The study aimed to investigate how working conditions, intention to leave and self-rated health among Swedish social workers in child welfare have developed over the course of fifteen years. In 2003 (n = 309), 2014 (n = 313) and 2018 (n = 305), the same questionnaire was distributed to social workers who were working with the same tasks in the same geographical areas. The results show that the social workers in 2018 overall rate their working conditions as better than they did in 2014, and in most respects also better than in 2003. The most salient improvements are that work demands in 2018 are described as significantly lower than in earlier years, and organisational climate, group work and support from their superior and co-workers are seen more positively. Despite these positive developments, the changes in how the social workers rate their health and to what extent they intend to leave the workplace were minor. Also, how the social workers rated positive challenges in work and the extent to which they perceived their work as meaningful or felt that their skills and knowledge often were useful in their work had deteriorated. Possible factors as the influence of New Public Management and increased use of manuals and forms are discussed. This article discusses the slightly confusing results from a follow-up study among social workers in child welfare on how their working conditions have developed over the course of fifteen years. Questionnaires on how the social workers perceive their work and their working conditions were collected in 2003, 2014 and 2018 in the same geographical areas. At the same time as the social workers in 2018 described their working conditions as better than in the earlier years, with lower demands and better organisational conditions, they did not rate their health significantly better, and almost as many of them as earlier still intended to leave the workplace and had thought of changing professions. One of the few aspects of the working conditions which the social workers were less satisfied with compared to earlier was the extent to which they perceived their work as positively challenging and meaningful. Possible factors behind the results are discussed.