1. Care manager: rhetoric or reality

When Griffiths presented his report ‘Community Care Agenda for Action’ to the Secretary of State, directors of social services heaved sighs of relief as it appeared to be some kind of confirmation that those of us responsible for delivery of a complex range of services were in reality performing an impossible set of tasks. Griffiths lent support to our view that we were being asked ‘to make bricks without straw’. Perhaps the euphoria that followed our gleeful approval of Griffiths’ recommendations addled our collective brain. Critical analysis of our capacity to manage and deliver a range of services ‘à la Griffiths’ and, in particular, the role of the care manager has not received the critical analysis that is essential if we are to have any chance of providing the services that Griffiths appears to envisage. It is important to remember that Griffiths was not asked to define the range, quality or quantity of services, or to comment on the sufficiency of resources, and although he does identify problem areas relating to manpower and levels of skill, and the need for training and development, these are ill-defined. In short, Griffiths, in relation to the management and organisation of services, raised more questions than answers and it is time that our views were clarified and articulated on a range of organisational and managerial issues which I believe, up to now, have been dealt with superficially or taken for granted. The issues are complex but nevertheless can be reduced to one single question. Have we the capacity to deliver? I wish to examine this with particular reference to the role of the care manager, for this role