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Celebrating 150 years of public health nursing.

For many, 2012 has been synonymous with London hosting the Olympic Games; however, for health visitors it has a more important meaning. 2012 is the year that the profession marks its sesquicentenary--here's a look back over the history of the CPHVA with our timeline, starting from its inception in 1862 until the present day ...

Much has occured over the last few years in the world of public health nursing, and the most significant of these events is arguably the manner in which the current government has decided to bring the health visiting profession to the fore, pledging an extra 4 200 health visitors in post by 2015 as part of the Health Visitor Implementation Plan: A Call to Action, launched in February 2011.

The prioritisation of investment into a much neglected profession has been welcomed; but there have been significant changes that have been less welcome--namely the successful passage of the controversial Health and Social Care Bill.

As always, Unite/CPHVA has campaigned throughout this period to forge a more equitable future for NHS workers, and continues to do so.

The beginning of 2012 also saw the start of the 150 years of public health nursing celebrations, culminating in the Unite/CPHVA November conference 2012-The Future of Public Health Nursing.


The Ladies' Sanitary Reform Association of Manchester and Salford is founded to promote health and sanitary conditions in poor neighbourhoods, appoints the first health visitors. The group is founded upon religious ideals, with Christian mission women visiting homes to advise residents. These women were employed by the I lady founders to visit working-class homes and I give counsel on health- I related issues, especially those related to infants I and children.


The Sanitary Journal documents the appointment of six women health inspectors in Glasgow.

What is to become the 'health visiting' profession begins to gain ground and move towards national status.



Seven women sanitary workers in London establish the Women Sanitary Inspectors' Association (WSIA), which later changes its name to the Health Visitors' Association. It is, at this point, an unofficial group of women with similar jobs and interests.



In April, the WSIA becomes a formal group, with rules and a written constitution. Both women sanitary inspectors and health visitors were included in the organisation, which promoted sharing knowledge between members. Like today's group, the WSIA covered topics like infant mortality and disease prevention in the home.


The Notification of Births Act 1907 passes in an attempt to cut down infant mortality. It states that newborns should be registered and a local medical officer of health informed of births as soon as possible so that the officer can send a trained health visitor to the mother's home. This promoted the profession and fuelled its rise.



Royal Sanitary Institute began to set examinations in health visiting and extended to school nursing, who came into being after medical examination of school children became mandatory in 1908, which led to Education Act of 1907, which provided for the appointment of medical officers and school nurses.


Association changes name to The Women Sanitary Inspectors' and Health Visitors' Association (WSIHVA).



College of Nursing is established.


HVA registers as trade union; WSIA formally became a Trade Union and affiliated to the Women's Trade Union League. Qualifications for health visiting legally necessary; Maternity and Child Welfare Act enabled Local Authorities to set up a range of services, including salaried health visitors.


Nurses Registration Act; health visiting formally established as profession. Empowers Local Authorities to provide new services like day nurseries, health visitors and child welfare clinics.


First health service union to affiliate to the Trades Union Congress (TUC).



Memorandum lot MCW

Ministry of Health requests that the Royal Sanitary Institute become sole Central Examining Body for the examination of Health Visitors. The Ministry of Health takes over responsibility for the training of health visitors, the RSI continued as the designated examining body, maintaining a register of those who achieved the qualification.


National Gardens Scheme

To help raise money for the QNI nurses, private parties open their gardens to the public, charging 'a shilling a head.' This money was no longer needed when the National Health Service took on the District Nursing Service after WWII, but the money was used to support retired nurses and nurse training. First issue of Association's journal, named the The Woman Health Officer, changed to Health Visitor in 1964.


Specific training course for health visitors made compulsory.

Institute becomes 'The Queen's Institute of District Nursing'.



The WSIHVA becomes the Women Public Health Qfficers' Association (WPHQA).


Becomes 'The Women Public Health Qfficers' Association'.



Regular series of annual conferences begins.


Birth of the NHS--this brings district nursing under the healthcare umbrella, thus releasing nurses from having to raise funds from patients and other activities and instead being governmentally funded.


Health visiting becomes an exclusive nursing speciality; Council for the Training of Health Visitors (CTHV) established by the Health Visiting and Social Work (Training) Act.

October--The HV Centenary Conference in Brighton.

April--The WPHQA becomes the HVA.


CETHV develops a curriculum for a 'new breed of health visitor' based on a 51-week course. At this point, a nursing qualification became statutory requirement for entry into health visitor training, along with either registration as a midwife or, at least Part I of the midwifery training


Public Health Nursing

becomes known as Community Health Nursing; CTHV becomes the Council for the Education and Training of Health Visitors (CETHV). Took over from Royal Sanitary Institute as examining body of health visitors; now the National Boards for Nursing, Midwifery and Health Visiting.


Health visiting service moves from local authority provision into the NHS. Health visitors, along with other public health and community nursing staff, are transferred from their local authority employment into the hospital dominated NHS.



CETHV produces the 'Principles': The search for health needs:

* The stimulation of an awareness of health needs

* The influence on policies affecting health

* The facilitation of health-enhancing activities


The Nurses, Midwives and Health Visitors Act; Regulatory duties taken up by UKCC and four national boards. CETHV disbanded, nursing unified under this act; responsibility for health visitor went to National Boards, now requiring registration as a nurse to become a health visitor.


UK Central Council for Nursing, Midwifery and Health Visiting set up--Known as the UKCC; Became the Nursing and Midwifery Council in 2002; Abolished the CETHV.



Cumberlege Report (Dept for Health and Social Security) on neighbourhood nursing was first to recommend reforms of community nursing services; health needs inclusive of older people, disabled people, the chronically sick, the terminally ill and preventive care. Recommended allowing community nurses to prescribe from limited list of medicines; legislation 1992.


Pre-registration HV education absorbed into a post-registration nursing framework for Specialist Community Health Care Nursing. The former51week programme of study was reduced to a minimum of 32 weeks.



The HVA becomes the Community Practitioners' and Health Visitors' Association (CPHVA).



Nursing and Midwifery Order passed; removal of title 'health visitor' from statute. AEEU and MSF merge to created Amicus.


The UKCC ceases to exist, with its functions taken up by the Nursing and Midwifery Council (NMC).



May--Amicus and the Transport and General Workers Union form to created Unite the Union.

Facing the Future

Independent report on health visiting; concluded it should focus where it can make the greatest impact: early intervention, prevention and health promotion for young children and families; requested national policy to support recommendations.


Action on Health Visiting programme launched (March)--Clearly states the key roles of the health visitor and take measures to promote reinvestment in it.


January--First reading in Commons of the Health and Social Care Bill Feburary: Health Visitor Implementation Plan: A Call to Action established (Feb)

Key aim: improve services and health outcomes in early years for children, families and local communities. CPHVA run a series of free workshops on the subject, across the UK.

July--Healthy Lives, Healthy People White Paper: Update and Way Forward Operational design of this work through a series of Public Health System Reform Updates'.


Healthy lives, healthy people: Improving outcomes and supporting transparency New public health outcomes framework published.

March Inaugural CPHVA awards were a celebration of 'innovation, hard work and dedication.'

Getting it right for children, young people and families is launched

April--HV Implementation Plan Quarterly Progress Report published

November--The Future of Public Health Nursing conference, 7&8 November at the Brighton Centre, Brighton.
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Publication:Community Practitioner
Date:Nov 1, 2012
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