Cuts to social work, health visiting and school nurses

Candidates at the Godalming hustings on 28 May 2017 were asked how they would ensure that services in SW Surrey for safeguarding children against abuse could be improved. I said that cuts to social work, health visiting and school nurses had jeopardised safeguarding and had to be reversed. Jeremy Hunt challenged me by saying health visiting had not been cut.

That’s not true. Since 2015 when health visiting was transferred to local authorities, funding for and numbers of health visitors have reduced.

A health visitor who works locally told me there had been a reduction in health visitor numbers in SW Surrey. Health Visitors are not being replaced when they leave and some student health visitors are not staying on. Health visitors are demoralised due to being down graded, and having their pay cut, and some are leaving. School nursing levels have also been cut due to lack of funding.

Official figures show that nationally at least 988 full time health visiting posts (NHS Digital, 2016) have been lost between Sept 2015 and August 2016, with 56% of local authorities planning further cuts. (Evidence to Health Select Committee, 2016).

According to the Institute of Health Visiting’s 2016 survey, 85% of health visitors surveyed said their workload had increased over the past two years due to a reduction in the number of health visitors.

Health visiting numbers had increased between 2010 and 2015 but in October 2015 health visiting was transferred to local authorities to fund. At the same time the public health budget for local authorities was cut by about a third. So around the country local authorities responded by cutting health visiting and school nursing.

This is a false economy. Children’s community nurses play a vital role in promoting children’s health.

Children in the UK have higher child death rates, obesity and ill-health than in much of Europe. https://www.theguardian.com/society/2017/jan/25/poverty-in-the-uk-jeopardising-childrens-health-warns-landmark-report

The public health cut was one of the ways that the government could claim it was “spending more on the NHS”. It moved money out of public health and doctor and nurse training budgets into direct NHS services and used this to claim it was “spending more on the NHS”.

The government was rebuked by the UK Statistics Authority and the chair of the Health Select Committee, Conservative MP Dr Sarah Wollaston, for misleading the public on the actual amount it was spending on the NHS. https://www.theguardian.com/society/2016/oct/30/theresa-mays-claim-on-health-funding-not-true-say-mps

It is tragic that children’s community nurses should have been casualties of this “creative accounting” for political purposes. Hived off into cash strapped local authorities with a reduced budget and no ring fencing it was clear those services were going to be vulnerable to cuts.

According to the Kings Fund public health spending will fall by at least £600 million in real terms by 2020/21, on top of £200 million cut from the budget in 2015/16. https://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/Autumn_Statement_Kings_Fund_Nov_2016_3.pdf

Health Secretary Jeremy Hunt told the House of Lords committee on NHS sustainability that reducing the public health budget would not necessarily impede progress on public health.

He clearly lives in a parallel universe where services can function on thin air and good will alone. Back in the real world public health and preventive services are being drastically cut. Across the country, as well as health visitors and school nurses, important preventive services such as smoking cessation, weight management, sexual and reproductive health, breast feeding support, community mental health services, addiction services, elderly people’s falls prevention services, and services to reduce levels of infant mortality and low birth weight are all being cut.

British Medical Journal (paywall): Death rate rising in UK’s poorest infants: http://www.bmj.com/content/357/bmj.j2258

The Times (paywall) : Infant mortality rate rises for first time in a decade: https://www.thetimes.co.uk/article/infant-mortality-rate-rises-for-first-time-in-a-decade-sq69wl6xp

Public health should not be some Cinderella service, neglected and starved of funds to shore up front line care and save the government’s face. In the long term it will cost the NHS more if we don’t invest properly now in public health. If Jeremy Hunt really cared about our nation’s health, and especially children’s health, he should be championing public health, not cutting it.

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One Response to Cuts to social work, health visiting and school nurses

  1. Pingback: NHS staffing in crisis – and government response still totally inadequate. | NHA – South West Surrey Group

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