Re: I thought people might be interested in this.

[Guest guest]

Dear All

I find this very interesting and I wondered how it all started. How did you

come to have these discussions with the midwives and who decides which is

best for the family - do they tell the midwife, does the midwife let the hv

know or how does it work?

Lynn

>From: " & Gareth " <tomsskids@...>

>Reply-

>< >

>Subject: Re: I thought people might be interested in this.

>Date: Tue, 8 Apr 2003 22:13:51 +0100

>

>Hear, Hear we in Thetford have recently adopted this approach, that is

>working closely with midwives to provide a smoother more effective service

>taking over from the midwives when they feel their work is done rather than

>duplicating services which also runs the risk of causing conflicting

>advice. our visits are aimed at individual need rather than a rigid

>regulated approach, there are those preferring to attend groups quite soon

>after delivery, Others prefer home visits for awhile longer. We try to meet

>these needs.

> I thought people might be interested in

>this.

>

>

> Parents warned about " unhelpful teaching "

> Parents who teach their pre-school children to read, write and

>add could be setting them up for mental health problems later in life, the

>Royal College of Paediatrics and Child Health says. A report issued today

>(04/04/03) encourages patients to interact with their infants through

>informal play, but warns against adopting a formal teaching approach. The

>study investigates why so many children have emotional and behavioural

>problems at a time when they are healthier and better educated than ever.

>It blames " unhelpful parenting practices " and a lack of understanding among

>parents of child development.

> (The Times 04/04/03; p.19)

>

> © HMG Worldwide 2003

> http://www.health-news.co.uk/

>

>

> Babies of divorced parents suffer

>

> " Babies forced to spend nights in the separate homes of divorced

>or separated parents often suffer emotional and physical anguish, according

>to new research. Such infants have more tantrums, develop eating and

>sleeping disorders, and exhibit distress through symptoms such as raised

>heartbeats. They also fail to identify their mothers as a source of comfort

>because they are confused by her regular absences. The findings were made

>in the world's first study of how infants' attachment to their parents is

>affected by overnight stays.

> (The Daily Telegraph 04/04/03; p.13)

>

> © HMG Worldwide 2003

> http://www.health-news.co.uk/

>

>

>

>

>

>

>

>

>

[Guest guest]

Do you think other professions struggle like this or is it only health and particularly nursing/

-----Original Message-----From: Ann GIRLING [mailto:annieg@...]Sent: 08 April 2003 18:29 Subject: Re: I thought people might be interested in this.

I think I work in an area where people are very defensive about practice and having been through the horror of disinvestment 5 or 6 years ago (remember the Cambridge experiment?) I'm not surprised. However i feel very strongly that we do need to move on if we are not to experience the same again.

We were promised reinvestment 2 years ago and I and others worked like Trojans on a modernisation package with no guidance and no support and still it has not happened. Is it surprising people walk away and try and influence from outsied maybe in arenas such as this.

This is becoming very therapeutic for me!!

Ann

I thought people might be interested in this.

Parents warned about “unhelpful teaching”

Parents who teach their pre-school children to read, write and add could be setting them up for mental health problems later in life, the Royal College of Paediatrics and Child Health says. A report issued today (04/04/03) encourages patients to interact with their infants through informal play, but warns against adopting a formal teaching approach. The study investigates why so many children have emotional and behavioural problems at a time when they are healthier and better educated than ever. It blames “unhelpful parenting practices” and a lack of understanding among parents of child development.(The Times 04/04/03; p.19)© HMG Worldwide 2003http://www.health-news.co.uk/

Babies of divorced parents suffer

”Babies forced to spend nights in the separate homes of divorced or separated parents often suffer emotional and physical anguish, according to new research. Such infants have more tantrums, develop eating and sleeping disorders, and exhibit distress through symptoms such as raised heartbeats. They also fail to identify their mothers as a source of comfort because they are confused by her regular absences. The findings were made in the world’s first study of how infants’ attachment to their parents is affected by overnight stays.(The Daily Telegraph 04/04/03; p.13)© HMG Worldwide 2003http://www.health-news.co.uk/

[Guest guest]

I am sorry but I will be out of the office from Friday 11 April 2003 until

Wednesday 23 April

2003.

[Guest guest]

Dear Ann

I was involved as a health visitor in a study carried out by Reading University in 98-99 which continued on from Brazelton. There was more intensive visiting in the ante-natal and postnatal period with emphasis on the parent/infant relationship. Professor Lynn Murray and Health visitor s produced a book called the 'Social Baby' from this work, I recommend it as an interesting book full of pictures showing babies responses to their parents. Although this study did not change the delivery of health visiting in Reading, those of us involved in the study continued to use what we had learnt from our experience in our practice.

Best wishes

Chris

-----Original Message-----From: Ann GIRLING [mailto:annieg@...]Sent: 09 April 2003 19:10 Subject: Re: I thought people might be interested in this.

Thank you for that, . I hope i may keep in touch should i make any progress with my ideas but will hopefully get the article you referenced

Ann

I thought people might be interested in this.

Parents warned about "unhelpful teaching"

Parents who teach their pre-school children to read, write and add could be setting them up for mental health problems later in life, the Royal College of Paediatrics and Child Health says. A report issued today (04/04/03) encourages patients to interact with their infants through informal play, but warns against adopting a formal teaching approach. The study investigates why so many children have emotional and behavioural problems at a time when they are healthier and better educated than ever. It blames "unhelpful parenting practices" and a lack of understanding among parents of child development.(The Times 04/04/03; p.19)© HMG Worldwide 2003http://www.health-news.co.uk/

Babies of divorced parents suffer

"Babies forced to spend nights in the separate homes of divorced or separated parents often suffer emotional and physical anguish, according to new research. Such infants have more tantrums, develop eating and sleeping disorders, and exhibit distress through symptoms such as raised heartbeats. They also fail to identify their mothers as a source of comfort because they are confused by her regular absences. The findings were made in the world's first study of how infants' attachment to their parents is affected by overnight stays.(The Daily Telegraph 04/04/03; p.13)© HMG Worldwide 2003http://www.health-news.co.uk/

[Guest guest]

I am sorry but I will be out of the office from Friday 11 April 2003 until

Wednesday 23 April

2003.

[Guest guest]

I am sorry but I will be out of the office from Friday 11 April 2003 until

Wednesday 23 April

2003.

[Guest guest]

I have been following this correspondence with a great degree of sadness as it

provides yet

another example to me of how much can be lost over time if as professional

practitioners we do

not have the vision and assertiveness to fight and make the case for what we

understand to be

good practice. I write as someone with regrets that I have not been as vocal as

I now

understand I needed to have been.

Recent attention to " modernising " the role of the health visitor similarly

grieves me. In 1970

I began to work as a young and inexperienced health visitor. I was employed by

the local

authority, and my nearest and only manager (the Superintendent Health Visitor!)

was 40 miles

away from my clinic base. From the point of view of protecting the public I had

a level of

freedom from supervision and monitoring which would rightly be unacceptable

today. However,

that freedom also allowed me the flexibility and autonomy to attempt practice as

I had been

taught.

What follows is an attempt to describe some of the values, priorities, and

practice of a young

and not very remarkable HV some 30+ years ago.

33 years ago my colleague and I developed antenatal classes in collaboration

with the local

community midwife, a client who was a qualified physiotherapist, a Marriage

Guidance (as it

then was) counsellor who wanted to do positive preventive work, and a GP with a

particular

commitment to obstetrics. Our classes were informal, used a variety of teaching

strategies,

and were increasingly client led. We involved fathers and indeed any

" significant others "

including grandmothers on occasion. The gains postnatally were evident in how

many of those

who came to the classes approached the trials and tribulations of becoming

parents, in the

informal support groups which developed out of the classes, in the collaboration

between

different professionals, and not least in the continuity of care which clients

felt they

experienced. We hadn't heard of partnership, interprofessional collaboration,

client-centred

practice, healthy alliances, flexible ways of working, - but we understood that

all those

things were an intrinsic part of what health visiting was all about.

We also held early evening drop-in group sessions in early pregnancy for working

mothers-to-be

who could stop off for a drink and an informal chat, and this strategy hugely

increased our

uptake of the main series of classes.

The attitude of our employer was essentially benevolently hands-off. Evening

work was

compensated by time in lieu, which we found almost more useful than extra cash.

So far as the birth visit was concerned, it was not often the first contact, as

we also

routinely paid at least one antenatal visit. We knew that those earliest

contacts were most

importantly about building the foundations of a meaningful and effective working

relationship

with each family, establishing our street cred. with clients, and that from the

start the

client's agenda was as important as our own. Antenatal contact and visits gave

me Having

qualified as a health visitor who then worked as a community midwife before

practising as a

health visitor, I didn't experience great dilemmas about overlap in visiting.

What was far

more important was firstly having a clear reason for visiting as a health

visitor which didn't

duplicate what the midwife was doing and secondly investing in good working

relationships with

the midwives so that neither professional group felt undermined by the other.

I had a large caseload in a new town - mainly families dislocated from their

family networks

and areas of origin, who came to this area for work. I and my colleagues lacked

adequate

preparation for identifying and dealing with child protection and domestic

violence. However,

from the outset we were committed to the notion of working for the long term

futures of our

clients and placed great importance on sufficient effort and input to build

valued

relationships with clients early on in our contact with them. Sometimes that was

achieved by

sustained home visiting and sometimes through informal group work with small

groups. Without

doubt this was not uncommonly to the detriment of routine contacts in the home

later on, but

at least many clients remembered us and contacted us in times of need because of

their early

experiences of us. Then as now there was the problem of whether a universal

service was

anything more than a cheerful fantasy - but a single contact at a birth visit

would have been

seen as meaningless.

I became aware of a local need amongst the " well " elderly (although I had never

heard of needs

assessment!) - living alone, isolated, on low income. I was told they were

" unclubbable " and

that efforts to set up a lunch club had foundered. I took advice from a local

WRVS worker,

recruited 12 " well " elderly as a team, and after 12 months was able to begin a

club on local

church premises which is still running today after more than 30 years and long

after I left

the area. I learned how to find pump priming funding, how to build the team's

confidence in

their ability, and the challenges of recruiting a leader/organiser. We hired a

bus from a

local voluntary group to bring people who were wheelchair bound, and I found a

retired lorry

driver to be the regular driver/club handyman. would not only transport

members, but do

fixing jobs in members' homes - on one occasion an elderly woman was in tears

because her bed

had collapsed, and by teatime had put it right. I made sure club

boundaries were

blurred. If someone crippled with osteoarthritis could peel a few potatoes, she

could see

herself as a provider rather than a consumer. The woman who took the money at

the door also

knew who was ill or needed help - and later, when she was terminally ill with

cancer club

members came to her aid and support. I deliberately recruited couples as well as

the single

and isolated, and the former often brought life and stimulus into the group.

Then when a

partner died the club was there for the one who was left. I hadn't heard of a

" special " public

health approach to practice or of community development. Public health and

community

development were simply and intrinsically what health visiting was about and

this was how they

were translated into everyday working.

When an insanitary local rubbish tip near to the homes of young families needed

closing I

joined with local teachers, householders and other agencies to fight

successfully for the

closure. When the company constructing the large new town development left

nowhere for

children to play safely I joined other agencies in lobbying, again successfully,

for some

redrafting of the plans.

The point I am trying to make is that I was not unusual, and that those with

whom I worked all

understood that these activities were as much a part of what health visiting was

about as the

other activities which Senate contributors have recently been describing as

" traditional " . It

wasn't " better in the good old days " - although the context was different there

was as much

scope for very poor practice as there is today, and there were many of the same

problems as

today which are still unresolved. Health visitors were a diverse bunch of

individuals, but

there was one thing which was very different then from now.Health visitors had a

strong sense

of what it was to be a health visitor which united them solidly. They might not

have been any

better then than now at articulating exactly what a health visitor is, but when

in 1972 the

Briggs Report proposed the title of " family health sister " and began the process

by which

health visiting was ultimately drawn under the statutory control of nursing,

health visitors

UK wide were vociferous and pretty united in opposition. My sadness today

includes the

awareness that as a group health visitors are more fragmented and uncertain as

to how they

regard themselves, and more willing to accept without question the right of

civil servants,

MPs, and non-health visiting managers to tell them what they are.

Health visiting began as a public health activity, has its roots in the need to

reconcile

social, political, environmental, and individual factors which affect the

quality of people's

lives and health, and hasn't essentially changed in this respect. It begins with

the

individual and the messiness of individual differences and diversity. Therefore

without home

visiting it cannot be effective. But it sees the individual's needs as only

being fully

understood in the context of the family, the local population, the community and

the wider

society. If what we are doing has departed too far from this, it might be

worthwhile, but it

isn't health visiting.

Betty

[Guest guest]

Dear

Is there a website link to this work..I would like to include it in PriMHE's imminent resource pack..which I am now thinking of calling the "Cradle to Grave NSF for mental health in primary care".

Would also like to contact them re possible article in the new PriMHE CAMH in primary care Journal

Best Wishes

Chris.

-----Original Message-----From: Ann GIRLING [mailto:annieg@...]Sent: 09 April 2003 19:10 Subject: Re: I thought people might be interested in this.

Thank you for that, . I hope i may keep in touch should i make any progress with my ideas but will hopefully get the article you referenced

Ann

I thought people might be interested in this.

Parents warned about “unhelpful teaching”

Parents who teach their pre-school children to read, write and add could be setting them up for mental health problems later in life, the Royal College of Paediatrics and Child Health says. A report issued today (04/04/03) encourages patients to interact with their infants through informal play, but warns against adopting a formal teaching approach. The study investigates why so many children have emotional and behavioural problems at a time when they are healthier and better educated than ever. It blames “unhelpful parenting practices” and a lack of understanding among parents of child development.(The Times 04/04/03; p.19)© HMG Worldwide 2003http://www.health-news.co.uk/

Babies of divorced parents suffer

”Babies forced to spend nights in the separate homes of divorced or separated parents often suffer emotional and physical anguish, according to new research. Such infants have more tantrums, develop eating and sleeping disorders, and exhibit distress through symptoms such as raised heartbeats. They also fail to identify their mothers as a source of comfort because they are confused by her regular absences. The findings were made in the world’s first study of how infants’ attachment to their parents is affected by overnight stays.(The Daily Telegraph 04/04/03; p.13)© HMG Worldwide 2003http://www.health-news.co.uk/

[Guest guest]

I am sorry but I will be out of the office from Friday 11 April 2003 until

Wednesday 23 April

2003.

[Guest guest]

I am sorry but I will be out of the office from Friday 11 April 2003 until

Wednesday 23 April

2003.

[Guest guest]

I have "Social Baby" and think it's a wonderful book and use it with mums a lot. Thanks

Ann

I thought people might be interested in this.

Parents warned about "unhelpful teaching"

Parents who teach their pre-school children to read, write and add could be setting them up for mental health problems later in life, the Royal College of Paediatrics and Child Health says. A report issued today (04/04/03) encourages patients to interact with their infants through informal play, but warns against adopting a formal teaching approach. The study investigates why so many children have emotional and behavioural problems at a time when they are healthier and better educated than ever. It blames "unhelpful parenting practices" and a lack of understanding among parents of child development.(The Times 04/04/03; p.19)© HMG Worldwide 2003http://www.health-news.co.uk/

Babies of divorced parents suffer

"Babies forced to spend nights in the separate homes of divorced or separated parents often suffer emotional and physical anguish, according to new research. Such infants have more tantrums, develop eating and sleeping disorders, and exhibit distress through symptoms such as raised heartbeats. They also fail to identify their mothers as a source of comfort because they are confused by her regular absences. The findings were made in the world's first study of how infants' attachment to their parents is affected by overnight stays.(The Daily Telegraph 04/04/03; p.13)© HMG Worldwide 2003http://www.health-news.co.uk/

[Guest guest]

I've just read all you have to say and it coincides with a conversation i have been having with a colleague today. We are just going to be creative with the resources we have, go for some WDC funding and work with various partners to begin to develop an embryonic infant mental health service. I have the moral support of a friend who is also a PCT chief exec (what it is to have friends in high places!!) She was fascinated to hear what I had to say about this area. This will include starting to gain support for a complete review of the new birth visit taking the parent infant relationship as the primary focus.

Ann

Re: I thought people might be interested in this.

I have been following this correspondence with a great degree of sadness as it provides yetanother example to me of how much can be lost over time if as professional practitioners we donot have the vision and assertiveness to fight and make the case for what we understand to begood practice. I write as someone with regrets that I have not been as vocal as I nowunderstand I needed to have been.Recent attention to "modernising" the role of the health visitor similarly grieves me. In 1970I began to work as a young and inexperienced health visitor. I was employed by the localauthority, and my nearest and only manager (the Superintendent Health Visitor!) was 40 milesaway from my clinic base. From the point of view of protecting the public I had a level offreedom from supervision and monitoring which would rightly be unacceptable today. However,that freedom also allowed me the flexibility and autonomy to attempt practice as I had beentaught.What follows is an attempt to describe some of the values, priorities, and practice of a youngand not very remarkable HV some 30+ years ago. 33 years ago my colleague and I developed antenatal classes in collaboration with the localcommunity midwife, a client who was a qualified physiotherapist, a Marriage Guidance (as itthen was) counsellor who wanted to do positive preventive work, and a GP with a particularcommitment to obstetrics. Our classes were informal, used a variety of teaching strategies,and were increasingly client led. We involved fathers and indeed any "significant others"including grandmothers on occasion. The gains postnatally were evident in how many of thosewho came to the classes approached the trials and tribulations of becoming parents, in theinformal support groups which developed out of the classes, in the collaboration betweendifferent professionals, and not least in the continuity of care which clients felt theyexperienced. We hadn't heard of partnership, interprofessional collaboration, client-centredpractice, healthy alliances, flexible ways of working, - but we understood that all thosethings were an intrinsic part of what health visiting was all about.We also held early evening drop-in group sessions in early pregnancy for working mothers-to-bewho could stop off for a drink and an informal chat, and this strategy hugely increased ouruptake of the main series of classes.The attitude of our employer was essentially benevolently hands-off. Evening work wascompensated by time in lieu, which we found almost more useful than extra cash.So far as the birth visit was concerned, it was not often the first contact, as we alsoroutinely paid at least one antenatal visit. We knew that those earliest contacts were mostimportantly about building the foundations of a meaningful and effective working relationshipwith each family, establishing our street cred. with clients, and that from the start theclient's agenda was as important as our own. Antenatal contact and visits gave me Havingqualified as a health visitor who then worked as a community midwife before practising as ahealth visitor, I didn't experience great dilemmas about overlap in visiting. What was farmore important was firstly having a clear reason for visiting as a health visitor which didn'tduplicate what the midwife was doing and secondly investing in good working relationships withthe midwives so that neither professional group felt undermined by the other.I had a large caseload in a new town - mainly families dislocated from their family networksand areas of origin, who came to this area for work. I and my colleagues lacked adequatepreparation for identifying and dealing with child protection and domestic violence. However,from the outset we were committed to the notion of working for the long term futures of ourclients and placed great importance on sufficient effort and input to build valuedrelationships with clients early on in our contact with them. Sometimes that was achieved bysustained home visiting and sometimes through informal group work with small groups. Withoutdoubt this was not uncommonly to the detriment of routine contacts in the home later on, butat least many clients remembered us and contacted us in times of need because of their earlyexperiences of us. Then as now there was the problem of whether a universal service wasanything more than a cheerful fantasy - but a single contact at a birth visit would have beenseen as meaningless.I became aware of a local need amongst the "well" elderly (although I had never heard of needsassessment!) - living alone, isolated, on low income. I was told they were "unclubbable" andthat efforts to set up a lunch club had foundered. I took advice from a local WRVS worker,recruited 12 "well" elderly as a team, and after 12 months was able to begin a club on localchurch premises which is still running today after more than 30 years and long after I leftthe area. I learned how to find pump priming funding, how to build the team's confidence intheir ability, and the challenges of recruiting a leader/organiser. We hired a bus from alocal voluntary group to bring people who were wheelchair bound, and I found a retired lorrydriver to be the regular driver/club handyman. would not only transport members, but dofixing jobs in members' homes - on one occasion an elderly woman was in tears because her bedhad collapsed, and by teatime had put it right. I made sure club boundaries wereblurred. If someone crippled with osteoarthritis could peel a few potatoes, she could seeherself as a provider rather than a consumer. The woman who took the money at the door alsoknew who was ill or needed help - and later, when she was terminally ill with cancer clubmembers came to her aid and support. I deliberately recruited couples as well as the singleand isolated, and the former often brought life and stimulus into the group. Then when apartner died the club was there for the one who was left. I hadn't heard of a "special" publichealth approach to practice or of community development. Public health and communitydevelopment were simply and intrinsically what health visiting was about and this was how theywere translated into everyday working.When an insanitary local rubbish tip near to the homes of young families needed closing Ijoined with local teachers, householders and other agencies to fight successfully for theclosure. When the company constructing the large new town development left nowhere forchildren to play safely I joined other agencies in lobbying, again successfully, for someredrafting of the plans.The point I am trying to make is that I was not unusual, and that those with whom I worked allunderstood that these activities were as much a part of what health visiting was about as theother activities which Senate contributors have recently been describing as "traditional". Itwasn't "better in the good old days" - although the context was different there was as muchscope for very poor practice as there is today, and there were many of the same problems astoday which are still unresolved. Health visitors were a diverse bunch of individuals, butthere was one thing which was very different then from now.Health visitors had a strong senseof what it was to be a health visitor which united them solidly. They might not have been anybetter then than now at articulating exactly what a health visitor is, but when in 1972 theBriggs Report proposed the title of "family health sister" and began the process by whichhealth visiting was ultimately drawn under the statutory control of nursing, health visitorsUK wide were vociferous and pretty united in opposition. My sadness today includes theawareness that as a group health visitors are more fragmented and uncertain as to how theyregard themselves, and more willing to accept without question the right of civil servants,MPs, and non-health visiting managers to tell them what they are. Health visiting began as a public health activity, has its roots in the need to reconcilesocial, political, environmental, and individual factors which affect the quality of people'slives and health, and hasn't essentially changed in this respect. It begins with theindividual and the messiness of individual differences and diversity. Therefore without homevisiting it cannot be effective. But it sees the individual's needs as only being fullyunderstood in the context of the family, the local population, the community and the widersociety. If what we are doing has departed too far from this, it might be worthwhile, but itisn't health visiting.Betty

[Guest guest]

I am sorry but I will be out of the office from Friday 11 April 2003 until

Wednesday 23 April

2003.

[Guest guest]

I am sorry but I will be out of the office from Friday 11 April 2003 until

Wednesday 23 April

2003.

[Guest guest]

OK - will let you know when i have other dates

Ann

I thought people might be interested in this.

Parents warned about “unhelpful teaching”

Parents who teach their pre-school children to read, write and add could be setting them up for mental health problems later in life, the Royal College of Paediatrics and Child Health says. A report issued today (04/04/03) encourages patients to interact with their infants through informal play, but warns against adopting a formal teaching approach. The study investigates why so many children have emotional and behavioural problems at a time when they are healthier and better educated than ever. It blames “unhelpful parenting practices” and a lack of understanding among parents of child development.(The Times 04/04/03; p.19)© HMG Worldwide 2003http://www.health-news.co.uk/

Babies of divorced parents suffer

”Babies forced to spend nights in the separate homes of divorced or separated parents often suffer emotional and physical anguish, according to new research. Such infants have more tantrums, develop eating and sleeping disorders, and exhibit distress through symptoms such as raised heartbeats. They also fail to identify their mothers as a source of comfort because they are confused by her regular absences. The findings were made in the world’s first study of how infants’ attachment to their parents is affected by overnight stays.(The Daily Telegraph 04/04/03; p.13)© HMG Worldwide 2003http://www.health-news.co.uk/

[Guest guest]

I am sorry but I will be out of the office from Friday 11 April 2003 until

Wednesday 23 April

2003.

[Guest guest]

Dear Ann

This is really interesting..how upstream can you go? Embryonic embryo mental health service?!

Chris.

-----Original Message-----From: Ann GIRLING [mailto:annieg@...]Sent: 10 April 2003 18:56 Subject: Re: I thought people might be interested in this.

I've just read all you have to say and it coincides with a conversation i have been having with a colleague today. We are just going to be creative with the resources we have, go for some WDC funding and work with various partners to begin to develop an embryonic infant mental health service. I have the moral support of a friend who is also a PCT chief exec (what it is to have friends in high places!!) She was fascinated to hear what I had to say about this area. This will include starting to gain support for a complete review of the new birth visit taking the parent infant relationship as the primary focus.

Ann

Re: I thought people might be interested in this.

I have been following this correspondence with a great degree of sadness as it provides yetanother example to me of how much can be lost over time if as professional practitioners we donot have the vision and assertiveness to fight and make the case for what we understand to begood practice. I write as someone with regrets that I have not been as vocal as I nowunderstand I needed to have been.Recent attention to "modernising" the role of the health visitor similarly grieves me. In 1970I began to work as a young and inexperienced health visitor. I was employed by the localauthority, and my nearest and only manager (the Superintendent Health Visitor!) was 40 milesaway from my clinic base. From the point of view of protecting the public I had a level offreedom from supervision and monitoring which would rightly be unacceptable today. However,that freedom also allowed me the flexibility and autonomy to attempt practice as I had beentaught.What follows is an attempt to describe some of the values, priorities, and practice of a youngand not very remarkable HV some 30+ years ago. 33 years ago my colleague and I developed antenatal classes in collaboration with the localcommunity midwife, a client who was a qualified physiotherapist, a Marriage Guidance (as itthen was) counsellor who wanted to do positive preventive work, and a GP with a particularcommitment to obstetrics. Our classes were informal, used a variety of teaching strategies,and were increasingly client led. We involved fathers and indeed any "significant others"including grandmothers on occasion. The gains postnatally were evident in how many of thosewho came to the classes approached the trials and tribulations of becoming parents, in theinformal support groups which developed out of the classes, in the collaboration betweendifferent professionals, and not least in the continuity of care which clients felt theyexperienced. We hadn't heard of partnership, interprofessional collaboration, client-centredpractice, healthy alliances, flexible ways of working, - but we understood that all thosethings were an intrinsic part of what health visiting was all about.We also held early evening drop-in group sessions in early pregnancy for working mothers-to-bewho could stop off for a drink and an informal chat, and this strategy hugely increased ouruptake of the main series of classes.The attitude of our employer was essentially benevolently hands-off. Evening work wascompensated by time in lieu, which we found almost more useful than extra cash.So far as the birth visit was concerned, it was not often the first contact, as we alsoroutinely paid at least one antenatal visit. We knew that those earliest contacts were mostimportantly about building the foundations of a meaningful and effective working relationshipwith each family, establishing our street cred. with clients, and that from the start theclient's agenda was as important as our own. Antenatal contact and visits gave me Havingqualified as a health visitor who then worked as a community midwife before practising as ahealth visitor, I didn't experience great dilemmas about overlap in visiting. What was farmore important was firstly having a clear reason for visiting as a health visitor which didn'tduplicate what the midwife was doing and secondly investing in good working relationships withthe midwives so that neither professional group felt undermined by the other.I had a large caseload in a new town - mainly families dislocated from their family networksand areas of origin, who came to this area for work. I and my colleagues lacked adequatepreparation for identifying and dealing with child protection and domestic violence. However,from the outset we were committed to the notion of working for the long term futures of ourclients and placed great importance on sufficient effort and input to build valuedrelationships with clients early on in our contact with them. Sometimes that was achieved bysustained home visiting and sometimes through informal group work with small groups. Withoutdoubt this was not uncommonly to the detriment of routine contacts in the home later on, butat least many clients remembered us and contacted us in times of need because of their earlyexperiences of us. Then as now there was the problem of whether a universal service wasanything more than a cheerful fantasy - but a single contact at a birth visit would have beenseen as meaningless.I became aware of a local need amongst the "well" elderly (although I had never heard of needsassessment!) - living alone, isolated, on low income. I was told they were "unclubbable" andthat efforts to set up a lunch club had foundered. I took advice from a local WRVS worker,recruited 12 "well" elderly as a team, and after 12 months was able to begin a club on localchurch premises which is still running today after more than 30 years and long after I leftthe area. I learned how to find pump priming funding, how to build the team's confidence intheir ability, and the challenges of recruiting a leader/organiser. We hired a bus from alocal voluntary group to bring people who were wheelchair bound, and I found a retired lorrydriver to be the regular driver/club handyman. would not only transport members, but dofixing jobs in members' homes - on one occasion an elderly woman was in tears because her bedhad collapsed, and by teatime had put it right. I made sure club boundaries wereblurred. If someone crippled with osteoarthritis could peel a few potatoes, she could seeherself as a provider rather than a consumer. The woman who took the money at the door alsoknew who was ill or needed help - and later, when she was terminally ill with cancer clubmembers came to her aid and support. I deliberately recruited couples as well as the singleand isolated, and the former often brought life and stimulus into the group. Then when apartner died the club was there for the one who was left. I hadn't heard of a "special" publichealth approach to practice or of community development. Public health and communitydevelopment were simply and intrinsically what health visiting was about and this was how theywere translated into everyday working.When an insanitary local rubbish tip near to the homes of young families needed closing Ijoined with local teachers, householders and other agencies to fight successfully for theclosure. When the company constructing the large new town development left nowhere forchildren to play safely I joined other agencies in lobbying, again successfully, for someredrafting of the plans.The point I am trying to make is that I was not unusual, and that those with whom I worked allunderstood that these activities were as much a part of what health visiting was about as theother activities which Senate contributors have recently been describing as "traditional". Itwasn't "better in the good old days" - although the context was different there was as muchscope for very poor practice as there is today, and there were many of the same problems astoday which are still unresolved. Health visitors were a diverse bunch of individuals, butthere was one thing which was very different then from now.Health visitors had a strong senseof what it was to be a health visitor which united them solidly. They might not have been anybetter then than now at articulating exactly what a health visitor is, but when in 1972 theBriggs Report proposed the title of "family health sister" and began the process by whichhealth visiting was ultimately drawn under the statutory control of nursing, health visitorsUK wide were vociferous and pretty united in opposition. My sadness today includes theawareness that as a group health visitors are more fragmented and uncertain as to how theyregard themselves, and more willing to accept without question the right of civil servants,MPs, and non-health visiting managers to tell them what they are. Health visiting began as a public health activity, has its roots in the need to reconcilesocial, political, environmental, and individual factors which affect the quality of people'slives and health, and hasn't essentially changed in this respect. It begins with theindividual and the messiness of individual differences and diversity. Therefore without homevisiting it cannot be effective. But it sees the individual's needs as only being fullyunderstood in the context of the family, the local population, the community and the widersociety. If what we are doing has departed too far from this, it might be worthwhile, but itisn't health visiting.Betty

[Guest guest]

I am sorry but I will be out of the office from Friday 11 April 2003 until

Wednesday 23 April

2003.

[Guest guest]

The Children's Project who were responsible for producing the 'Social Baby' by Liz s and Lynn Murray, have now produced 'the social Toddler' by Clive and Helen Dorman. www.childrensproject.co.uk These are excellent resources for health visitors to share with families. The children's Project also produce a set of 10 colour laminated A4 prints which are enlarged video stills and are great for use in post natal groups. They show Ethan's first half hour of life from the moment of delivery putting his thumb in his mouth, engaging his mother, copying his father's tongue protrusion and turning to the sound of his mother's voice. They are just brilliant!

Best wishes,

I thought people might be interested in this.

Parents warned about "unhelpful teaching"

Parents who teach their pre-school children to read, write and add could be setting them up for mental health problems later in life, the Royal College of Paediatrics and Child Health says. A report issued today (04/04/03) encourages patients to interact with their infants through informal play, but warns against adopting a formal teaching approach. The study investigates why so many children have emotional and behavioural problems at a time when they are healthier and better educated than ever. It blames "unhelpful parenting practices" and a lack of understanding among parents of child development.(The Times 04/04/03; p.19)© HMG Worldwide 2003http://www.health-news.co.uk/

Babies of divorced parents suffer

"Babies forced to spend nights in the separate homes of divorced or separated parents often suffer emotional and physical anguish, according to new research. Such infants have more tantrums, develop eating and sleeping disorders, and exhibit distress through symptoms such as raised heartbeats. They also fail to identify their mothers as a source of comfort because they are confused by her regular absences. The findings were made in the world's first study of how infants' attachment to their parents is affected by overnight stays.(The Daily Telegraph 04/04/03; p.13)© HMG Worldwide 2003http://www.health-news.co.uk/

[Guest guest]

I am sorry but I will be out of the office from Friday 11 April 2003 until

Wednesday 23 April

2003.

[Guest guest]

I am sorry but I will be out of the office from Friday 11 April 2003 until

Wednesday 23 April

2003.

[Guest guest]

I am sorry but I will be out of the office from Friday 11 April 2003 until

Wednesday 23 April

2003.

[Guest guest]

I am sorry but I will be out of the office from Friday 11 April 2003 until

Wednesday 23 April

2003.

[Guest guest]

The primary visit seems much more focused on the individual Family needs and our initial feelings are that the midwives are more satisfied as are the clients. The packages of care are more complete and the families seem to identify our visit with 'moving on'to the next stage. It feels like a definite move away from the more medicalised model that could be perceived to be that of the midwives. It is early days and yes it will need evaluation. We make it quite clear when we see families ante nataly that this will be happening and they are given our contact numbers at that point. I thought people might be interested in this.

Parents warned about “unhelpful teaching”

Parents who teach their pre-school children to read, write and add could be setting them up for mental health problems later in life, the Royal College of Paediatrics and Child Health says. A report issued today (04/04/03) encourages patients to interact with their infants through informal play, but warns against adopting a formal teaching approach. The study investigates why so many children have emotional and behavioural problems at a time when they are healthier and better educated than ever. It blames “unhelpful parenting practices” and a lack of understanding among parents of child development.(The Times 04/04/03; p.19)© HMG Worldwide 2003http://www.health-news.co.uk/

Babies of divorced parents suffer

”Babies forced to spend nights in the separate homes of divorced or separated parents often suffer emotional and physical anguish, according to new research. Such infants have more tantrums, develop eating and sleeping disorders, and exhibit distress through symptoms such as raised heartbeats. They also fail to identify their mothers as a source of comfort because they are confused by her regular absences. The findings were made in the world’s first study of how infants’ attachment to their parents is affected by overnight stays.(The Daily Telegraph 04/04/03; p.13)© HMG Worldwide 2003http://www.health-news.co.uk/

[Guest guest]

I am sorry but I will be out of the office from Friday 11 April 2003 until

Wednesday 23 April

2003.