Hospital social work: cui bono?

The role of hospital social work departments (SWDs) is often the subject of dispute. Medical administrators, who hold the purse and policy strings, and heads of SWDs will have a major influence on the evolution of these departments in times of continued financial constraint. Their views on the importance of the services provided by the SWD, both currently and in the future, were canvassed by mailing a questionnaire to all teaching hospitals in Australia. A 90% overall response was achieved. In general, instrumental tasks (those associated with the traditional "almoner" role) were perceived by medical administrators and heads of SWDs as of equal importance. Independent professional social work activities and social change agent services were more highly valued by heads of SWDs. Most services were expected to increase, with only "placement" declining in the future. More change was expected by heads of SWDs than by medical administrators. These results are seen to reflect the differing values of the two groups, the significance of which is discussed.