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Problematical Priorities


I spent a very rewarding day earlier this week with a group of Health Visitors in the Midlands. Like Social Workers, Health Visitors often seem to get a bad press. I think it’s generally  more appropriate to applaud the women – and men – who shoulder the huge responsibility of looking after families with very young children. What would we do in a situation such as this?

A young mother (24) with two children (5 and 2) gets up in the morning and has her first spliff. She then takes the older child to school. Her partner gets up a few hours later and goes to his local dealer (an old school mate) to buy the weekly supply of cannabis for which he pays £80 – money he cannot afford. The couple generally take the younger child out for a walk around lunch-time and collect the older one from school. As soon as the children are in bed, both parents settle down for an evening of cannabis and tv.

So how do you separate the sensitive parenting that this couple demonstrate on a daily basis from the rest? Do you intervene or don’t you? To what extent are these parents at risk? And their children? Are there perhaps worse problems in far more troubled families, so not worth pursuing this case?

It’s certainly not easy. I asked one of the very motivated, bright women at the group what she considered to be the most pressing problems confronting the families on her patch. Without hesitating, she came back with two answers, a) housing and b) lack of parenting role models in their own lives.

She felt strongly about Early Intervention and was enthusiastic about parent education, but she also thought that attracting parents with multiple challenges in their lives to sessions was very difficult. She rated the Family Nurse Partnership highly and was grateful for its presence in her area as this meant that many of the young mothers who had previously taken up nearly all her time were now receiving care and education from FNP nurses. This left her with more time to focus on the next group of needy parents – not those struggling at the very bottom of the socio-economic pile, but those barely off the bottom who received little attention because they weren’t sufficiently articulate to demand it, or they weren’t sufficiently desperate to receive targeted assistance.

So what use can we be to these mothers and fathers? If parent education is truly to have an impact, we need to have a universal parent education offer so that it becomes the norm for every new mother and father to be offered – and attend – a series of high quality sessions, and to use the opportunity to identify and signpost attendees who are more needy than others in the direction of further help.

While we haven’t got the universal offer, while it isn’t embedded in the transition to parenthood culture of the UK, it’s going to be very difficult to help the mothers and fathers who don’t have parenting role models to become model parents themselves.

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