TopicsProfessionalHow has health visiting changed?

How has health visiting changed?

Patricia Rock, retired health visitor and member before the CPHVA had even been renamed, reflects on her 1957 training and practice to highlight the progressions for HVs today.

When I started my health visitor course in 1957 we were told we were the ‘Professional Friend’. What people had to say to us was in confidence and must not be divulged to anyone. No records should be taken into the home, although we could take a small notebook to write down the child’s name.

I have now been retired for more than
30 years and recently published my
autobiography Following my leader
– a health visitor remembers. It
clearly shows how the introduction of the
NHS and changes during the rest of the
20th century affected health visiting. My
book starts in 1938. That year there was
an outbreak of diphtheria in our village
so we all had the diphtheria immunisation
at school.

I took my health visitors’ course in
1957 just as the association was
changing from ‘Women’s Public Health
Officers’ Association’ to ‘Health Visitors’
Association’ and was a member for many
years. Here (left), I reflect on my training
and health visiting at the time.

The time for writing was when were turned to the office, though little was then required. Just ‘Good progress’ or ‘NR’ if they were out. (By the time I retired in 1990 everything had to be recorded.) We learned that health education could teach people to feed their families well and prevent illness and accidents. There was as yet no social services but voluntary agencies such as the NSPCC, Barnardo’s and the Children’s Society were then very good at solving social problems.

We had a concentrated course on Tuberculosis. Although it could now be treated, the only prevention was fresh air and good food. Polio still killed and maimed. Measles, mumps, whooping cough, chickenpox and Rubella could be expected during childhood often leaving health problems in their wake.

A mature HV was responsible for our practical experience. Visiting was either by walking or cycling. Only those in rural areas used cars. New babies were first visited on the 10th day. Regular visits were then made as the HV thought necessary. The baby clinics were well attended where the HV briefly spoke to every mother, making an appointment for a home visit if there were problems. Smallpox vaccination was given to small babies, followed by diphtheria immunisation.

National dried milk and other welfare foods were available if the HV advised it. At this time, it was thought babies were only weighed for the satisfaction of the grandmother. For this reason, volunteers usually weighed the babies.

We were under contract to our local authority for three years during which time we were paid half salary. After the year of our training, we were allocated to an area of the authority’s choice to work for the final two years of our contract.

GPs did not realise the extent of our training so had little respect for us. For instance, soon after I started in my area, a mother told me she was worried because her son did not seem to stand properly. Onlooking at his feet I agreed with her but still thinking in medical language I said: ‘There could be some degree of spasticity there. Come when the doctor is here next week.’ Alarmed, she went to see him that evening. ‘Rubbish!’ the GP replied. It was two years later when a hospital diagnosed her son. Having previously worked with physically disabled children I had come into health visiting in order to get disabilities treated earlier. It was many years before we were able to refer directly to a paediatrician.

Visiting an elderly man I found that abuse was not always visible. His wife would not let him drink anything in case he wet himself. I had much to learn.


What are your thoughts on health visiting today compared to 1957? Do you have training or practice experiences, past or present that you would like to reflect on and share? Whatever the topic, simply email editor Aviva Attias

Image | Shutterstock


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