To ask the Secretary of State for Health how many health visitors there are as a proportion of children on the child care register in each borough in England and Wales.
It is not possible to calculate the proportion requested. The number of children and young persons on child protection registers in each local authority area is published in "Survey of Children and Young Persons on child protection registers year ending 31 March 1988: England". This is available in the Library. Data for health visitors are shown by region in table C9.5(a) in the 1990 edition of "NHS Workforce in England" (page C102). I have arranged for a copy of this to be placed in the Library.
To ask the Secretary of State for Health if he will take steps to improve health visiting facilities where the infant mortality is above national average; and if he will make a statement.
The measures we are taking to achieve further reductions in infant mortality were described in the Government's reply to the first report from the Social Services Committee on perinatal, neonatal and infant mortality (CM 741). We accept that health visitors play a key role in the health surveillance and care of infants: the organisation and staffing of these services is best determined by health authorities in the light of local circumstances.
To ask the Secretary of State for Health what is the average caseload of a health visitor.
The information is not available in the form requested. The average number of people seen by each health visitor (whole-time equivalent) in England in the financial year 1987–88 was 395. Each person may be seen more than once, the annual average being three visits per person.Figures for 1988–89 are not yet available.
To ask the Secretary of State for Health what steps he is taking to ensure that there is an effective and safe child care service provided by health visitors; and if he will make a statement.
Provision of health visiting services is the responsibility of health authorities. Guidance on child protection was given in "Working Together: A Guide to Arrangements for Interagency Co-operation for the Protection of Children from Abuse" prepared by the Department and "Child Protection: Guidance for Senior Nurses, Health Visitors and Midwives" prepared by the Standing Nursing and Midwifery Advisory Committee; both of which were published in 1988; copies are available in the Library.Any evidence of shortcomings in a health authority's children's services could be taken up in the annual review process and, if appropriate, discussed at the review meeting between the management executive and the region.