Gender, money and professional identity: medical social work and the coming of the British National Health Service

Abstract

The arrival of the British National Health Service (NHS) in 1948 heralded significant changes for all health workers, but the establishment of a ‘free’ health service was especially meaningful for the hospital almoners—or medical social workers, as they were starting to be known—who had previously been responsible for the assessment and collection of patient payments. It was on this basis they had gained a foothold in the hospital, capitalising on gendered assumptions of financial understanding and behaviour. Yet what might have caused an identity crisis was embraced. This was a dual strategy of both repositioning the profession in alignment with the planned NHS and of asserting an enhanced professional status by distancing themselves from the handling of payment. It was an episode in the history of this distinctly female profession that speaks to women’s historic relationship with money.