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Health Visiting
This has been an exciting year for the Health Visiting Service. Two great events have
occurred—first the birth of the new Borough of Waltham Forest which has certainly not been
uneventful. Like the birth of a baby it has brought with it many challenges which are being met.
The other great occurrence in 1965 was the introduction by the Council for the Training of Health
Visitors of the new syllabus of training. This is an important landmark in the history of our
service which is now over one hundred years old.
The new syllabus has a broad approach and is concerned with five main points of study:-
(1) The development of the individual—physical, mental and emotional
(2) The individual in the group—understanding of society and group structure.
(3) The development of social policy.
(4) The social aspect of health and disease.
(5) The principles and practice of health visiting.
One third of this training is concerned with practical work under the guidance of a specially
selected and trained health visitor designated as Fieldwork Instructor. This Borough has appointed
two fieldwork instructors whose duties include helping the students to understand the methods of
working with families in depth.
The amalgamation of the three Boroughs has brought with it many differences of approach
to the work, and the large area now covered requires a decentralised service. In order to minimise
travelling for public and staff, we therefore now base the health visitors at nine clinics throughout
the Borough. This has many advantages. The clinic becomes part of the community and the
people know where to contact the health visitor.
To meet the present needs of the community which we serve and to provide a uniform service,
but one that is flexible to allow for individual requirements, we carried out a detailed study of the
duties at present undertaken, and this included a "Time Spent Analysis" over a period of ten
working days of the various types of work done by health visitors, T.B. visitors, school and clinic
nurses. This study has provided the basis for reorganisation of the Health Visiting Service.
The health visitor's function is primarily that of teaching the principles of health. She is
concerned with family health, and much of her teaching is given individually when visiting
families in their homes.
The health visitor's powers of observation through constant practice are high, and she is
the only medico-social worker who knows a family before any specific problem has arisen. Health
visitors can therefore be of considerable help to other branches of the medical service by detecting
early deviations from the normal in individuals, whether they be members of the family at home or
children in school. They are able to watch the interaction between individuals within the family
group; the effect of ill-health and external pressure on its members and the outcome of internal
family stresses on the health of individuals. We therefore work in close co-operation with the
following:-
LIAISON WITH GENERAL PRACTITIONERS
Health visitors are now attached in a part-time capacity to several family doctors in the
area and work in close co-operation with the majority. We hope in the future to extend our duties
in this sphere as the general practitioner is the key figure, especially in hospital after-care work,
and this too is the province of the health visitor.
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