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33
Personal Health Services
have held positions of responsibility in the hospital service before undertaking the health visitor's
training.
The Present Training for Health Visiting
As from 1962, the Council for the Training of Health Visitors was established under the Health
Visiting and Social Work Training Act of 1962 to promote training and approve suitable courses.
Pre-requisite Qualifications
Anyone wishing to be trained as a health visitor must be a general state registered nurse with
midwifery experience, which may be full qualification as a midwife, or Part I Certificate of the Central
Midwives Board, or a three months' approved obstetric course. Candidates should also hold the
General Certificate of Education (England and Wales) at Ordinary Level in a minimum of five subjects
including English, Welsh or History. Scotland and Northern Ireland require similar qualifications.
Training is a mixture of theoretical and practical work which lasts a calendar year and which can
be undertaken at any of the 36 training centres in the United Kingdom. Six of these centres organise an
integrated course of n
urse education for students who have at least two additional "A" Level qualifications.
Students undertaking these integrated courses obtain several nursing qualifications, one of
which is the Health Visitor's Certificate. On the completion of such a course a candidate obtains a
qualification at a much younger age than the present-day senior staff formerly did.
One third of the training period is spent in practical work under the guidance of field work instructors,
who are health visitors specially trained and qualified to undertake this work. The Health
and Welfare Department has four such field work instructors. They are specially trained to impart to
the student the practical skills of health visiting and have sympathetic understanding of young students,
particularly those undertaking the integrated courses.
The department's staff have taken part in two of the six national integrated courses; one linked with
Hammersmith Hospital and the University of Surrey (previously Battersea College of Technology)
and the other with Hillingdon Hospital linked with Chiswick Polytechnic.
Comments on the Present Health Visiting Service
The health visitors, who are also the school nurses for this department, have had difficulty in
covering the full range of work because of the difficulties of recruitment following retirement of numbers
of colleagues. The only replacements have been sponsored students who are under contract to the
borough. The number of students being trained is increasing annually, but the national shortage is
such that it is only local authorities who are able to offer favourable conditions of service who maintain
their full establishment.
As suggested by the Ministry of Health, health visitors have been relieved of all duties which do not
require their full qualification. Clinic nurses, who are general state registered nurses, with part or full
midwifery qualifications, undertake all the clinic activities such as immunisation sessions, school
health sessions, attendance at midwives ante-natal sessions and the routine medical inspections carried
out in all senior schools.
Health assistants, who have only some nursing experience, supervise the cleanliness inspections in
all schools and carry out numerous duties in clinics to ensure smooth running of the services.
The health visitor may well be in touch with children from birth to the time they leave school,
whereas officers of other sections of the department, e.g. midwives, home nurses, mental welfare officers,
and social workers from other departments, such as Children's and the Probation Service, only come
in contact with the family when it is already in trouble of some kind or needs a specific service. The
health visitor's main task is to make contact with untroubled families and when appropriate to anticipate,
prevent and ameliorate any potential problems.