What readings would you recommend on the history of women’s work, especially those rare relatively high-status occupations and professions typically seen as female ones?
In my research on paying the hospital before the NHS and the meaning of a ‘free’ health service in Britain since the 1940s, one figure keeps attracting my attention. The Lady Almoner was the name by which hospital social workers were known from the time the first was appointed in 1895 until they officially changed their name to medical social workers in 1964.
She (and the almoner was almost always a woman, in contrast to the typically male inquiry officer that preceded her) was a social case worker, who provided the link between care in the hospital and support for life outside. She was a crucial figure in the integration of neighbouring institutions in an age of minimal government oversight or interference in healthcare. She operated at the hub of the era’s mixed economy of welfare, navigating patients through the myriad public agencies, charitable and church relief and mutual aid organisations to whom the poor would turn in times of need before the welfare state. She was also the assessor who sought to set a fair price for receiving treatment in the pre-NHS hospitals.
The almoner was, therefore, an important even if incidental figure in the social history of early twentieth-century British life. She shaped much of the material reality of managing the return from hospital to home, from sickness to health. Yet she has been largely forgotten. The records of her department were rarely amongst those prized for posterity, and the archive is generally silent on her role in the hospital. And as a consequence, she has mostly featured only in passing in the social history of the hospital.
This is something I hope to change when my book comes out early next year. That book examines the workings and meanings of payment in the short period of only three decades (1920s-1940s) when it was the norm for patients to pay the hospital in Britain. Given her formative role in establishing and administering those payment schemes, the almoner features heavily. Yet in the book, the almoner features as a means to an end – that is, understanding what it meant to pay the hospital before the advent of socialised medicine.
The almoner deserves attention as a subject in her own right. I blogged before about the plans I had for a major research project on the rise of the almoner profession, but, as with so many painstakingly crafted ideas in academia, that fell by the wayside when I was unable to either get that project funded or secure a permanent position that would allow me to research it regardless. But she’s cropped up again in my new research, as I move forward to focus on the National Health Service that stripped the almoner of her financial duties. So I’m remoulding some of my earlier work to sit alongside new material on the almoner’s shifting professional identity within the NHS.
I’m not short of material on the almoner, but the next phase is to properly contexutalise this as a distinctly female profession. Profession is the right word. Before long, a two-year university course followed by a series of metropolitan and provincial hospital placements, covering voluntary and public, general and specialist hospitals were required for even junior appointments. This practical and academic training was rewarded with good salaries, often £200 or £300 per year in the 1930s, a level feminist campaigner Ray Strachey described as “quite an achievement, even for a highly qualified woman with years of experience”. Almoners had salaries lower than those national pay scales guaranteed for female teachers, but they were higher than most social workers’ and their starting salaries were three times higher than those of nurses, marking theirs out as an occupation for the educated middle classes. And, unlike the far-better-paid first women moving into senior posts in the Civil Service, theirs was unmistakeably women’s work. Their authority rested on their ability to bring an otherwise absent understanding of the social and domestic life of the patient to decisions about their treatment and planned recovery, as well as what the patient could afford to contribute financially to provide for those that would follow them into the wards.
So here is where I ask my question to the hivemind of the History blogosphere. I know my almoners pretty well, but I want to understand them in context. I want to know more about the history (in modern Britain, or perhaps elsewhere) of women’s work and of distinctly female occupations, of women in the professions and the formation of professional identities. What do you consider the best works in this field?