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in communications inevitably occur and follow up services,
although valiantly attempting to do their best, have not
managed to maintain previous standards.
A further problem is that the good working relationship
which existed between general practitioners and the Mental
Welfare Officers has to a large extent broken down, and
there has been a return of the old system of direct referral
"doctor to doctor", rather than through the intermediary
services of a known and trusted psychiatrically trained
social worker. Doubtless as the area teams become more
established this will again improve, but it has been
unfortunate to see smaller numbers of direct referrals from
general practitioners to social workers in the mental health
sphere.
The liaison that exists between hospital and the Day Care
Centres at Bath Road and Heston has been maintained and
indeed developed, with insistence on the personnel at the
day centres having the final say on admission and discharge
of their clients (one of the adjustments a doctor has to make
is to refrain from using the word 'patients' in this context).
Furthermore, the Orchard Hostel continues to provide as
excellent a residential rehabilitative service as it ever did.
These few comments will undoubtedly sound embittered
and out of keeping with modern views of social work. One
hopes that as the Social Services Departments throughout
the country settle down they will be less pertinent, but the
need for specialist social workers dealing with psychiatry
will, in my opinion, always be present if a true "community
approach" is to be maintained.
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