The Duties Required of a Health Visitor - Salaries - Necessary Qualifications - Training and Fees

A fresh opening in paid municipal work has been provided for women by the creation of a new office, that of the health visitor.

During the last two years a considerable number of women, both in London and the provinces, have been appointed to these posts, and there is no doubt that in a short time most of the London sanitary authorities and many provincial ones will have at least one health visitor on their staff.

Duties of a Health Visitor

The health visitor has to perform duties which are quite distinct from those of the sanitary inspector. While the latter has to see that certain Acts of Parliament relating to public health are observed, and has the right of entry into every house where there is reason to believe that a nuisance exists, the health visitor is a purely advisory officer, whose duty it is to spread among the poor of her district a knowledge of everything that makes for healthy living.

She enters each home with the consent of the occupants, and teaches the housewife the importance of cleanliness and proper ventilation and explains the dangers of dirt and overcrowding. She instructs her in the choice of suitable food and clothing, shows her how to cook, and especially points out the dangers of using impure water, at the same time explaining how best to prevent its contamination and that of food generally. She helps to nurse the sick, and promotes a knowledge of home nursing and all that relates to the care of young children.

One of the health visitor's most important duties also is to attend on women during or shortly after childbirth.

As a general rule, her visits are well received by the people, since she is recognised as a real helper, and her advice and assistance are often voluntarily sought.

Salaries and Hours of Work

The salary to be paid to health visitors is not absolutely fixed, but varies in different districts from 50 to 3100 a year; but the Local Government Board has intimated that it considers that the remuneration in London should not be less than 100 a year, as these appointments, especially since the passing of the Notification of Births Act, are very important.

The health visitor works about the same number of hours as the sanitary inspector, sometimes rather longer, as her duties are not so strictly defined, but she has no Sunday work, a half-holiday on Saturday, and a fortnight's holiday in the summer.

She is entitled to three months' notice, and, of course, has to give the same.

Qualifications And Training

Although power to appoint health visitors with the consent of the Local Government Board and according to the conditions laid down by that department was conferred on sanitary authorities by an Act in 1908, it was not until September of the following year that the Board issued an order clearly defining the qualifications required of candidates and the duties of the office.

Under this order, which applies to London only, any of the following women are qualified to be appointed without going through a special training - viz., registered medical practitioners; nurses who have had at least three years' training in the medical and surgical wards of any hospital or infirmary which is a training school for nurses, and which has a resident physician or house surgeon; and midwives duly certified under the Act of 1902.

By special consent of the Board, too, those who have performed similar duties in other parts of the country can be appointed, and also, where the circumstances require it, any woman who has a competent knowledge of the theory and practice of attendance on women during or immediately after childbirth, and of nursing in cases of sickness and other mental and bodily infirmity, may, by special consent, be chosen.

The Examination

It may be said at once that the Board lays so much stress on the importance of maternity work that the possession of the C.m.b. certificate is one of the best single qualifications that a candidate can possess, though, of course, those who both have this certificate and are fully trained nurses as well stand a better chance.

For those who are neither nurses nor midwives, and who possess none of the other qualifications mentioned, it is necessary to go through a special, though comparatively short, course of hospital training, and then pass the examinations for health visitors and school nurses of the Royal Sanitary Institute or of the National Health Society.

The hospital training must last at least six months, and be undertaken in a hospital or infirmary receiving children as well as adults, and must include a course of instruction in subjects relating to social hygiene.

The subjects of examination include the

Woman's Work following: General structure of the body, personal hygiene, air, water, food, clothing, the dwelling, elements of home nursing, care of infants and young children, prevention of communicable disease, first aid, treatment of injuries, ailments and accidents, and statistics. A full course of lectures is given at the Royal Sanitary Institute, for which the fee of 1 is. is charged.

Openings And Prospects

Although fresh openings are constantly being made - and these appointments are bound to increase in importance - there are at the present time a fairly large number of well-qualified women waiting for these posts, so that it is very important that those who wish to take up the work should train as fully as possible, and not be content with the minimum at present laid down by the Local Government Board.

Every intending health visitor, whatever her experience or qualifications, would do well to pass the special examinations of the Royal Sanitary Institute or of the National Health Society, as it is highly probable that in the future every candidate will be expected to possess the certificate of one of those or similar bodies. She should also take her C.m.b., and obtain as thorough a training in nursing as circumstances permit.

Age. No age limit has been fixed for these appointments, and this is one of the few professions where a well-qualified, energetic, and capable woman of middle age may stand a better chance than a woman several years her junior. It all depends on the individual and the way in which she impresses the-selection committee. Some women are really "too old at forty" for the work, while others may be practically as active as ever, and be preferred on account of their greater knowledge and experience.

Candidates who require further information as to the qualifications for those posts which may be from time to time most in demand can always obtain it from the Secretary of the Royal Sanitary Institute, Buckingham Palace Road, S.w., or they could probably also do so from the Local Government Board, which has the final voice in deciding the selection of all candidates, but there is no special provision made for giving such information by this or any other official department.

Appointments are advertised in such papers as "The Sanitary Record," "The Municipal Journal," "The Local Government Chronicle," which can generally be seen at the free libraries, and in the case of many country appointments advertisements appear in the local paper of the district.