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MEDICAL SOCIAL WORK
(l) Prevention of Break-up of Families
The work of the section has continued along the lines
indicated in last year's report. As this is essentially in
the nature of long term, intensive casework support, figures
are apt to be misleading. The amount of time devoted to a very
small number of families or even a single family in a time of
crisis, cannot readily be measured in a statistical return.
It is by no means unusual for one or two families to occupy almost
the whole of one person's working week, until they have been tided
over the crisis, by which time major difficulties have often
arisen in another family whose social problems have been quiescent
for a time. The work follows very much this pattern, making
it difficult to plan a work schedule and demands flexibility of
organisation and of working hours.
The year started with 56 families all of whom needed long
term support in varying degrees of intensity. A further 37
were added during the year. Most of these families' problems
are due to a combination of factors, the commonest of which are
poor mental or physical health, personal inadequacy, marital
difficulties, marginal employability, low incomes and large
families, or financial mismanagement even when there is a high
income, leading to potential homelessness through rent arrears.
This last factor is often the presenting problem and the
means by which many families in difficulty are brought to our notice.
Well over 100 cases of rent arrears are regularly considered by the
co-ordinating meetings to decide upon the most appropriate action
to be taken on each. Heavy debts are almost always a symptom
of deeper social distress of which the client may well be unaware
until the practical consequences of failing to pay gas and
electricity bills, of facing possible eviction through rent arrears
or even imprisonment for contempt of court when a judgment summons
is not paid, are forced upon them. Sometimes it is not until
families reach this stage that they come to light though the various early
warning procedures which have been instituted are proving effective.
In many instances the biggest difficulty is to try and persuade
the clients to face reality and to accept the need to tackle their
problems. It is all too easy to ignore repeated bills or not to
answer the door to callers and to hope that nothing further will
happen. This is a situation that is often met particularly with
wives who do not wish their husbands to know that they have squandered
the housekeeping money. It may take weeks of patient effort and of
apparently fruitless visiting before it is possible to bring both
husband and wife into the picture. Even then the social worker has to
help them to work through the recriminations and arguments which the
truth precipitates before there can be any hope of an improvement,
not only in financial management, but in family relationships generally.
It is by no means uncommon to visit regularly over a period of weeks
before the client is willing to confide in the social worker.
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