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(b) Work of the Social Worker
Report by Mr„NCB.Forward
The appointment of a Social Worker to the Public Health Department became operative
on January 9th, 1950 Obviously the intention was to appoint an officer for social work in
a medical setting and the popular and most commonly used designation for such an officer is
"Almoner". Though this name is to some degree still associated in the public mind with the
hospital officer who assesses patient*s payments to the hospital, it is now much more
commonly accepted that the Almoner is the officer who "helps11 the patients. Accordingly,
while the designation of the post remains the same, the appointed officer has now become
generally known as the "Almoner", a name which appears to have given satisfaction to all
concerned.
An Almoner's function is to help the doctor in the treatment of the .patient, the
doctor relieving physically and mentally, and the Almoner, where required, environmentally
and mentally insofar as improved social conditions affect the patient*s outlook. Broadly,
the duties fall into three main categoriesj-
(1) Medical social work directly concerned with the doctorts investigation and
treatment of the illness.
(2) Liaison with other agencies concerned with the social aspect of medicine and
association with the planning of the National Health Service. The .latter is mainly
met by co-operation with the Public Health Department.
(3) Other work, such as teaching, research, or planning facilities for patients in
which the knowledge and skill of a trained social worker are needed. Medical social
work itself likewise can be classified under three headings•-
(a) Social investigation, being a study of the patient1s environment and
consultation with the doctor on those factors which may be relative to the case.
(b) Social treatment, being sometimes a simple consultation, sometimes
provision of small material help to overcome a temporary difficulty, sometimes
more extensive and difficult rehabilitation or on occasion some personal and
private problem needing adjustment, without which medical treatment may be less
valuable. This also covers prevention by co-operation with the doctor in securing
the segregation of contacts and arrangement of convalescence to increase resistance
to infection.
(c) After care, a general contact with resolved cases and contacts to ensure
that the value of treatment given is not lost and which sometimes of itself is
sufficient to give encouragement or an assurance that there are interested agencies
should misfortune be repeated.
Thus the Doctor and the Almoner jointly help the patient through an illness and its
implications in such a way that eventually the patient is restored to independence and security.
At the.start of a newly created post much energy and time needs to be given to finding
ones way about, to planning work and records, to making contacts and to making experiments in
the most satisfactory ways of giving help and guidance to persons in need,,. Suitable office
accommodation and equipment has to be found.
Though it may be desirable, it is not possible at present to interview all patients
attending the Chest Clinic and it has, therefore, been necessary to confine the work to
that referred either by the Chest Physician or by the Tuberculosis Health Visitors as far
as the tuberculous patients are concerned.
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