Medical social work in the community

Medical social workers (and other professionally trained social workers) have only recently been employed by Local Authorities: in the past these Authorities were concerned with the provision of personal services to very limited extent. From the time when the Poor Law system began breaking up, following the publication of the Reports of the Royal Commission on the English Poor Laws in 1909, until the outbreak of the Second World War, Local Authorities were faced with the considerable problem of the transfer and integration under their auspices of the various functions of the Poor Law. With very few exceptions, their energies were confined to this task; no new programmes were initiated which would put a greater emphasis on an individualised approach towards those who fell into the different categories of need. One exception was in relation to the ex-Poor Law Hospitals which were taken over in 1929, and some of which began employing almoners shortly after. Another area of Local Government activity in which medical social workers participated early were the tuberculosis dispensaries. Tuberculosis had been a notifiable disease since 1912, and Local Authorities were thus responsible for both the treatment of people who had the illness and for the prevention of its spreading. On the whole, however, the emphasis during the period 1909-1939 was on institutional care for the various ‘problem groups’ in society rather than on enabling their members to remain in the community.