Turbulent future for school nursing and health visiting

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7129.406 (Published 07 February 1998) Cite this as: BMJ 1998;316:406

Change the bathwater—but hang on to the baby

  1. Kate Billingham, Director of public health nursinga,
  2. David Hall, Professor of community paediatrics (d.hall@sheffield.ac.uk)b
  1. a Sheffield Health, Sheffield S10 3TG
  2. b Community Health Sheffield, Children's Hospital, Sheffield S10 2TH

    The government is attempting to reduce inequalities in health by public health measures rather than by a fundamental redistribution of wealth.1 Primary prevention and health promotion will be encouraged and health action zones will “provide more integrated care … better housing, healthy schools, and healthy workplaces.”2 In the light of this, the recent proposal by Cambridge and Huntingdon Health Authority to move resources from health visiting and school nursing into acute care may seem perverse. Of course, health authorities must consider cost effectiveness, but it seems shortsighted to sacrifice primary prevention and health promotion to pay for technology and acute services.

    What do health visitors and school nurses do, and how effective is it? The health visitor's first task is to identify health care needs. Together with general practitioners, they provide the child health surveillance programme of immunisations, screening, and advice. They aim to identify those important conditions that parents might overlook and, for the rest, to …

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