On universalism, I agree with what has been said about how crucial health visitors are in being proactive and going out to seek patients. GPs are also highly important, but they are not going into people’s homes to find families. In identifying the increased level of need, health visitors are absolutely crucial to those people who do not necessarily present themselves. I therefore welcome the increased investment in health visiting and the ability of health visitors to be the named person.
I work with school nurses a lot and wish that there were more of them. We must remember that, under GIRFEC, once a child is in school it is the education service that provides the named person role, so we need to think about how we support the people who perform that role. It is not a question of recreating health visitors for schools because, once children are in school every day, the people who provide their education will have a much better idea about them and will, we hope, form relationships with their families as well.
The SHANARRI indicators—safe, healthy, achieving, nurtured, active, respected, responsible and included—are pretty much from the United Nations Convention on the Rights of the Child, and people in all other parts of the UK will be working towards similar outcomes. We should ask what we are doing to make our children safe, healthy, achieving and so on, not just on an individual basis but at a population level, and health visitors and professionals in the local area should be able to build that up using initiatives such as the bottom-up initiative in Govan to which Anne Mullin referred. There are also initiatives such as the responsive, intersectoral-interdisciplinary, child-community, health, education and research initiative—the RICHER project—in Vancouver, where additional resource is put in to areas that, at a population scale, are more needy according to early development index scores, to make services more accessible.
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As I said at the beginning, the more complex the circumstances are, the more time the professionals will require to undertake assessments of need and support families. Overall, building up the population view is all about raising the status of children and supporting GPs and health visitors on the front line while providing easily accessible services. Specialist services—those that are provided by paediatricians, for example—must be more accessible for consultation and advocacy at the population level in addition to working with individual children.
Sorry—I have so many things to say that I get them all rather jumbled up together.