Health Visitors (England)

Part of the debate – in Westminster Hall at 5:05 pm on 23rd October 2019.

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Photo of Karen Lee Karen Lee Shadow Minister (Home Office) (Fire) 5:05 pm, 23rd October 2019

It is a pleasure to serve under your chairmanship, Mr Bone. I congratulate Tim Loughton on securing this vital debate. The role of the health visitor is important to our local communities. The health visiting service provides the vital support that young children and their families need to ensure that every child has the best start in life. Health visitors address cross-departmental priorities for children and give a voice to young children living with adversity, who can in some cases be invisible to other services. The health visiting service provides an important safety net for infants and young children who are at particularly high risk of having their needs missed, as they are not visible in the same way as children who are accessing an early years setting or are at school.

Early intervention is vital for children and their families and an effective health visitor service is a proven way to improve health outcomes and reduce inequalities. However, in January 2019, the Royal College of Paediatrics and Child Health raised serious concerns about widening child health inequalities, highlighting that:

“Universal early years services continue to bear the brunt of cuts to public health services”.

In Lincoln, 28% of children live in poverty. Health visitors are desperately needed to ensure that those children receive the support they deserve. In 2015, the commissioning of health visitors was transferred from the NHS to local government—a bad move in my view—and that has resulted in a negative impact on the working conditions of local health visitors and the capacity of the service delivered to my constituents, as the funding is not ring-fenced. I am deeply worried by the steps that Lincolnshire County Council has taken to divide the health visitor role, and I was proud to support the health visitor strike against the proposed changes.

The changes will divide the health visitor role into two different job descriptions, which will create a flawed career progression scheme that restricts health visitor career progression. All health visitors undertake the same training, and upon qualification they are all expected to carry out every facet of their role on a daily basis. It is my understanding that there is no rationale to explain why one health visitor would be demoted to a junior job description while another continued at the same level. It is a fact that fully qualified top band 6s are leaving or have left—many with years of experience—due to a reduction in their status and an enforced three-year pay freeze. We are losing an important skilled workforce that is invaluable to our community. As a qualified nurse, I have to say that nurses and healthcare professionals do not go on strike without a really good reason.

Analysis undertaken by Unite shows that those held back from progression due to the changes will lose a substantial sum annually in comparison with the NHS pay structure. I am concerned that the reforms are not being undertaken in the best interests of the health visitor service, but rather as a mechanism to deskill the service in order to reduce pay. Financial efficiency must come second to the wellbeing of our local communities. It risks the long-term social benefits created by investing in our children’s future at a crucial early stage. Will the Minister make representations to Lincolnshire County Council—please do not push it one side and say it is a local government issue—to prevent the downgrading of the health visitor role? It is important in my constituency of Lincoln, and I hope I am being heard. It is important that Lincolnshire County Council recognises health visitors’ professionalism and importance to our community and rewards them accordingly.