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136
Indeed, the difficult non-statutory progressive steps in community
medicine, once the hallmark of an "avant garde" authority, are
becoming even harder to take and there is a tendency for authorities
to "conform" to a standard not necessarily of the highest
quality.
Successful planning, especially of community services, must be
built around sound economic, statistical and social knowledge.
This involves an accurate assessment of resources in which due
regard must be had to the availability of various skills for, clearly,
schools cannot function without teachers nor clinics without
doctors and nurses. Furthermore, it is of the utmost importance
to determine the extent to which future resources have already
been mortgaged for if future policies are to remain in balance, they
must progress pari passu with the amount of "new" money becoming
available and with the attainable increase in trained personnel.
But, above all, success will come only after a period of stability.
Unhappily, prospects of such a period of stability in the immediate
future are far from promising. Government plans for the
health services are awaited with trepidation and the uncertainty
created can hardly be beneficial to these services as a whole. A
great deal of the uncertainty arises from the fact that, despite
emphasising the inseparable nature of health and social welfare,
Seebohm has proposed a dichotomy of these very services. Lord
Amulree, in stating that "a medical or health element is present
in most problems that confront the social workers", has intimated
that the health and social professions cannot, with reasonable
success, function in isolation and a recent Nuffield report showing
that 50% - 70% of referrals to "child guidance" were from medical
sources supports this contention.
Leaving aside the question of increased administrative costs
involved in separate establishments, what would be required
of a worker in a future unified domiciliary team founded to
provide comprehensive integrated health and family welfare
services? Ideally, if one could start de novo, this officer would be
a complete social worker able to administer to the whole of a
family's needs and training could be geared to this re-orientation.
Naturally, the period of training would be prolonged and this is
unlikely to be received enthusiastically without evidence that a
well-paid career would be the end result.
Today, most social workers would claim that they had chosen
their particular profession because they feel and know that it is
the only vocation for them, i.e., child care, health visiting, geriatrics,
mental health, handicapped, etc. This is not to say, however, that
they would be incapable of undertaking work in other fields if