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often has to give continued support and encouragement to some patients who find it difficult to
adjust to a work routine after being unfit for some considerable time. Some patients have chronic
chest conditions which prevent their working or having any social life outside their homes. These
patients have been helped considerably by the facilities offered at the day centres for the physically
handicapped.
in the catchment area of one of the Chest Clinics there is a very large lodging house and the social
worker attends the six monthly mass X-ray visits to encourage the men there to be X-rayed. There
are many problems involved in trying to keep up contact with men and women in lodging houses
and hostels and the Ministry of Social Security has given a great deal of help towards maintaining
contact with these people and granting allowances for extra nourishment.
One social worker comments that although the number of tuberculous patients has been decreasing,
there are greater numbers of lung cancer patients who are followed-up at the clinic and it
seems that the social worker will have an increasing part to play in her contribution towards the
problems of helping these patients and their families in the community.
At another Chest Clinic the social worker gives a list of some of the items with which she had
dealt during the previous eight months. Briefly they may be summarised as follows:— Housing
difficulties, financial problems, extra nourishment grants, employment problems, convalescence,
invalid meals and medical equipment on loan. The social worker makes herself available to any
patient who may turn to her for help and advice concerning any of his or her problems. The
social worker also attends the hospital ward rounds with the consultant and so keeps in close touch
with the patient.
Social work at V.D. Clinics
Three social workers are employed full-time in connection with this work; one at each of the
following three hospitals:— St. Mary's, Middlesex and Westminster. Owing to the increase in
numbers of cases it is anticipated that an additional social worker will be required full-time both at
St. Mary's and Middlesex Hospitals. During the last four months of 1966 additional social work
help was made available on a part-time basis at these two hospitals.
In addition to the work of contact tracing many visits are made to defaulters and in difficult cases
and endless amount of persuasion, health education, tact and perseverance is required.
It is essential that a good relationship is formed with the patient who is frequently very frightened
and distressed when he or she attends the clinic. An increasing variety of social problems is now
being dealt with and visits are made to Probation Officers and other social workers and to Prisons
and Remand Centres. Much evening and weekend work is entailed and many clubs and cafes in
the less salubrious parts of the area are visited. One social worker says:— "I have become familiar
with the areas in which delinquency and vice flourish, and this knowledge does help in tracing
defaulters and contacts. The girls and women with whom I deal have sometimes low mentality,
are prostitutes, women addicted to alcohol, promiscuous and amoral youngsters who, quite
genuinely, see nothing abnormal in their sexual behaviour. A number come from extremely bad
family backgrounds, others from all walks of life". Another social worker writes:— "Many of our
patients live in the underworld fringe and some indeed are deeply implicated in the criminal world.
They are very suspicious of our intentions but we impress upon them that our interest is in their health,
and that of the public. Many come to the clinic in quite a distraught state and we act rather as a
safety valve." Help of a practical nature can often be given when the social worker sees the patient
at the clinic, e.g., arranging hostel accommodation for the homeless, obtaining financial help through
the Ministry of Social Security, arranging appointments with the local birth control clinic, and
arranging for drug addicts to be put in touch with the appropriate organisation.
Contact tracing in respect of persons referred from the Armed Forces of this and other countries
is also carried out by the social workers, (see page 56).
The number of home visits in 1966 made by social workers at St. Mary's and Middlesex Hospitals
was 1,026.
Social work at Special Investigation Clinics and in connection with the School Health
Service
The primary function of the social workers is to ensure that the school children who are referred to
them have access to the many facilities which exist for their medical supervision and treatment and to
provide social work help as and when required. They are in touch with many parents and children
and are ready to advise on the various public and voluntary services which are available to the
community. They work closely with the local voluntary Care Committee workers and with the
organising staff in the education service. They attend special investigation clinics for the investigation
of such problems as enuresis, behaviour disorders and failure to make satisfactory physical and
educational progress. These conditions are often associated with disturbed home backgrounds