| Summary: | This thesis reports on an ethnography of a hospital social work team in Wales. The aim of this study was to explore the nature of the statutory social work role within hospitals, to examine how hospital social workers do their work, and to shed light on how social work fits into the hospital context. My findings indicate that hospital social workers face constant pressure from managers and clinicians to expedite patient discharges, and exclude almost all other tasks from their role. Their daily work is a sequence of bureaucratic tasks, focused on management of the failing body, often to the exclusion of considering the wider social or psychological needs of the patient. Drawing on the work of Bauman, I argue that the bureaucratic and managerial systems in which hospital social workers operate produce dehumanising practices and distance decision makers from the human consequences and moral dimensions of their decisions. Even within these systems, however, some levels of discretion are maintained and hospital social workers use their discretion in a variety of ways. The hospital social workers in this study consistently expressed values derived from anti-discriminatory practice and, despite the constraints they encountered, were able to perform work that showed a concern for social justice, human rights and empowerment at the individual’s level. Thus, I argue that hospital social work in the UK is driven by liberal, rather than radical values, and is largely unconcerned with addressing wider issues of structure, social disadvantage and oppression. The hospital social work role involves the co- ordination of knowledge provided by clinical professions, which must then be processed to match the needs of the patient to the services that are available. Social workers are outsiders within the hospital setting and there is a considerable amount of distrust between them and the clinical professionals, which occasionally manifests in open conflict. I draw on Goffman’s dramaturgical insights to analyse how social workers manage their position within the hospital and draw on his theory of frame analysis to understand the way conflicts arise. Hospital social workers maintain a distinct identity within the hospital that is tied to their liberal values. I argue that their practices can be interpreted both as arising from the zeitgeist of liquid modernity and as adapting to the human need brought about by liquid modernity. I suggest that social work must either pursue individual liberation further, following the liberal values currently underpinning these hospital social workers’ practice, or adopt a more radical or critical approach in seeking to influence government policies around social care.
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