It is a pleasure to serve under your chairmanship, Mr Bone, and I am grateful to Tim Loughton for securing this important and timely debate.
Before I was elected to this place, I was a lay representative who chaired Unite the union’s national health sector committee. As a result, I had a great deal of involvement in the work done by our health visitors and community practitioners under the umbrella of the Community Practitioners and Health Visitors Association, which operates under the auspices of Unite the union.
I gave up that role in 2014 when I was elected to serve the constituents of Heywood and Middleton. However, I recall that at that time there was great deal of disquiet and unrest about health visitor services, which, as a result of the Health and Social Care Act 2012, were being transferred from NHS commissioning to be commissioned by local authorities. It seems, from what the hon. Gentleman has said and from readily available figures, that the worries that existed at that time have come to pass, as the number of children’s health visitors fell by 31% between 2015 and 2019.
The Local Government Association says that the number of health visitors who are retiring or taking other NHS jobs, combined with too few trainees entering the profession, has led to the workforce being stretched to its limits, at a time when the number of vulnerable children and families is rising.
With cuts to public health budgets, councils are struggling to afford the number of health visitors needed to cope with the workload. Figures from the Office for National Statistics show that the number of under-fives in the borough of Rochdale, in which my constituency is situated, is just over 15,000. With just 52 health visitors in the borough, that gives an average case load of 290 children per health visitor, when the recommended maximum—as recommended by both the CPHVA and the Institute of Health Visiting— is 250.
With health visitors being so overworked, they may, through no fault of their own, fail to spot child abuse, domestic violence and post-natal depression, and they may also have too little time to help mothers to bond with their babies. A survey conducted by the Institute for Health Visiting showed that health visitors themselves are voicing fears about child tragedy, as a result of increasing case loads and high levels of stress.
With year-on-year cuts to our public health grant, it is difficult to see where the funding will come from to provide and improve this vital service. In the borough of Rochdale, the public health grant is now £3 million lower than it was in 2016-17, having decreased from £19.7 million then to £16.7 million in 2018-19. For this financial year—2019-20—the budget has been cut yet again, to £16.3 million, giving cumulative cuts over the past four years in the Borough of Rochdale of more than £8 million. Nationally, councils’ public health budgets have reduced by £531 million between 2015-16 and 2019-20.
I welcome the fact that in the NHS long-term plan the Government pledge to look again at commissioning arrangements, not only for health visitors but for school nursing and sexual health—areas of health provision that are also suffering with increasing case loads and staff shortages. It is my hope that the responsibility for commissioning will revert to the NHS, and that it will be adequately funded and resourced. I will be very interested to hear the Minister’s comments on that.
Before I conclude, I will just mention some good news about the CPHVA. It has just appointed two high-profile vice-presidents: Professor Gina Higginbottom, who was the first black, Asian or minority ethnic nurse to hold a professorial role at a Russell Group university; and Sara Rowbotham, who is a friend and colleague of mine. Sara worked for Rochdale’s crisis intervention team from 2004 to 2014, and she helped to expose the Rochdale grooming gang scandal. She is also currently the deputy leader of Rochdale Council.
These appointments are welcome at a time when health visiting and school nursing are facing this crisis of falling numbers. Professor Higginbottom has declared her commitment to reducing health inequalities in the role, while Sara has pledged to fight for members’ voices to be heard. I hope that the Minister might find the time to meet these two inspiring women. I am sure that she will find such a meeting productive and helpful in preparing a much-needed clear plan to improve health visiting numbers and the quality of care provided for children and families.