Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[Report of the Medical Officer of Health for Waltham Forest]
This page requires JavaScript
Conversely someone may deal perfunctorily with a trivial request where the perceptive
trained worker sees the "tip of the iceberg" of a social disorder, and by dint of work in depth is
able to alter the course of events which might otherwise become a chronic social disability,
perhaps extending to later generations of a family.
Effectiveness of social workers can only be assessed and evoked by able colleagues.
Thorough and on-going training of field staff and the availability of sufficient able and
trained senior people is therefore the key requirement in the social services - and the officer
concerned with training has a most important place in the departmental hierarchy.
What about productivity and cost effectiveness - these fashionable words - in the
administrative support?
Here again, simple analysis of how time is spent combined with supervision gives good
guidance in respect of some staff while in others assessment is complex.
The department deals with emotionally charged subjects, with the crises of life like
birth, death and illness, and with situations such as stigma, protectiveness, strained personal
relationships which make administration far more than something a computer might take over some
day. It may make an apparendy straightforward request unexpectedly time consuming. A person
who is dealing with something which for them is highly emotionally charged, however routine it is
to us, cannot be abruptly dealt with: the old man whose wife is dying and who is trying to tell you
she has become incontinent, has a simple routine request, but it is far from that to him; the firsttime
expectant father is a well known figure of fun to whom the same statement applies. There are
always the frank mental patients who lead the administration no end of a dance.
It is the social workers, it may be said, who should deal with these things. It is, but the
administrative staff inevitably get drawn in, and moreover it is they who may be at the centre of
the cross currents arising from a variety of procedures which relate to one household where the
family situation must be understood if the departments complex relationship with the public is to
be integrated, effective, and of a human compassion.
The administration needs on the financial and management side competent managerial
staff, this is easy to understand, but for the reason given above it is important to have able senior
staff in the administration supporting the social workers - unless of course the social workers do
the administration themselves. This latter system can work but in a situation where trained social
workers are the class of staff which, of all in the department, are in the shortest supply, the
advantages of this must be weighed carefully against the disadvantages. Moreover, if they are to
fill this role they require at least as much training in administration as the equivalent administrative
staff have had.
The balanced approach therefore for seeking efficiency involves a statesmanlike approach
to the provision of extra resources, seeing why in the national interest they are indicated, and it
involves the provision of sufficient able trained professional and administrative staff, combined
with a thorough training programme for all staff.
These things will cost more.
- 6 -