Working parents: What the doctor ordered for working mums

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Matching your child's health care needs with office life doesn't have to be a nightmare, says Jackie Cassell

Time off due to a child's illness and other emergencies is an occupational hazard for the working parent. But "flexible workforce" arrangements for health care needs can be a major headache. Jane, a retail supervisor, resents the difficulties she encountered in getting her child's MMA (measles, mumps and rubella) vaccination. "My GP practice will only do vaccinations between 2pm and 3pm on a Tuesday. While my manager understands that I might need to be off for emergencies, she can't easily arrange for me to be off for odd half-days."

Much child health provision is designed for the mother at home with young children or perhaps at primary school. For her, early afternoon or 10am clinics may be ideal, but for working parents these are the least convenient times. Yet parents are often unaware of other options.

Immunisations are provided by GPs and by child health clinics. All families with a child under five have a health visitor, who can give information on all local clinics. Some GP surgeries are flexible about when they can give immunisations, while others, like Jane's, are less helpful. Increasingly, however, working parents are being recognised. Optimum Healthcare NHS Trust in South London, for example, runs a number of evening child health clinics.

Similar arrangements are in force for developmental checks. If your practice has a GP "approved for child health surveillance", it may be possible to make an appointment at a time to suit you. Again, your health visitor can help.

Hospital appointments are not often available in the evenings. As one community paediatrician in London says: "One issue is safety. I want a lot of people around when I am working, not just me and a receptionist. At present, it's easier for me to provide a good service between 9am and 5pm when the back-up services are available. I may need medical notes, blood tests, results from the lab, a letter typed and faxed, or to discuss something with a more experienced member of staff."

She does, however, recognise that things could be made easier for parents. "Of course, we absolutely must start clinics on time. Appointment times need to be kept to. And appointment letters need to make it clear how long you will need to be there. A lot of frustration is caused when people aren't told how long it will take for the child to be weighed, see the doctor and have tests."

Her advice is to ask for the first appointment of the day. "At least when the clinic starts you will be seen straightaway. If it's a drop-in clinic, go half-an-hour early. Then you can leave with the minimum of wasted time."

Life can be made easier if your GP practice is child-friendly. Some GPs state a particular interest in children in the practice guide. Look for a GP who has child health care qualifications or is registered for child health surveillance. Often this will go hand-in-hand with child-friendly policies, but it's worth checking on the availability of emergency appointments and clinic times.

Often, a parent's need is simply for information on a common condition. Sometimes the practice nurse may be available by phone in the early evening. In some areas, such as Lewes, East Sussex, the health visitors work late some evenings. Other sources of information and advice are available, which may occasionally save you a trip to the doctor's. Perhaps most comprehensive is the Health Information Service. Staff can put you through to an array of tapes, ranging from "asthma in children" through "speech problems in children" to "earache in children". Its directory, available in libraries or through a Freephone number, allows access to tapes out of hours via a code.

Health Information Service: Freephone 0800 665544. Staffed 9am-7pm Mon- Thurs, 9am-5pm Fri. Tapes available as listed.