Case Finding and Screening for Social Work in Acute General Hospitals

Paul Bywaters, Senior Lecturer, Department of Social Science and Policy Studies, Coventry Polytechnic, Priory St., Coventry, CVI 5FB. Summary Since the first appointment of a ‘Lady Almoner’social workers in hospitals have complained about the problemof obtaining referrals appropriate to their skills and knowledge,and sufficiently early in the patient's stay to allow for effectiveintervention. Often, due to shortage of staff, workers haveto rely on referrals from other staff, patients and carers.But where social workers find their own cases, a wider rangeof problems and patients are selected. In the United Statesduring the past twenty years there has been a rapid spread ofscreening at the point of admission or pre-admission, to identifyhigh risk patients for social work assessment. The evidencefor the effectiveness of this approach to case finding is examined.     

Government, Social Services Departments and the Health of Children and Young People: Which Way Forward?

Summary Despite the dearth of research into the health of children andyoung people in contact with or ‘looked after’ bylocal authorities, a series of official and quasi-official reportshave begun to raise awareness of this issue. There are goodreasons to believe that this group of children will be disadvantagedin terms of health as they are in other aspects of their lives.The evidence suggests that local authorities do not live upto the standards of ‘good parents’. Current notionsof good practice are critically appraised and the article concludesthat social work is unable to do more than mitigate the effectsof Government policies which affect health and social servicesand which have lead to widening social inequalities.     

Tackling Inequalities in Physical Health: A New Objective for Social Work

Correspondence to Eileen McLeod, Department of Social Policy and Social Work, University of Warwick, Coventry, CV4 7AL, UK. Summary We argue that tackling the impact of social inequality on physicalhealth should become a central objective of social work andintrinsic to the development of anti-oppressive practice. Thisis on three grounds. First, the suffering embodied in inequalityin physical health should be a cause of concern to social workers,as a pervasive social problem. Secondly, awareness of socialwork's complicity in contributing to such a problem, throughits historical role in implementing state policies, needs toinform assessment of social work outcomes. Nevertheless, thirdly,social work—not confined to health care settings—whichredresses social disadvantage and tackles its consequences forphysical well-being can contribute to greater equity in health.Indicative examples of such practice are provided in relationto health maintenance, living with ill health and terminal illness.Finally, consideration is given to the current wider politicalcontext in which social work addressing health inequalitiesis embedded and to the need for complementary organizational,professional and political initiatives to buttress its development.     

Social Work and the Medical Profession--Arguments Against Unconditional Collaboration

Summary The history and major texts of medical social work emphasizethe need for collaboration with the medical profession. Howeverthere is a less visible history of conflict between medicineand social work. It is proposed that a critique of medicine’scontribution to health provides the foundation for a statementof principles for a social model of health for social work practice.Collaboration with medicine should be negotiated on the basisof such principles, rather than unconditional.     

An Interactionist1 Model: An Answer or Just a Better Question?

Summary It has been argued that an interactionist approach illuminatesthe relationship between public issues and private troubles.However, the model has been fundamentally criticized as beingtheoretically empty. The value of the approach is examined bythe analysis of a practice example. The basic criticisms ofthe model are confirmed but nevertheless it may offer a usefulstepping-stone away from the rigidities of case-based practice