In-Reply-To: <[log in to unmask]>
Thanks for the responses Gareth & Joe - thought I'd arrived in the wrong
planet there, to judge by the deafening silence (musn't post such a long
peice again, apart from anything else!).

Grateful for the pointers to some P'Care-specific material on the topic.
For my part I'd thoroughly recommend a couple of brief works by Gerry
Smale et al on the Care Management, Empowerment topic. Both published by
the DoH, but interestingly scarcely ever avowed - I wonder why?...I'll
dig out proper refs in the office tomorrow, in case of interest.
re: the information models, systems concerned, I'd be keen to collate
details, contact points etc. An excellent excuse to talk to them again
myself to see how they've been getting on recently. Will post details
asap.

I'm thinking about your response & will write at a bit more length when
thoughts are a bit better ordered. For now:

 Ethical dilemma terribly reminiscent of what SWs went through in the
early 90s with C'Care (and are still embroiled in, methinks).

Though a younger generation now said to be more at ease with the
spreadsheet aspects of it all.

 Meanwhile older community empowerment tradition said to have 'gone
underground'.

  Vivid memory of a 1993 memo to all staff, from our Dir SW, to the
effect that he didn't want SWs to be put in the position of saying no to
clients (who did he think wd do the dastardly deed? - answer came there
none).

  'Advocate' OK for self-image (again, SWs have been/are there too), but
how much is achieved in the mid/longer term without resource transfer? -
oft heard tales of once snooty acute sector folk taking care to be polite
nowadays to primary care practitiioners etc. are all these fisherpeoples'
tales?

 And what about explicit/transparent rationing processes? Are early
not-so-encouraging tales to be put down as preliminary fumblings as with
any radical innovation, or are Oregon-style exercises just 'too
difficult'?

 Apart from anything else, I suspect that the ethical dilemma won't go
away, however unresolvable it seems to be. Don't most of us operate on
mutually incompatible bases a fair part of the time with various parts of
our lives, anyway (sorry, philosophic alarm-buzzer sounds)...

Will try to organise babble a bit better next time!

Peter



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