Almoners, patients, and the formation of medical social work in London, 1895-1948

How to provide hospital aftercare, and to whom, are two major challenges facing social work today. Social workers and their clients continually question what they can expect from social care within the limited resources available to them. These questions are not new, but originate in the role of the hospital almoners. The first almoners were appointed to charitable hospitals at the end of the nineteenth century to means-test patients and determine if they should be made to contribute toward their treatment, and, when necessary, refer them to charitable aftercare. In this project, I argue that these almoners were precursors to today’s social workers. I will demonstrate that the role of almoner developed over the first half of the twentieth century into what would be recognised today as social work. The period 1895-1948 was one of intense upheaval, witnessing a devastating pandemic, global economic depression, and two world wars. This was accompanied by constantly changing demands on medical care, charitable provision, and on almoners who acted as gatekeepers between the two. By identifying the people who shaped the profession, almoners, patients, and their families, I will provide a new insight into the history of early twentieth century social work.