 along with

information from Lord Hunt, that health visitors

would have a separate

register, protection of their title and that

professional regulation of

health visitors was therefore fully preserved. In reality

because it is

a Nurses and Midwives Order, this cannot be

allowed as health visitors

are not named in it.

The outcome of the legislation is that by

de-regulating of the

profession, anyone can call himself or herself a

health visitor after

April 2004. How are the to be public protected?

Unfortunately, whether

we like it or not, the public know what health

visitors are and what

they do. Will families know that the person

knocking on their door may

be anyone who calls himself or herself a health

visitor, are competent

safe practitioners? This could equally apply to

commercial companies who

would wish to use the name health visitor to

ensure that their products

reach the mothers e.g. infant/children's food

companies and others who

are in the business of baby/children's products.

It would appear that health visitors themselves

are unaware that they

are being de-regulated as they had been assured

that their profession

and title would be protected. Having recently

alerted a lot of people

and a Professor in Child and Family Law, they seem

totally be unaware

that this is happening and are very likewise very

concerned.

This all seems very much at odds with the

government agenda and policies

that mention health visitors' role in the context

of health and social

well-being, reduction in health inequalities and

social inclusion.

I would really like to be assured that all these

issues of concern have

been thoroughly discussed and explained to the

practitioners and indeed

the public, but sadly and regrettably I think this

has not been so.

Although I am not in practice now but work as an

Independent Public

Health Specialist - a very different role and

responsibility, my Public

Health Specialist colleagues are also confused about

who will be on the

third part of the register and what the

practitioners will be competent

to do in practice.

--

Rowe

Link to comment
Share on other sites

,

Very articulate.Please can I have

permission to share with my colleagues then adapt to formulate letter to local MP

?

Many thanks,

Letter to MP

I enclose the letter that I have sent to my MP if

it is any help to

anyone thinking of doing likewise.

Dear Ann Keen

I write to you again about health visiting as my

fears have been

justified.

The health visiting profession is to be

de-regulated and the health

visitors' professional register will disappear in April

2004. (The

Nursing and Midwifery Order 2001 (Consequential

Amendments) Order 2002)

The only registers that will be in existence will

be for nurses and

midwives, which, in effect, denote the demise of

the health visiting

profession. What is more disturbing is that

the Nursing & Midwifery

Council had accepted the Requirements for

Pre-registration Health

Visitor programmes in August 2002 and were widely

accepted by the

profession and other agencies. The proposed

competency framework for

Specialist Community Public Health Nurses (third

register) is out for

consultation. The framework and the competencies

themselves are narrowly

defined as a biomedical model in their focus and

wording. There is no

purpose described for Specialist Practice in

Public Health Nursing.

Health visiting is not mentioned in the document,

except to state that

the framework is drawn from the principles of

health visiting, which

they do not. The briefing note from the Nursing

& Midwifery Council

indicates that future courses will be based on

knowledge and skills of

nursing and midwifery models, not a social model

of health that was the

basis and principles for health visiting. It will

be nurses who will

develop public health nursing courses and outcomes

for professional

practice.

I had been assured in your letter to me in June

2001 along with

information from Lord Hunt, that health visitors

would have a separate

register, protection of their title and that

professional regulation of

health visitors was therefore fully preserved. In reality

because it is

a Nurses and Midwives Order, this cannot be

allowed as health visitors

are not named in it.

The outcome of the legislation is that by

de-regulating of the

profession, anyone can call himself or herself a

health visitor after

April 2004. How are the to be public protected?

Unfortunately, whether

we like it or not, the public know what health

visitors are and what

they do. Will families know that the person

knocking on their door may

be anyone who calls himself or herself a health

visitor, are competent

safe practitioners? This could equally apply to

commercial companies who

would wish to use the name health visitor to

ensure that their products

reach the mothers e.g. infant/children's food

companies and others who

are in the business of baby/children's products.

It would appear that health visitors themselves

are unaware that they

are being de-regulated as they had been assured

that their profession

and title would be protected. Having recently

alerted a lot of people

and a Professor in Child and Family Law, they seem

totally be unaware

that this is happening and are very likewise very

concerned.

This all seems very much at odds with the

government agenda and policies

that mention health visitors' role in the context

of health and social

well-being, reduction in health inequalities and

social inclusion.

I would really like to be assured that all these

issues of concern have

been thoroughly discussed and explained to the

practitioners and indeed

the public, but sadly and regrettably I think this

has not been so.

Although I am not in practice now but work as an

Independent Public

Health Specialist - a very different role and

responsibility, my Public

Health Specialist colleagues are also confused about

who will be on the

third part of the register and what the

practitioners will be competent

to do in practice.

--

Rowe

Link to comment
Share on other sites

Dear

But of course – the original

inspiration and some of the direct passages came from Rowe’s

brilliant letter – keep adapting and hopefully we can whip up some

support from lots of M.P’s.

Letter to MP

I enclose the letter that I have sent to my MP if

it is any help to

anyone thinking of doing likewise.

Dear Ann Keen

I write to you again about health visiting as my

fears have been

justified.

The health visiting profession is to be

de-regulated and the health

visitors' professional register will disappear in

April 2004. (The

Nursing and Midwifery Order 2001 (Consequential

Amendments) Order 2002)

The only registers that will be in existence will

be for nurses and

midwives, which, in effect, denote the demise of

the health visiting

profession. What is more disturbing is that

the Nursing & Midwifery

Council had accepted the Requirements for

Pre-registration Health

Visitor programmes in August 2002 and were widely

accepted by the

profession and other agencies. The proposed

competency framework for

Specialist Community Public Health Nurses (third

register) is out for

consultation. The framework and the competencies

themselves are narrowly

defined as a biomedical model in their focus and

wording. There is no

purpose described for Specialist Practice in

Public Health Nursing.

Health visiting is not mentioned in the document,

except to state that

the framework is drawn from the principles of

health visiting, which

they do not. The briefing note from the Nursing

& Midwifery Council

indicates that future courses will be based on

knowledge and skills of

nursing and midwifery models, not a social model

of health that was the

basis and principles for health visiting. It will

be nurses who will

develop public health nursing courses and outcomes

for professional

practice.

I had been assured in your letter to me in June

2001 along with

information from Lord Hunt, that health visitors

would have a separate

register, protection of their title and that

professional regulation of

health visitors was therefore fully preserved. In

reality because it is

a Nurses and Midwives Order, this cannot be

allowed as health visitors

are not named in it.

The outcome of the legislation is that by

de-regulating of the

profession, anyone can call himself or herself a

health visitor after

April 2004. How are the to be public protected?

Unfortunately, whether

we like it or not, the public know what health

visitors are and what

they do. Will families know that the person

knocking on their door may

be anyone who calls himself or herself a health

visitor, are competent

safe practitioners? This could equally apply to

commercial companies who

would wish to use the name health visitor to

ensure that their products

reach the mothers e.g. infant/children's food

companies and others who

are in the business of baby/children's products.

It would appear that health visitors themselves

are unaware that they

are being de-regulated as they had been assured

that their profession

and title would be protected. Having recently

alerted a lot of people

and a Professor in Child and Family Law, they seem

totally be unaware

that this is happening and are very likewise very

concerned.

This all seems very much at odds with the government

agenda and policies

that mention health visitors' role in the context

of health and social

well-being, reduction in health inequalities and

social inclusion.

I would really like to be assured that all these

issues of concern have

been thoroughly discussed and explained to the

practitioners and indeed

the public, but sadly and regrettably I think this

has not been so.

Although I am not in practice now but work as an

Independent Public

Health Specialist - a very different role and

responsibility, my Public

Health Specialist colleagues are also confused

about who will be on the

third part of the register and what the

practitioners will be competent

to do in practice.

--

Rowe

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Share on other sites

Dear

But of course – the original

inspiration and some of the direct passages came from Rowe’s

brilliant letter – keep adapting and hopefully we can whip up some

support from lots of M.P’s.

Letter to MP

I enclose the letter that I have sent to my MP if

it is any help to

anyone thinking of doing likewise.

Dear Ann Keen

I write to you again about health visiting as my

fears have been

justified.

The health visiting profession is to be

de-regulated and the health

visitors' professional register will disappear in

April 2004. (The

Nursing and Midwifery Order 2001 (Consequential

Amendments) Order 2002)

The only registers that will be in existence will

be for nurses and

midwives, which, in effect, denote the demise of

the health visiting

profession. What is more disturbing is that

the Nursing & Midwifery

Council had accepted the Requirements for

Pre-registration Health

Visitor programmes in August 2002 and were widely

accepted by the

profession and other agencies. The proposed

competency framework for

Specialist Community Public Health Nurses (third

register) is out for

consultation. The framework and the competencies

themselves are narrowly

defined as a biomedical model in their focus and

wording. There is no

purpose described for Specialist Practice in

Public Health Nursing.

Health visiting is not mentioned in the document,

except to state that

the framework is drawn from the principles of

health visiting, which

they do not. The briefing note from the Nursing

& Midwifery Council

indicates that future courses will be based on

knowledge and skills of

nursing and midwifery models, not a social model

of health that was the

basis and principles for health visiting. It will

be nurses who will

develop public health nursing courses and outcomes

for professional

practice.

I had been assured in your letter to me in June

2001 along with

information from Lord Hunt, that health visitors

would have a separate

register, protection of their title and that

professional regulation of

health visitors was therefore fully preserved. In

reality because it is

a Nurses and Midwives Order, this cannot be

allowed as health visitors

are not named in it.

The outcome of the legislation is that by

de-regulating of the

profession, anyone can call himself or herself a

health visitor after

April 2004. How are the to be public protected?

Unfortunately, whether

we like it or not, the public know what health

visitors are and what

they do. Will families know that the person

knocking on their door may

be anyone who calls himself or herself a health

visitor, are competent

safe practitioners? This could equally apply to

commercial companies who

would wish to use the name health visitor to

ensure that their products

reach the mothers e.g. infant/children's food

companies and others who

are in the business of baby/children's products.

It would appear that health visitors themselves

are unaware that they

are being de-regulated as they had been assured

that their profession

and title would be protected. Having recently

alerted a lot of people

and a Professor in Child and Family Law, they seem

totally be unaware

that this is happening and are very likewise very

concerned.

This all seems very much at odds with the government

agenda and policies

that mention health visitors' role in the context

of health and social

well-being, reduction in health inequalities and

social inclusion.

I would really like to be assured that all these

issues of concern have

been thoroughly discussed and explained to the

practitioners and indeed

the public, but sadly and regrettably I think this

has not been so.

Although I am not in practice now but work as an

Independent Public

Health Specialist - a very different role and

responsibility, my Public

Health Specialist colleagues are also confused

about who will be on the

third part of the register and what the

practitioners will be competent

to do in practice.

--

Rowe

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  • 7 years later...
Guest guest

Sent the suggested letter to my MP at end of July and have today received a

response that he has raised matter with Secretary of State for Health asking him

to investigate.

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Guest guest

I got my response from my MP at the House of Commons today too, thanking me for coming to his constituency office last Friday to discuss my concerns in person.  (I

spent half an hour with him but as he didn't even write any notes, I didn't really feel he was taking much interest except to ask if it affected men !!!!!

I then spent the whole of the weekend writing a really good detailed e-mail spelling out what we wanted together with 12 specific questions which I wanted answers to and suggesting he could copy and paste as much

of it to the DoH as he wanted.

He

said he'd written to the DoH on my behalf asking for a public enquiry but I wonder if he also sent my (about 12) specific questions which I wanted answering.  One of which was about Germany recently reducing their TSH to 2 due to iodine deficiency.  I said that as the UK was also

iodine deficient then perhaps it was time to reduce ours to 2 also.

I think I'll write to him again asking what it was he actually sent and was it ONLY asking for a public enquiry or for answers to my specific questions.

I won't be holding my breath though, BUT if everyone did this, Lansley would at least realise how many of us there are !!!

Jackie xOn Wed, Aug 3, 2011 at 1:44 PM, PAMELA <pamelaswain@...> wrote:

 

Sent the suggested letter to my MP at end of July and have today received a response that he has raised matter with Secretary of State for Health asking him to investigate.

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Guest guest

Well, I'm shocked !!!  I did write earlier to my MP thanking him for writing to the DoH and asking if he had specifically put my questions forward as well as asking for a public enquiry and he has!  You can read below what he said.  I'm sure it will get kicked back by the DoH but at least my MP is doing his best !

Jackie xThank you for your email. Given the complexity of this issue I took the opportunity to cut and paste your 11 specific points and include them in

the letter

I sent the Minister. You quite rightly mentioned in your previous email

how much information there was on this issue and given your knowledge I

decided it would be far more productive to actually use your wording to form the basis of a second letter rather than

try and generalise. I also asked for a public enquiry as you requested.

 

I have

asked for a reply to each of the 11 points and I will let you have a copy of the reply as soon as possible. Once this is to hand, I would be happy to

discuss what the Minister has said and to then raise any other concerns

that may arise from his response.

 

Please let me know if I can be of any other assistance in the meantime.I got my response from my MP at the House of Commons today too, thanking me for coming to his constituency office last Friday to discuss my concerns in person.  (I

spent half an hour with him but as he didn't even write any notes, I didn't really feel he was taking much interest except to ask if it affected men !!!!!

I think I'll write to him again asking what it was he actually sent and was it ONLY asking for a public enquiry or for answers to my specific questions.

Jackie x

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  • 4 weeks later...

Despite the fact that I listed 12 specific questions I requested answers to, it seems my response received today is only a slight variation on the usual generic one :(

They noted my 'frustrations and concerns' but they are fobbing me off and passing the buck back to me to contact both the GMC and NICE to ultimately then, no doubt, receive even further generic dismissals.

No mention of the requested Public Enquiry either!

Jackie x 

Response to my MP from Burstow MP, Minister of State for Care Services at the

Dept of Health

Thank you for your letters of 2 and 3

August to Lansley on behalf of your constituent Ms Kay of ……

about hypothyroidism.  I am replying as

the Minister responsible for policy on long-term conditions.

I appreciate Ms Kay’s frustration that some

patients are not correctly diagnosed with thyroid problems.  It is for health professionals to diagnose

hypothyroidism using their clinical knowledge as well as the results of blood

tests they may decide are needed.  Health

professionals are expected to take account of any relevant guidelines when

making a diagnosis, these would include the guidelines issued jointly by the

British Thyroid Association and the Royal College of physicians.  It is important that health professionals are

free to use their clinical expertise to diagnose and treat patients.  If a clinician believes that their patient

needs a particular test then they can request it.  Clinical issues are a matter for trained

professionals who can consider all aspects of a case.  It would not be appropriate for the

Department of Health to comment on clinical decisions.

GPs are regulated by the General Medical

Council (GMC) who ensure that professional standards are maintained.  Ms Kay may therefore wish to raise her

concerns about the way in which GPs diagnose hypothyroidism directly with the

GMC.  The contact details are:

GMC

Regent’s Place

350 Euston Road

London NW1 3JN(Shall we all bombard the GMC with our requests?)

I note Ms Kay’s concerns that only

guidelines from the British Thyroid Association and the Royal College of

Physicians are available on how to diagnose and treat thyroid problems such as

hypothyroidism.  Ms Kay may be aware that

the Department of Health does not get involved in producing guidelines for the

treatment of specific medical conditions. 

The National Institute for Health and Clinical Excellence (NICE) is also

involved in producing clinical guidelines on the treatment of particular illnesses.  Ms Kay may wish to contact NICE to suggest a

topic for it to develop guidance on.  The

details can be found at www.nice.org by

typing ‘topic selection’ into the search bar.(Shall we all bombard the NICE website with our requests?)

Armour natural thyroid hormone extract is

currently not licensed for use in the UK – it is a matter for the manufacturer

to apply for a UK licence.  Medicines

that are not licensed for use in the UK are not generally available by the NHS.

However, these medicines can still be

prescribed by a health professional for the personal use of a named

patient.  Under their terms of service,

GPs are allowed to prescribe any product, including any unlicensed product,

which they consider to be a drug necessary for the treatment of their patients

under the NHS, subject to two provisos: firstly, that the product is not

included in Schedules 1 or 2 to the NHS (General Medical Services contract)

Regulations 2004 and secondly, that the GP is

are (yes they appeared to make a typo here or my cynical side says perhaps they were trying to make it look less like a

copy and paste job!!!) prepared to justify any

challenges to their prescribing by the local primary care trust.

Schedule 1 to the NHS (General Medical

Services Contracts) (Prescription of Drugs etc) Regulations 2004 is a list of

drugs which GPs may not prescribe on the NHS (also known as the ‘Blacklist’)

and Schedule 2 to these regulations is a list of drugs which GPs may prescribe

on the NHS only in specified circumstances, and/or for specified patient

groups.

I hope this reply is helpful.

Yours sincerely,

White

pp

Burstow

This letter has been signed by Burstow’s

Private Secretary in his absence.

On Thu, Aug 4, 2011 at 10:19 AM, Sheila <sheila@...> wrote:

Still catching up with messages Jackie - have you heard anything

further from your MP 

Luv - Sheila

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