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Vol. 31 No. 11 · 11 June 2009
Diary

On Being a Social Worker

Hilary Mantel

Let us call her Ruby, because she had a name like that: old-fashioned, staid, anomalous. ‘I am known everywhere as sparrer,’ she said. We had sparrows enough and to spare in those days, but I couldn’t think of her as a cheery little bird. She was 16, with the face of a skull. She wrapped bony limbs around herself, bending stiff joints; she was always cold. She looked like a victim of anorexia nervosa, but in fact she had pulmonary tuberculosis, and for the next long weeks, possibly months, she was confined to hospital. Ruby was no daughter of the developing world. She lived on a council estate in Stockport, which didn’t in 1974 seem to be developing; dominated by a massive railway viaduct, the town had steep streets connected by flights of steps, red brick buildings glued together by soot, and a handsome wedding-cake town hall, which I passed every day as I headed uphill from the bus station in Mersey Square.

My place of work was a geriatric hospital, so it was only tangentially that I came into contact with Ruby. I was a social work assistant, paid a very small sum by the NHS and meant to be learning on the job, pending some formal traineeship that never in fact materialised. No one knew what I was for or how I should spend my days. Sometimes the real social workers took me out with them to other hospitals in the group: the Home for Incurables, for instance, or the busy, modern general hospital where I once saw a young doctor looking at X-ray plates upside down. On quiet days I read through stacks of clinical files, getting a purchase on arcane abbreviations and summary prognoses. On foot or by bus I visited the streets and towns around, to report on the home conditions of families desperate for admission or respite care for a demented relative. I wrote them up as desperate, while knowing that desperation would be sifted by degree; how many loads of soiled bedding does it take before a daughter and her washing machine break down? These families were locked in misery, racked by guilt, physically exhausted and often financially broken. Sometimes, the cared-for would hit their carers. Often, they didn’t recognise them, or mistook them for their own parents, or for old enemies, or for playground bullies they had faced as children. There weren’t nearly enough beds for the people who needed nursing, and the hospital offered no more than a vault, a pre-tomb or dying room, in which patients sometimes loitered for months. The hospital was reluctant to give its beds away, because almost no one went home again.

My days passed in a ferment of anger and indignation. I thought scarce resources were the problem, that old people were low-priority, and I thought – there was something in this – that they got the worst doctors. I was getting a crash course in what age can do to the body and brain. Through writing them down repeatedly, I became familiar with some of the worst phrases in the English language: you can’t beat ‘terminal’, but a close second is ‘immobile, disorientated and doubly incontinent’. Sometimes, back at the hospital, I sat on the wards and held patients’ hands, chatting with whatever self they were that day. It seemed as good a use of my time as any. Our hospital had once been a workhouse and some patients still thought it was. It was an easy place in which to lose the will to live. About once a fortnight I would get away after lunch, and take a longer bus ride than usual. Leaving the main road, I would plunge down a long rural path to a deep wooded valley. It sheltered a small chest hospital, built in the 1920s as a sanatorium for the care of TB patients in times when the condition was intractable.

My patient there, Mr M, was not yet 70. But in those days, and in the industrial north, 70 was old. He had a complex of diseases, none good enough to kill him; he hacked, gasped, wheezed, and re-lit a cigarette. The hospital rooms had half-doors, and the upper halves could be folded back, so the patients were like horses in stalls. There were deep verandas where, in former times, TB patients lay wrapped in blankets on wheeled pallets, breathing in the mild air. Sitting in a wheelchair on one of these verandas, Mr M told me he had one relative living, his sister Mrs B, older than himself and a long-time widow. She would visit, he said, if somebody would find her and bring her.

I found Mrs B near the town centre on a short street of condemned houses. I think she was the only person left living there; the ground opposite was vacant except for the foundations of demolished houses, and in the long while I stood on her doorstep I never saw another soul. When she opened the door at last she did not wait to see who I was. She collapsed against the wall. I stepped in. I thought she was frightened because she was huddled into her clothes. I didn’t at first realise that she was crying. She cried silently. Her tears fell so fast that her face seemed to be changing shape, as if wax were melting. Her whole body seeped tears, tears seemed to run through her skin. It took her a long time to form words. Her trouble, she said: a broken window. Also, fleas. Also, rats. Her real trouble, a child could have seen, was her total and self-annihilating loneliness. She could hardly remember how to speak. I had never imagined that, unless by brain damage or in some cruel experiment, a human personality could be so nearly erased.

Hurrying back to the office, I met the district nurse, who said she’d call on Mrs B first thing next day; this woman always did what she promised, unlike almost everyone else I encountered in my job. Later that week, with Mrs B removed to an emergency psychiatric bed, and her door key in my pocket, I went around to her house to rendezvous with the town hall pest man. He was a civil chap in a tweed jacket, turning up ‘just for a look-see’, he said; no space suits, no masks, just a man who knew his rodents. He put on bicycle clips before he went into the house. He rapidly ducked out again; ‘now they’ll be jumping,’ he said of the fleas. When I next saw Mrs B, she was in the dining-room at our day hospital. She’d had a perm and ECT, and was getting her dinner down her. Only part of this was the result I had intended. She held her cutlery in suspension, gave me a gummy smile. I was surprised she recognised me. Impossible to say if it was human company or an electric current through the head that had jolted her back into personhood. Depression doesn’t usually lift so fast. It was already a liberal axiom that ECT was barbarous. And I proceeded by liberal axioms. Mrs B’s case worried me for years.

When I visited the chest hospital to tell Mr M that we’d found his sister, one of the nurses took me in to see Ruby. She was the only young creature in the hospital, and as lonely in her way as Mrs B, her days stretching out before her and nothing to see but trees. She was going to get better, but it would be a long job, and her family had never been near her. ‘Will you ask me mam to come and see us?’ I caught up with her mam a day or two later, on a council estate a couple of miles from the town centre. Running in and out of the house, which was barely furnished, was a tribe of dirty little children, whom mam regarded with a practised indifference; she stood in her front room, door open to the street, fag in hand, hair wild and wiry, bare legs blue. ‘I were in there six months with TB,’ she said, ‘when I were Ruby’s age. And my mam never came to see me.’ I went back to Ruby and found I couldn’t repeat this answer. Being untrained, I acted just like a natural human being; I was evasive. ‘She won’t come, will she?’ Ruby knew the score. Mam’s boyfriend, she said, was hitting the younger children.

The previous year, a child of seven called Maria Colwell had been beaten and kicked to death by her mother’s live-in lover. She had been returned to her parents from foster care, and been checked out by social workers, the NSPCC, a doctor, an education welfare officer and a housing official. Neighbours reported that they had seen her, looking skeletal, one eye a pool of blood; sometimes she foraged in bins for food. On a January night she was loaded into a pram and pushed to a hospital by her mother and stepfather; she was dead on arrival. In court, the couple blamed each other. The stepfather was sentenced to eight years, halved on appeal. The official report blamed bad decisions by undertrained staff and poor communication between agencies. ‘It must never happen again,’ was the decree.

In the wake of the Baby P case, and all the slaughters between, it is easy to see this formulation as an empty piety. People meant it at the time; but it was like saying ‘God have mercy on us,’ and expecting an immediate result. When Ruby made her allegations, public outrage over Maria Colwell was still fresh. Back at the hospital, I reported to my senior. ‘Go and see social services,’ she said. I went round to the area office. Young women, sinewy and tense, scuttled from desk to desk with scraps of paper. Phones rang constantly. Everyone was frowning, harried, abrupt. The duty officer had trouble taking in what I was saying. I had to explain to her who I was, and how I had come across Ruby, and that TB was a disease of poverty, not of poets. She thought it was a thing you only got in books.

Who’d be a social worker, anyway? The problem was the same then as now. Communal expectation was riven by contradiction. You were a busybody and a do-gooder, interfering in private life; or you were a useless, gormless, uncaring drain on the public purse. Whichever role you were cast in you had to get on with the job. My next stop was the community worker: Ruby’s estate was such a trouble spot that it needed its own staff. He was a jaunty young man, and he balled his fists in his pockets as he told me he knew the stepfather: ‘Nah, he’s all right.’ Shrugging, he made it clear that he intended to do precisely nothing. And there was nothing more I could do. I’d liaised with the ‘appropriate agencies’. I’d told my seniors. Ruby’s allegations were not so particular that I could go to the police, and she was in no state to be badgered for specifics. She complained of a climate of violence, not one discrete incident. Even if they were willing to investigate, a police visit with no follow-through might make things worse. Certainly, I’d never get into the house again.

What sort of judgment was the community social worker making when he swore the stepfather was a nice feller? Was he frightened of the man? That was possible; but more likely he wanted to be his mate. The young social workers of the time, coming up through university courses – postgraduate training after a sociology degree – thought it a sin to be judgmental. In fact they were making judgments all the time. Uneasy about their own middle-class backgrounds, and always feeling vaguely uncool, they believed they should not ‘label’ clients or assess ‘working-class’ people by their own middle-class criteria; so they treated them as if they were dogs and cats, not responsible for their actions. They had a whole set of interesting beliefs about the uneducated and the poor. They didn’t see that they were being grossly condescending, while pretending to be the opposite. Aspiration was a middle-class trait, they thought; the working classes preferred to muddle along. The privileged had their ethical standards, but it was unfair to universalise them. The workers had their own amusements, bless them, and should be allowed their vices. Their houses were dirty, but it was petty bourgeois to worry about grime. And if they were drunken or semi-criminal, and beat each other, wasn’t that their culture? These young graduates took as typical the malfunctioning families with whom their case files brought them into contact. Worse, they wanted their clients to like them. They dressed in recidivist chic and roughed up their accents. Their heads were full of Durkheim, their mouths full of glottal stops. They were occupied in creating a moral vacuum; theirs was a world safe for theory but profoundly unsafe for any child who needed them to shape up and go to work.

I wrote down the details of Ruby’s case and put it in the files. Soon after, I left my job. The chest hospital closed its doors in 1982 and, the National Archives says, ‘no records are known to survive.’ I don’t know the end of the story. There never is an end, just a weary iteration of abuse, the kicks passed down the line from one generation to the next. When all is said about social work – the defective procedures, the ill-defined aims, the simple lack of conscientiousness and common sense – we may in child protection be up against something ancient and ineradicable in human nature: the belief that, if I have suffered, someone else must suffer, that two wrongs make a right. ‘I was in there six months, and my mam never came to see me.’ Ruby’s mother, angry at the way her mother had treated her, displaced the anger onto her own children, punishing them for the way she had been punished, neglecting them as she had been neglected. When her elders slapped Ruby’s mam, as I’m sure they did, you can bet they yelled at her: ‘It never did me any harm.’

After the Colwell inquiry, the structures and procedures of child protection work were reformed. I fear the personnel weren’t reformed, though I have no doubt their anxiety levels shot up, and their case-loads increased year by year, and public abuse became harder to bear. In the case of Baby P, who was killed in August 2007, it emerged that the mother had a complex of childhood problems. Her boyfriend had an IQ of about 60, and had practised hurting animals before killing the baby. Maybe it’s time to stop being sentimental about the family; Baby P’s carers were on a ‘mellow parenting programme’ when it’s clear they should have been in the dock. On the day they were sentenced, BBC News 24 showed an outline diagram of a notional infant, with pointers to show where this particular child was injured: here a gash, here a bruise, here a broken bone. Meanwhile, in later bulletins, the row about parliamentary expenses rumbled on. For years, it seems, our legislators have been gleefully hacking at the body politic. The more thoughtful person doesn’t usually agree with the things the spontaneous shout in the street, and still less with the vengeful vox pop outside courtrooms. But on the ten o’clock news that night there was a woman, young, blonde, bawling, who seemed to have a point. Out of her mouth issued not a rallying cry for procedural innovation, nor a demand for inter-agency co-operation, nor a plea for more resources, but just a furious, helpless roar: ‘Shame on this country! Shame on England!’

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