The Book That Transformed Social Care

The modern social care system that prioritises independent living, care that is designed to meet the individual needs of a person, allows for residential care or an at-home care provider as appropriate and encourages adaptation to care needs and disabilities is a system that evolved gradually.

However, whilst the late Marjory Warren and the necessity of relying on community care needs in the late 1940s established the early social care system as we know it, the most seismic transformation came as a result of a vitally important 1967 book that at the time was controversial and scandalous.

The book Sans Everything: A Case to Answer by Barbara Robb, was a collection of various accounts of the conditions of long-stay wards in NHS psychiatric hospitals, and was harshly critical of not only the quality of care but the philosophical approach to said care and the institutions that caused it to continue.

Mrs Robb was a psychotherapist and was inspired to write the book and establish AEGIS (Aid for the Elderly in Governmental Institutions) as a pressure group to call for a fundamental change to social care, with solutions that would prioritise community care, independence and respect.

Her accounts, titled Diary of Nobody, were included alongside accounts from nurses and social workers at the time.

The response to the book caused a national scandal, as whilst the press and many relatives of parents at larger long-stay wards endorsed the book, its claims were rejected outright by the Ministry of Health and the government of the time.

Then Minister of Health, Kenneth Robinson publicly criticised the book in what was an unusual measure for him and was strongly rebuked in the press for his remarks at the time and the subsequent white paper inquiry reports.

His successor, Richard Crossman set up what is now the Care Quality Commission and later reforms would lead to a shift away from large institutional care and towards care in the community.

Sadly, AEGIS itself stopped when Mrs Robb was diagnosed with cancer in 1974 but the impact she made was phenomenal and can be seen today in social care.