Saturday, 25 July 2015

Surveillance and support: can there be both ?

From Brid Hehir, a writer, researcher and retired nurse who worked in the NHS for more than 30 years.

"During the consultation on the Children and Young People Bill, I can understand why community practitioner representatives responded as they did. They want the Scottish government to value health visitors, to appreciate their early intervention role with families and realise more are needed so that a universal service can be provided again. "

"Although these points were forcefully made, the representatives did not appear to understand how much this proposal undermines parents or how unpopular it is. Community practitioners who adopt this role will certainly not win any new friends. Instead, they will turn into family spies, where the state rather than the parents will become the mother and father to all children."

"Writing in The Scotsman, sociologist Tiffany Jenkins explained why this measure was considered necessary: ‘In the last few decades, the family and the early years of a child’s life have been identified, in political circles, as the breeding ground for social problems. The family is fingered as the place where everything goes wrong: poor educational attainment, obesity, joblessness, stress, addiction, criminality, if not intentionally so, then accidental…’ "

"So the measure is designed to ensure any potential cases of abuse or developmental difficulties are spotted and acted upon at an early stage. Scottish government guidance says: ‘Sometimes children can be in a position of risk or harm without their parents or others being aware until it is too late. The named person is the single point of contact for every child so that no one is left without support.’ The suggestion that a named person should hold a privileged insight into the life of a child that the child’s parents do not, undermines parents who are considered untrustworthy in recognising a problem or acting upon it when they do. "

Professor Phil Wilson, at a recent Parenting Across Scotland conference, said that the Scottish Government`s new health visiting core programme was a major step in the right direction in re-establishing good relationships between universal services and parents/children.

"GPs are more likely to identify issues through their relationships with extended family members or adult-oriented services such as addictions or A&E departments, while health visitors are more likely to make direct observations in the home or hear information about a child's behaviour in a nursery. It is, therefore, essential to foster close working relationships between GPs and health visitors - the only professions in routine contact with every pre-school child. As with trust in professional judgement, face-to-face close working relationships promote efficiency - intelligence can be exchanged quickly without formal referral. Furthermore, low-level concerns can be shared and acted upon without the fear of alienating families..."

He could not be more wrong.

Jean Robinson writing in AIMS Journal as far back as 2004 drew attention to the changing role of the health visitor which was becoming increasingly dominated by surveillance, not support. AIMs began to receive increasing numbers of complaints. As Jean Robinson has pointed out, the surveillance role and the support role do not sit comfortably within the same person. It is always seen as a betrayal by service users.

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