58. Alms at Joyce Green Hospital

Key words/phrases: Dame Cecily Saunders, Ida Maude Cannon, St Thomas’ Hospital, London, The St. Paul City & County Hospital Training School, Minnesota, Boston School for Social Workers, The Simmons College Boston, Dr Richard Cabot, Massachusetts General Hospital, Medical Social Work Department at Joyce Green, Lady Almoners, The Almoner’s Office, Royal Free Hospital London, the River Hospitals

No.58

Although neither Dame Cecily Saunders nor Ida Maude Cannon ever worked at Joyce Green Hospital I think that we can accept the fact that they had a lot in common with several members of Joyce Green staff.

Both of them began their professional lives as nurses, both became frustrated by their inability to meet patient’s psychosocial needs and both subsequently went on to become medical social workers.

Cecily Saunders, the well-known pioneer of the British hospice movement, began her career by qualifying as an S.R.N. at St Thomas’ Hospital, London in 1944. Next she qualified as a social worker in 1947 and then finally she went on to study medicine before opening the UK’s first Hospice in Sydenham, South London in 1948.

Ida Cannon trained at the St. Paul City & County Hospital Training School, Minnesota between 1896-98 and then worked in a state school for the ‘feeble-minded’ during which time she studied sociology and psychology at the University of Minnesota.

Between 1903-06 she was the first ever “visiting nurse” for the St. Paul Associated Charities and seeing the home conditions in which the sick and poor lived first-hand helped her to understand the interconnectedness of illness, poverty and other social ills.

Following a failed romance in 1906, her sister-in-law persuaded her to enrol at the new Boston School for Social Workers (now The Simmons College) and in 1907 she accepted Richard Cabot’s offer to become the fourth full-time social worker at The Massachusetts General Hospital. Dr Cabot, a physician, had just established the first ever hospital social service department in America there in 1905.

From its very inception the outlook of department was very outward looking and its members encouraged the participation of doctors, nurses, teachers and volunteers. Ms. Cannon insisted however that social workers needed to have sufficient medical training and that nurses who wanted to be part of the department should receive training in casework and other social work skills.

Her department was extremely innovative and created programmes that included such activities as clay-modelling classes for patients with "nervous disorders" and "hygiene education" classes for adolescent girls and young mothers. They set up a low-cost lunch counter for patients and staff and organised country outings for those receiving psychiatric care.

This new department focused strongly upon “the social element” as a vital part of the medical treatment plan and in particular they initiated what today are known as "rounds" and implemented systems to measure social work interventions, even documenting these using charts.

Ida Cannon subsequently went on to become a leading figure in the hospital social work movement influencing the development of medical social work throughout the U.S.A. and becoming a Florence Nightingale equivalent of social work.

Both of these women were strongly influenced by their religious beliefs and following a well established precedent in Christian society they might well have become known as social work missioners (early probation officers you may recall were referred to as police court missionaries and health visitor’s forebears as sanitary missioners) but instead they became known as Lady Almoners and later on as almoners.

And this is the link with Joyce Green Hospital because the Medical Social Work Department at Joyce Green was still called “The Almoner’s Office” when I worked in the Admission’s Office (or the Registry Office as it was known then) in 1964.

Originally of course an almoner was an official whose job it was to distribute alms to the poor and historically they were either crown officials, belonged to religious bodies or worked within English church parishes however it seems that the first attempt to introduce social work into hospitals in England occurred with the establishment of Lady Almoners in the out-patient sections of one or two of the larger London hospitals. The first one in fact appears to have been appointed at the Royal Free Hospital in 1895.

But as to when the first almoner was appointed within any of the River Hospitals or at Joyce Green Hospital must for the moment remain a matter of speculation. But maybe you have some recollections of the hospital social workers at Joyce Green during the time that you spent working within the hospital ?

I can certainly remember a very pleasant and seemly effective almoner based in her office next door to the Admissions Office (or “The Registry”), who also came to lecture us as student nurses in the Preliminary Training School although I have no recollection whatsoever of her name. So what do you remember about the Social Work Department at Joyce Green Hospital ? Anything ?