Health Visitors (Hansard, 22 May 1991)

§ The Parliamentary Under-Secretary of State, Department of Health (Baroness Hooper)
My Lords, the Government are involved in a number of measures to help with the recruitment and retention of health visitors, but it is for individual service units to decide on how many health visitors and supporting staff they need in order to fulfil their contracts with district health authorities and other purchasers. The role of district health authorities is to ensure that those contracts adequately reflect the community health needs of their resident populations.

§ Lord Molloy
My Lords, I am grateful to the noble Baroness for that Answer. Is she aware that the real complaint of health visitors is against the regional health authorities which they feel are not carrying out their duties? The regional health authorities have had the money from the Government so to do but are not spending it on health visitors. The general medical profession regards health visitors as the first line of defence. They play a vital role. The Health Visitors' Association acknowledges the abilities of its members but believes that their talents are not being fully utilised.

§ Baroness Hooper
My Lords, we recognise the valuable service provided by health visitors. They have an important role in giving general family support. It is vital in terms of the progress into community care and to the plans to integrate primary and secondary care. However, we believe that the reforms will help greatly in this area by providing delivery mechanisms and in the sense that the region is now responsible both for FHSAs and district health authorities which form two important elements in this provision.

§ Lord Ennals
My Lords, is the Minister aware that the new system seems to be totally falling apart? She says that there is great merit in it and that the opportunities for district health authorities are there. I am told by the Health Visitors' Association that the new system—working under Working Paper No. 10 239 —does not seem to have produced as much as a half of the expected number of people in training. The secondments are not coming through. Is it the case that they are being held up by the regions? What is the problem? Is she further aware that, if there is no increase in the number of health visitors, there will be a crisis? There has been no increase in the complement of health visitors over the past few years.

§ Baroness Hooper
My Lords, in terms of training, which is the point that the noble Lord is getting at, during the year ending 31st March 1990, 847 students entered health visitor training in England. This represented a 2.9 per cent. increase on the previous year. In terms of safeguarding the future training of health visitors, we have asked that post-registration professional training for nurses, including health visitor training, should for the time being at least be funded from the separate and protected regional budget. We have also asked regional health authorities to identify current investment in this training to form the initial baseline for a budget in the next financial year. "That perhaps goes some way to meeting the concerns expressed by the noble Lord.

§ Lord Ennals
My Lords, I heard the assurance but I ask the Minister to look into the matter very carefully. The Health Visitors' Association says that the number of people now being transferred for training; is very low indeed, at about 50 per cent. of what is needed. Will the noble Baroness look into the matter personally?

§ Baroness Hooper
My Lords, I shall most certainly look into it and also refer it to my honourable friend the Minister for Health. We are concerned that there should be adequate provision of health service workers for the community care plans.

§ Lord Ennals
My Lords, I thank the noble Baroness.

§ Lord Molloy
My Lords, will the noble Baroness agree that health visitors have made a magnificent contribution in serving the community in a variety of ways? Many GPs say that hospital waiting lists would be much longer if it were not for health visitors. Health visitors want to contribute more to the community. They believe they have great talents and think that more of them can help the National Health Service, the country and those who need some form of help but do not necessarily need to go into hospital. The Health Visitors' Association believes that health visitors can make this contribution and it is proud of the talents of its members. Will the Minister be good enough to look into its complaints? It wants to do more to make the National Health Service even more efficient

§ Baroness Hooper
My Lords, I have already given an assurance that I shall look into the matter. I refer the noble Lord to the findings of the Roy Report, published last December, which was commissioned to look into this whole area. It very interestingly sets out 240 five different organisational models for the organisation of community nursing, including GP-based practice nurses. There has been a phenomenal increase in the number of GP-based practice nurses.