North Yorkshire County Council, which is having to reduce its public health budget by £4m following government cuts, looks set to press ahead with proposals to radically change key services it provides to 130,000 children and young people.
Residents are to be consulted over North Yorkshire County Council’s proposals to cut the number of mandated home visits carried out by health visitors following the birth of children and end checks at school, such as hearing and vision tests, which have identified health issues for generations of pupils.
At a meeting next week, the authority’s executive will consider transforming its Healthy Child Programme, the latest in a series of public health cutbacks this year which have seen the council’s road safety team reduced from six staff to one and its acclaimed programme for overweight children being abandoned.
The council has run the Healthy Child Programme since public health services were moved from the NHS to local authorities in 2015, and earlier this year approved a ten-year partnership with Harrogate and District NHS Trust, but with a £750,000 drop in funding.
In a report to the executive, officers’ state the changes would enable “resources to be targeted at those most in need”.
It adds: “Both organisations recognise that there are potential risks with the proposed new model, but consider these risks can be sufficiently mitigated.”
Currently, families automatically get the government-recommended five child health and development reviews from before birth to the age of five, but under the proposals they will only get two health visits, when a child is about ten days old and two years old.
Government guidelines state home visits at 28 weeks’ pregnancy are “particularly important for first-time parents”, at six weeks old “crucial for assessing the baby’s growth and wellbeing alongside the health of the parent” and are needed at nine months to assess of the baby’s development.
However, the council is proposed that, amongst other things, with the learning from virtual visits during Covid-19, virtual meetings could be introduced for the remaining three reviews if the family is not deemed to face significant issues.
Stuart Carlton, the council’s children service director, said: “We now have really strong learning about how to provide a safe and effective personal service via digital platforms which can be taken forward for the Healthy Child Programme.”
Nevertheless, the report to the executive states: “Clearly a virtual meeting will not provide as much information about a family’s home as a physical meeting.”
In response, health visitors have said fewer contacts will leave children at risk, as cutting families’ time with health visitors would reduce the likelihood of issues, such as domestic violence, being disclosed.
David Munday, health visitor and lead professional officer at trade union Unite, said: “We’ve got a government that likes to shout out quite loudly about things that it’s implementing, but when you look at the balance of what’s being improved and what’s being made worse, the scales absolutely come down on the side of things being made worse.”
The proposals state the council and NHS trust will intensify their focus on children aged under 5, based on the evidence that supporting them has a greater impact throughout life, gives them the best start in life and supports lifelong positive outcomes.
The proposals, which are to be outlined in a ten-week public consultation exercise, include the introduction of more prevention and early intervention activities, such as infant feeding and family diet, to reduce childhood obesity.
Much of the proposed cuts will be in services provided in school settings, such as hearing and vision screening for children aged four to five years and sexual health services drop-ins in schools.
The authority says safeguarding support would continue to be provided and support for emotional wellbeing will be enhanced.
Mr Munday added: “We know that failing to provide support to young people causes so many more problems later on.”
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