What's a health visitor?

If someone stopped you in the street and asked you the name of your health visitor, would you know?  Ok, so you may not see one right now, but in the UK we’ve all had one at some point - do you remember?

What if they asked what they do - would you have any idea?  To my shame, I’d have blankly shrugged at both questions.

But all this is about to change.  If you believe David Cameron (and why wouldn’t you?), by 2015 everyone will know not only who their health visitor is, but also what services they offer.

Part of my new job is to help recruit my region’s share of the 4,200 extra posts deemed necessary to ensure our Big Society is healthy – and that our pubs remain full of students and our glorious leader remains in office.

So yesterday I left my ivory tower and spent the day with a real, bone-fide health visitor.  It was quite an eye-opener.

The morning clinic was a ‘drop in’, and half a dozen mums came with their bundles of joy.  There was a remarkable range, from a proficient professor clutching recent research to a newly-single mum just trying to hold things together.

Babies were weighed and measured, and growth charted against expected progress in the child’s ‘red book’.  The endearingly old-school health visitor obligingly weighed in kilos, but I could see she was translating back to pounds and ounces!

The old and the new also contrasted in the ongoing use of paper notes, despite electronic records now being the norm.   It may be partly inertia, but in fairness the systems are not yet easy to use.  For example, they don’t link to GPs’ network (how can this be?), and can be painfully slow – if you’re lucky enough to get access to a computer.  Rather than realising the benefits of IT, so far computerization risks adding an extra task to already burdened professionals.

Whilst the influx of new, young health visitors may bring fresh thinking (and improved computer literacy), they will be hard-pushed to match the wise reassurance of the seasoned health visitor. 

Mums often came with seemingly minor issues such as feeding, sleeping and cradle-cap - but there were real anxieties, and were calmly and confidently addressed by someone with such a wealth of knowledge.

And after all, how do parents know how to bring up kids?  Is it innate, or must we learn it?  In the time of Call The Midwife, nearly everyone grew up around children, and had first-hand experience of raising siblings, cousins or neighbours. 

In contrast, families now are smaller and more distant, and parents are a lot older – all reducing our opportunities to learn parenting before we become one ourselves.

There are serious problems too, particularly post-natal depression.  I wondered why I never came across this when working in developing countries.  It’s hardly the kind of western luxury we’re thankful for: a staggering 10% of mums suffer from it in some form – isn’t it something we should talk about more?

One mum was clearly struggling to cope with her hyper-active son, and the health visitor arranged to see her for a longer session the next week.  Another boy was clearly autistic, and through gentle questioning the health visitor identified the issues and helped the mother plan how to cope.

After the clinic, a GP asked the health visitor to visit a family with an unemployed, alcoholic dad, who she feared might be a risk to his children.  It was sobering to learn that just below the surface of seemingly affluent areas can lurk drug / alcohol dependency, domestic violence and child abuse. 

Fifteen years ago I spent a fascinating day with a health visitor on the Craigmillar estate in Edinburgh, and was struck by how even people with troubled and chaotic lives clearly distinguished health visitors from social workers - and they certainly knew their names!

By law, health visitors must visit every family with a new child – so they are uniquely placed to improve health and prevent harm in the crucial first few years of life.

One of the most telling comments I heard from a mum showed the value of parents having access to experienced, dependable, sympathetic health visitors:  “I didn’t know who to go to” she whispered tearfully, “so I came to you”.

Whatever else can be said for the present government’s health policies, they’ve got this one right:  I’m delighted to be helping with this recruitment drive.  But I also hope to support those who are already in post to continue the often remarkable, frequently under-appreciated work of health visitors.

John Peel’s Shed

What’s the only London tube station containing no letters from the word mackerel?

If you don’t know, maybe you need to listen to the radio more?  (Specifically, to Steve Wright in his heyday).

But maybe you were more of a John Peel fan.  His weird, wonderful mix was in a different league from the usual commercial mush, or even Radio 1 of the time.

Even as a seasoned presenter he showed more passion and innovation than jumped up DJs half his age.  His Desert Island Discs were recently re-broadcast on Radio 4, where he revealed his original remit was “to look beyond the horizons of pop”.  He surely succeeded beyond all expectations.

But eventually even the great man himself started to drown under a sea of vinyl sent by bands hoping for airtime.  So he offered all the records from his shed to the listener who could best sum up his show. 

The lucky recipient was a student called John Osborne, with the winning phrase: "Records you want to hear, played by a man who wants you to hear them".

Once he’d got over the first problem – he didn’t own a record player – he spent a good part of the next six years working his way through the fascinating, eclectic mix of sounds liberated from Peel’s shed.

Favourites included a fantastic punk take on boybands called Oizone, and the incomparable Screeming Lord Such, famous not for his faultering pop career but rather as founder of the marvelous Monster Raving Loony Party (whose policies including making winter shorter by scrapping January and February, bringing peace to the middle east by rebranding the 'roadmap' as a satnav - and stopping the country going to the dogs by banning greyhound racing).

Osborne was desperate to share his new-found treasures, and approached ‘Future Radio’, his local community station.  They sound like something from Alan Partridge, but were clearly astute enough to give him airtime.  There followed a book and now a theatre show, taking the records as a starting-point, but also waxing lyrical about radio in all its varieties.  

Having just re-watched Radio Days, Woody Allen’s cinematic eulogy to the golden era of the wireless, it was interesting that it now falls to a form of stand-up to make the case.  But he makes it well, having spent each day listening to a different radio station whilst surviving his mind-numbing data-processing job at Anglia Windows.  His gentle, humourous journey takes us not only through music, but also the stories told inbetween tracks. 

These range from a rare, touching tale in between Virgin Radio’s mundanity, through to the strangeness of Resonance FM’s ‘Me and My Floor’ (the ambient noise from leaving a mic on a lounge floor for an hour – different floor each programme).

Despite the range of radio he experienced, his two best clips were probably from the ever-present Radio 1.

Terry Wogan told a corking story about an aunt who sent her niece a card at Christmas containing just the message ‘Get your own presents this year’.  Imagine how she felt when she realised months later that she had forgotten to include the book tokens!

And Steve Wright’s fishy brainteaser – the answer to which, of course, is St John’s Wood. 

My first record, bought with my brother Jonny, was by the Buggles, a band worthy of John Peel airtime.  The track, naturally, was Video Killed The Radio Star. 

Happily it didn’t – radio has evolved, just as the music it plays, but even in this image-heavy age the trusty wireless continues to form an important and enriching part of our lives – long may it continue!  

The hard sell

Mr Hypotec:  [Smiling]  Congratulations, your mortgage came through!

Oly:  [Excited]  A shed of my own!

Katja:  [Dreamy]  I think lilac for the lounge…

Mr Hypotec:  You have buildings insurance?

Oly:  Should we?

Mr Hypotec:  No buildings insurance, no mortgage.

Oly:  Um, ok, if you could get us a quote…

Mr Hypotec:  You’ll be wanting contents cover too?

Katja:   How many shoes fit in that downstairs cupboard?

Oly:  Naah, we’ve nothing worth nicking...  and  I doubt Iffley hill is often under water!

Katja:  There were floods when I first arrived in Oxford - I went to the shops to buy boots, but I hardly spoke English.  It took ages and my feet got soaked – probably as I was asking to buy ‘willies’!

Mr Hypotec:  Heh heh, well it’s your shout - but what if the house burns down?

Oly:  Yeah I guess – it’s just that where we’ve just been living you can’t even get insurance – you kind of ‘insure your self’. 

Katja:  Is that fizzing noise our Cambodian fairy lights?

Oly:  Actually, maybe a quote on that too…

Mr Hypotec:  With pleasure.  Now:  do you travel?  Like to ski?

Oly:  Is the pope a Catholic?  But we get annual travel cover from our Coop bank account.

Katja:  He’s German also, the pope.  And he loves cats, like me.  But they're not allowed in his palace.  

Mr Hypotec:  You’ll be wanting life insurance of course…

Oly:  Will we?

Mr Hypotec:  [Signs]  Well, what if you die?  Could Katja pay the mortgage?

Katja:  It’s ok - for $15 you can buy a little cardinal hat.  For the cat.

Oly:  I agree that some insurance you have to have:  if you want to buy a house, you need buildings insurance;  if you choose to drive, you have to be insured.  

Mr Hypotec:  Agreed.  And if you take a mortgage, you need life insurance, yes?

Oly:  No!  For everything else – including life - you choose whether to buy insurance or to cover the possible cost yourself.  It depends on your attitude to risk – and the cost of the premium.  

Mr Hypotec:  Well, everyone gets life insurance - including the poor chap your age I saw just last week who's now dead of a terrible brain disease called  defectum discrimine ratio...  I mean, are you really saying you’ll insure yourself against the unlikely event of a ski accident, but not the certainty of your own death? – and for a man like you, isn’t Katja worth £100 a month?

Oly:  Woah, that’s more logical fallacies than straw men at an Iowan corn-dolly convention!

Mr Hypotec:  [Resigned] Oh dear, another philosopher.  Well I’ll leave you to think through your insurance options.  Congratulations again on the mortgage!  [He finally leaves].

Oly:  Phew!  He’s a decent mortgage advisor – and so he should be, we’re paying him £600 for that.  But do we really need life insurance?

Katja:  Hmmm?

Oly:  Well, all this insurance stuff – do you think he’s just putting on a hard sell as he’s on commission?  

Katja:  Should we get pet insurance for Tiddles?