Friday, 4 March 2011

How much power should NHS health visitors have?

This is a personal experience that has sparked an investigation.

Our case centres around one family in Gillingham, I will keep their names secret for the moment but their daughter's name is Sophie. They moved into their address in 2008, it was inherited from the husband's paternal grandfather and was in a state of quite some neglect. There was no central heating, no insulation in the roof and a garden that hasn't been properly worked on since the late 90's. The couple themselves have not been particularly tidy nor motivated to unpack their boxes and stored them in the spare rooms, the husband works 45 hours a week in London and is effectively out of the building for 65 hours a week, the wife works locally at about 21 hours a week averagely. Although untidy the couple were never dirty nor unhygienic. The toilets and kitchen were cleaned regularly and the carpets regularly vacuumed.

On the birth of their daughter they agreed to sort out issues as quickly as possible. Their health visitor (To be referred to as HV from now on) said that they would contact Social services if the situation with the clutter did not improve.

Over the following six months the house was transformed, rooms were cleared, a nursery was created and had power point installed, insulation was installed in the roof and a new front door was placed to create a porch and cut out drafts. However the HV continued to call around almost monthly and each time would issue a list of things to be dealt with before her next visit. The wife found it difficult to relate to the HV or to discuss matters to do with baby Sophie's health or diet.

On a previous visit a suggestion was made that a family member would be coming to assist with the garden bringing with him a chainsaw and much needed industrial weed killer. This fell through and the garden was put as a low priority compared to sorting the house out or taking care of Sophie.

In early February the HV came on a visit and demanded to see the house and did a thorough inspection with only 4 cursory questions as to Sophie's health. At the end of it she gave the family 3 weeks to clear the garden or she would be contacting Social services.

The mother was distraught and contacted the HV office and requested a second opinion and asked for a new HV, someone she felt comfortable with and could talk to.

A week passed and the family heard nothing. The following Tuesday (15th February) they received a hand delivered note telling them that they had ignored all the advice of the HV and a Social worker and the HV would be around to see the house at 11.30 for a full inspection.
During this inspection the HV ignored requests to remove her shoes in the house, a house rule, and forced her way around. A follow up meeting was scheduled with the Social worker the following week to discuss the situation with out the HV.

Basically Social services have found no cause for complaint, the house is perfectly clean and hygienic, baby Sophie is friendly and well looked after and the parents loving and caring. The referral has been passed and all is in the clear. She also stated that the family were free to bring their daughter up the way they wanted and live the way they wanted.

The fundamental questions are though... What right does a HV have to tell someone how to live? Or to order a family around? I've read their referral and the words "Acceptable standard" are used quite liberally and ultimately what is this standard and who decides it? She also used words such as "Unhygienic" and "Squalid." I understand that Social services give families in particularly bad and squalid houses 24 hours to rectify situations or they will remove the child, the social worker on this case found no such evidence of either poor hygiene or squalor. From what I have seen this particular HV has treated the family quite poorly and dictated what "SHE" expects.

I have also read about another case where a young expecting mother said she had no need for a HV and was immediately threatened with Social services. There are also cases of HV's who have angered people in their homes with demands, reporting them for being aggressive to NHS staff!

It seems this particular organ of the state has abused its power in cases. They seem to believe they have the same power as the Police and demand access to homes and tell people how they live within them!

This case is on going and I will post updates as to the families struggle. They have complained to the trust and are requesting their right to a different HV or their other right, one they weren't told at first, to dispense with the service all together.


  1. The vast majority of people who make these complaints against professionals in this country are themselves in the wrong.

    What real involvement do you have in this case? What empirical evidence do you have of these claims? Or is this whole blog based on a person's "story" about how they've been wronged?

    Social services are trained professionals, they don't go around trying to cause "aggro" for people. Of course, there is always the chance of incompetence or human error but this is usually the exception to the rule.

    I'd be very careful about getting both sides of the arguments rather than listening to one-side from a potentially negligent person before making accusations.

  2. I agree with you that in many instances complaints are wrong and that it is either a smoke screen or people reacting poorly however there are some cases that are genuine and I believe this is one of them.

    The Social worker in this case was fantastic, I was present for their meeting and she was thorough, supportive and conducted her inspection and questionaire very well. She also gave the impression that had there been a real problem she would have dealt with it firmly and swiftly.
    You must bear in mind the speed with which the Social services acted, they recieved the referal on the monday, alerted the family tuesday morning and visited 2 hours later. There is no way that they would have been able to hide signs of neglect that quickly.
    In fact the SW's report showed that Sophie was a well looked after and happy child with loving parents who were making a home for her.

    Yes the house was in a state when Sophie was born but her parents had long acknowledged that action needed to be taken and did work rapidly to sort the situation. They are more than willing to cooperate with any one. The thrust of the blog was questioning the HV's power to come into the house and "Command" the family to act even though they had already brought the house up to an acceptable standard (according to Social Services.). Also that she used Social Services as a weapon when the family asked to have a different HV on the grounds that the mother could not talk to her about Sophie. Had they moved to dispense with the service all together then certainly but...

    I'm very close to the family concerned and have been with baby Sophie for much of her life, I even helped with the household renivation including laying the roof insulation. I can assure you that she is in no way neglected. her clothes, toys, eatting utensils, are always clean, her mother spends every hour she can with her and playing with her. Her nursary report says that she is happy and bright.

  3. Greetings--I attempted to make this inquiry in an e-mail but got an error message back from Hotmail, so I'm attempting it as a comment.

    irst, a bit of background: from 2001 through 2007 I visited the UK once a year nearly every year for business. During one of those visits I caught a news story on BBC radio about the NHS Health Visits program. Interviewees--parents of small children--were sharing their experiences with the program, some expressing marked aversion to how intrusive it could be, with Health Visitors inspecting the fridge for sanitation and "acceptable foods," etc.

    When I heard this it really was really an eye opener. On one hand this is the kind of government intrusiveness scenario of which we in the States tend to be so fearful. And on the other hand it's a scenario that, based on what I've seen of the human services and child protective services bureaucracy here in the States, could easily develop here as well.

    I run a somewhat quirky podcast called "Thoughts from a Useless Eater" (, and I was hoping you might consider joining me for an interview to talk about your general take on the NHS Health Visits program, its pros and cons, your experience with the couple whose story you relate on the blog, your sense of just how pervasive the intrusiveness becomes, how frequent the incidence is of children being removed from parental custody on grounds that most reasonable people would consider unreasonable, etc.

    I normally work in 60 minute segments. Would you be interested in joining me for an hour at some point to record an interview? We could probably connect via Skype, which I believe would also enable me to call a UK landline even if you don't use Skype.

    Thank you in advance for your consideration!

    Best regards,

    J.Q. Useless
    Editor & Host, Thoughts from a Useless Eater