Abstract
The Australian health care system is experiencing major changes as it struggles to adapt to demographic shifts, technological advances and changing treatment philosophies against a background of fiscal restraints. Current health policies and the planned introduction of casemix funding are supporting the development of a market-driven health care system which is challenging social work in health care to redefine its services. This paper reviews the changes affecting health care and the need for social work to respond in a more creative and competitive way to ensure that the psychological impact of illness on patients and families continues to be recognised and treated.