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Council's general hospitals and in the county mental hospitals. When the National Health
Service Act, 1946 came into operation the community after-care services for the mentally
ill in London were at first carried out by the National Association for Mental Health and
the Mental After-Care Association; but in 1953 the service was undertaken directly by the
Council. Five qualified psychiatric social workers, working under the general direction of a
consultant psychiatrist, the Council's adviser in mental health, are employed in this work.
The work of taking the initial proceedings in providing care and treatment for persons
suffering from mental illness is at present carried out by a separate group of mental welfare
officers (duly authorised officers). These officers will be integrated into the divisional
mental health teams under the proposed new arrangements. Unfortunately, there is no
nationally organised course of training for persons undertaking these responsible duties.
When these duties were first placed under the direction of the Medical Officer of Health in
1948 relieving officers with experience in the work were transferred to form the nucleus
of the staff. Since then trained social workers, mental and general trained nurses, and
others with suitable experience and character have been appointed to fill the vacancies
that have arisen and in-service training has been given to new entrants.
Services for the care and after care of the sick—
Tuberculosis—The Council provides for the care of tuberculous patients after discharge
from hospital and while they are being treated at home. The tuberculosis care organiser,
who is a trained social worker, has the duty at each chest clinic to advise on the social
needs of the tuberculous patient and his family. As a matter of course all new cases are
referred to the care organiser, for so often social problems which may profoundly affect
the course of the patient's illness may only reveal themselves with skilled and patient
interviewing. Case discussions are also held regularly between chest physician, care
organiser and tuberculosis health visitor. The tuberculosis care organiser maintains contact
with many voluntary agencies, with the housing departments, National Assistance Board
and other statutory organisations. The social care of residents at the Council's tuberculosis
hostels is another of her duties. She acts as the secretary of the local tuberculosis care
committee, which includes representatives of the metropolitan borough councils and other
bodies interested in the welfare of tuberculous persons and their families.
Venereal diseases—Work in this field was initiated during the last war as a result of
Defence Regulation 33b, which provided for compulsory treatment in certain circumstances.
The Council employed a number of welfare officers whose duty it was to trace
contacts, to ensure that they attended clinics for examination and treatment, and to
follow-up cases who defaulted in attendance. Under the National Health Service Act, 1946
the venereal disease clinics became the responsibility of the hospital service and the policy
now is to encourage patients to persuade the contacts to attend a clinic. If however a
home visit is necessary for this purpose it is carried out by a social worker or an inspector
employed by the Council. Not all hospital venereal disease clinics avail themselves of this
service. Four social workers are employed on this work. Three undertake part-time duties
in the hospital clinics and one worker, at the request of the Prison Commissioners, is
attached full-time to Holloway Prison for women and undertakes the follow-up of
prisoners on discharge.
Social work with families, including problem families and unmarried mothers—
Divisional co-ordinating committees, set up since 1952 under the chairmanship of divisional
medical officers with the object of bringing together all interests and activities
deployed to help families with difficult or intractable problems, have gained most valuable
experience in the intervening years. In each division the divisional treatment organiser,
an experienced and trained social worker, was appointed to act as secretary to the coordinating
committee and this further strengthened the link between the social agencies
in the area, both voluntary and statutory. Increasingly the children's, education, housing
and welfare departments, as well as other statutory and voluntary agencies and individuals,
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