Nursing & Health Care, Medical Faculty, University of Glasgow, 59 Oakfield Avenue, Hillhead, Glasgow Scotland G12 8LL, United Kingdom.
Health Policy. 2009 Dec;93(2-3):93-101. doi: 10.1016/j.healthpol.2009.08.001. Epub 2009 Aug 28.
In 1997 Health Visiting was deemed by New Labour to be an important player in reducing health inequalities. It was acknowledged that if Health Visiting was to fulfill this vision it would have to work out with its traditional child health role and also engage with groups, communities and populations to tackle the determinants of ill health. Twelve years on, external factors such as, NHS cut backs, recent changes to how Health Visitors are regulated throughout the UK and devolved Health Visiting policy making structures have led to the rapid demise in status and legitimacy of Health Visiting and its wider public health role. This article argues that the unintended consequences of devolved Health Visiting policy has resulted in 3 recent community nursing and health-visiting reviews in Scotland and England which have made divergent policy recommendations about the role of the Health Visitor in tackling health inequalities. The recommendations outlined in the Scottish review in particular threatened to jeopardise the very future provision of a UK wide Health Visiting service. If Health Visiting is to survive as a UK wide entity, a radical independent rethink as to its future direction and its public health role is urgently required.
1997 年，新工党认为健康访视是减少健康不平等的重要参与者。人们认识到，如果健康访视要实现这一愿景，它必须在其传统的儿童健康角色之外，还必须与群体、社区和人群合作，解决健康不良的决定因素。12 年后，外部因素，如国民保健制度的削减、英国各地对健康访视者监管方式的最近变化以及下放的健康访视政策制定结构，导致健康访视及其更广泛的公共卫生角色的地位和合法性迅速丧失。本文认为，下放的健康访视政策的意外后果导致苏格兰和英格兰最近进行了 3 次社区护理和健康访视审查，对健康访视者在解决健康不平等方面的作用提出了不同的政策建议。苏格兰审查中概述的建议特别有可能危及英国范围内提供健康访视服务的未来。如果健康访视要作为一个全英范围的实体生存下去，就迫切需要对其未来方向及其公共卫生角色进行激进的独立思考。
