Writer, foster carer and adopter, Petrina Banfield, was so captivated by the case files kept by hospital almoners in the 1920s – and their link to modern fostering - that she wrote a book about their work.
When I first set out to piece together my father’s family tree, I had no idea that the project would lead me to unearthing a treasure trove of case papers about fostering and adoption in years gone by.
I had been fostering since 2007, but I had little knowledge about what happened years ago, before the ‘boarding out’ of children was officially regulated, and pre-1926, when legislation for adoption in England and Wales first emerged. I knew that informal fostering and adoption was likely as old as humankind itself, with friends, relatives and neighbours stepping in to take care of ‘friendless’ children. I also knew that the Church and Salvation Army played a major role in matching children with willing carers, alongside adoption societies and child rescue organisations. However, it was in the reading room of the London Metropolitan Archives that I began to learn more about the role of hospital almoners (the forerunners to modern social workers) in the arena of child protection.
My father had grown up in care in the 1940s, and with a war going on and children’s homes being commandeered for listening and command centres, there was little chance for anyone to pay much attention to life story work. As a youngster he was moved from one care home to another and separated from his identical twin in the process, his few belongings, wrapped in brown paper and tied up with string, tucked under his arm. My dad has none of the little memory box trinkets from childhood that most of us take for granted; ticket stubs, a first tooth, seashells from a long summers day at the beach. He doesn’t even have a single photograph of himself before the age of sixteen.
I knew that he had been admitted to a London hospital for a prolonged period towards the end of the Second World War, so I requested the files for the London hospitals and began my search there. As I flicked through the old case files, the reports written by the hospital almoners of The Royal Free Hospital in London caught my eye.
The role of hospital almoners
The almoners were originally employed by the voluntary London hospitals from around the turn of the twentieth century, to bring order to the chaotic outpatient departments by weeding out those patients who were in a position to pay for their own medical treatment. Since the task of financially assessing patients took the almoners out in the community, their role gradually evolved into that of a social worker.
Joining the charge for social reform, these women (men were sometimes employed in the early days, but apparently couldn’t cope with the emotional demands of the work!) refused to condemn those who strayed outside social norms, concentrating their energies instead on supporting them and sourcing charitable relief. I read about young girls, ‘very young, not more than 16 or 17 years old’, who had ‘fallen into trouble’ as a result of living in conditions that were ‘past belief... involving very grave and unusual risks of infection’. I learned that it wasn’t unusual for babies to be delivered to the London voluntary hospitals by panicked and desperate birth parents, who never returned to pick them up. Quite often it was the ward sisters, doctors or the almoners who arranged for a child to be rehomed.
The almoners also arranged for children to be boarded out to assist overstretched families, or those with no wider family network who needed temporary help to allow them to access medical treatment. ‘Sometimes the almoner is called on to... find a suitable home into which young children can be temporarily admitted or find a foster mother for the baby either herself or through an outside agency, and probably raise the funds to pay for this’, according to The Hospital Almoner; A Brief Study of Hospital Social Science in Great Britain, 1910. ‘Her aim, in addition to arranging that the children shall be satisfactorily looked after, is to secure as far as possible mental peace for the patient, for worry is a bad bedfellow’.
A reference book for almoners written in 1895, How to Help Cases of Distress, recorded the case of ‘a poor widow’ who was gravely ill and needed a lengthened stay in hospital. ‘She did not know how she would manage it, as her eldest boy was only fifteen and was out all day, and the other children were too young to be left alone.
'She was very much respected by all who knew her and her life depended on going into hospital at once... Great efforts were made and two children were placed in orphanages. The eldest girl was boarded out [and] the baby was boarded out with a woman who bestowed on it all the care and attention that could be desired.
'The mother was most grateful for what had been done. She has since come out of hospital... though still not strong, she has a light place, and is contributing 2s.6d. a week towards the support of her baby'.
The scandal of baby farming
Sadly, not all "foster mothers" were as attentive, and a series of baby-farming scandals – where foster mothers accepted lump sums to care for a child and then either drowned them in dolly tubs in their back yards or stuck them in the attic to wither away so that another paying customer could take their place – led to the emergence of the first act of parliament concerned with the prevention of cruelty to children – the Children’s Charter of 1889.
The Children Act requiring the registration of foster carers followed in 1908, and the regulations that followed became the backbone of the care system we see today. The almoners continued to support families and youngsters in foster care throughout the first half of the twentieth century. It was delicate, challenging work that will resonate with anyone in the field of social work today.
Letters from Alice by Petrina Banfield, published by HarperCollins, in August 2018.