WORK IN PROGRESS

Any papers described or included here are drafts, incomplete or due for revision or development.
Please do not use or quote without permission and acknowledgement. But do comment if you wish:
tim.dartington@btopenworld.com

See: http://politics-of-identity.blogspot.com

I am currently working on:

1. health and social care

‘We see a continuing struggle to make and maintain distinctions between health and social care, for example in their financing. At the same time there is a wish to integrate these services. We continue to suffer from the issues of splitting between services which are interventionist, short-term, results focused, and services which take a more ‘depressive position’ approach to morbidity and physical and mental dependency.’

I am exploring this proposition with examples from consultancy and personal experience, with particular reference to Kleinian propositions to do with ps-d dynamics in working relations within and between agencies working with vulnerable people.

The management challenge in this import-export business of health and social care has also now to provide for the dependency needs of staff in the context of a can-do management environment looking for short-term outcomes.

Managers, distanced but not out of touch with their previous clinical identities, may be very uncomfortable to find that they are thinking in this way. And yet the underlying realities of virtual institutionalisation or ‘social death’ continue to affect the implementation of policy.
In the integration of health and social care, there has to be respect for difference. Otherwise a part of the reality is always going to be obscured.

What can we do to relieve the pressure that everyone experiences and to allow for the expression of caring and therapeutic skills? Without time to build a necessary trust, individuals look to their own needs and cannot easily function together. Reorganisations often seem to drive professional groups into competition with each other, by forcing them into an intimacy for which they are not yet ready, rather than the co-operation that is necessary for survival and to keep the whole person in mind in providing services.

Negotiating Partnerships – some reflections of our fear of the vulnerable in health and social care

Skirmishes in the war between human nature and organisational change

The integration of health and social care - OPUS conference paper 2006

Showing respect for dependency - a Tavistock approach

2. living and working with dementia

The costs of social care

For a day to day account of living with dementia see:
http://dementiathoughts.blogspot.com

3. group relations

On Directing Leicester – OPUS conference paper 2003


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