View report page

But who can tell how much investment in Health Education, Public Health Inspection,
and preventive work generally, is required to alter the public attitudes and habits so that savings
on public funds due to their health and productivity make an overall profit? I write in financial
terms because these can be quantified and because health, strength and social well-being cannot
be shown on a balance sheet. I hope no one needs persuading of their value in their own right.
The relief of social distress is full of examples of gross inefficiency. There are in the
borough old people who desperately need the help and attention available in our old people's
homes. There are in these same expensive old people's homes sixty or so old people who should
not be there. There are in mental hospitals, at very great cost and in highly inappropriate surroundings,
a number of mentally subnormal people who ought to be in the communities that they know,
with the support of people they know. Greater efficiency in respect of these two glaring examples
require warden flatlets and hostels respectively - in other words a substantial increase in
resources.
Many people get admitted to hospital simply because the domiciliary support is inadequate.
Where there are too few social workers in any field they make too perfunctory or too
infrequent visits to those they serve and they may therefore be ineffective - the very reverse of
efficiency.
Underpowered social services are as inefficient as underpowered cars.
The ten-year plan of expansion is for the very purpose of increasing efficiency as well
of course for the implementation of the modern concept of a caring community.
One cannot therefore, looking at the problem in a statesmanlike way, expect efficiency
without much greater resources, and the Ministry of Health has in most cases given guidance as
to what resources should make efficiency possible. This authority falls well below these
recommendations, cruelly so, in some instances.
One can however reasonably expect a fair day's output from each member of staff and
effectiveness is worth examining.
In some fields, supervision and statistical returns give most of the answer - this perhaps
applies to Public Health Inspection, Home Nursing and some of the more routine field work
procedures.
In social work, where supervision cannot take the form of a follow-up visit to inspect the
work done, assessment is much more difficult. One client will be almost pathetically grateful for a
trivial service, while another who has exhausted much time and the energies of a number of staff
will continue to call on Members, M.P.s and write to the papers complaining that no one has done
anything.
Assessing effectiveness in social work is full of pitfalls. It is possible to be intensely
active over long hours and still be achieving a low effectiveness.Not uncommonly a social need is
manifested in disguise: for instance requests for all sorts of services may be received, when the
true but unspoken request is for a friend; or persistent advice on infant feeding is sought, when
the true request is for reassurance on success as a mother. There are many examples one could
offer where the worker who does not perceive the true need can spend hours of useless effort,
while the perceptive worker can deal with it in one stroke.
- 5 -