May, T. and M. Buck (1998)
'Power, Professionalism and Organisational
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Received: 19/2/98 Accepted: 12/6/98 Published: 30/6/98
Dramatic changes in the realms of geopolitics, consumer and financial markets, technology, government policy and legislation, macro- economic stability and capital flows, corporate organizational forms and practices, and the politics of the environment are only some of the factors which continue to transform the world (Kiernan quoted in Greenwood and Lachman, 1997: p. 564).
The only remedy is for production to be private and, simultaneously, for any residual monopoly power to be broken up, and protection to be removed; in short, simultaneous privatization and competition (Minford, 1991: p. 73).
because the purchasing power of consumers under these new arrangements is not expressed in terms of cash, but in the form of an ear-marked sum which can only be used for the purchase of a particular service (e.g. the budgets of fund-holding GPs) (Butcher, 1995: p. 116).
an improvement in information gathering systems and a more vigorous approach to management which is likely to require a clear distinction to be made between the purchasing and providing functions within a local authority (quoted in Means and Smith, 1994: p. 126).
Separation of purchaser/commissioner and provider functions at the local level. This model involves a series of separate purchaser/commissioner and provider teams operating under a combined management structure at the areas level... Care management teams would take new referrals, assess need and put together packages of care, taking account of resource limitations. They would purchase appropriate care packages from in-house providers or independent suppliers (Means and Smith, 1994: p. 127).
that the government's prime concern was to hold public spending and if possible reduce it. That did not feature as such in the guidance, but the need to make the most of the infusion of new money into local authorities' budgets did (Lewis and Glennerster, 1996: p. 12).
the replacement of the existing bureaucratic hierarchy with one dedicated to 'process'. Instead of being a comfortable reward for past efforts, management posts and their occupants should be continuously reassessed in terms of fulfilment of targets and achievement of strategic objectives (Langan and Clarke, 1994: pp. 79 - 80).
the consumer...can exert pressure on providers to improve the quality of services...Performance indicators monitor the progress and compare the performance of different delivery agencies. League tables enable the users of service to compare the performance of competing delivery agencies (Butcher, 1995: p. 158).
Autonomous professionalism was never a serious possibility for social workers, partly because of the drive towards state managerialism, but also because of limited market opportunities. What in fact emerged was a hybrid form of organization for social services which was reflected in the Seebohm report and incorporated in the reform of local government in 1974. This form we have called bureau-professionalism (Parry and Parry, 1979: p. 47).
expert power and control is an unstable and contestable outcome of the interaction between social constructions and structural constraints as they respond to the dynamics of economic, technological and cultural changes within advanced capitalist economies (Reed, 1997: p. 574).
A way of tailoring help to meet individual assessed need by placing the responsibility for co-ordinating and evaluating the services they receive with one person ('Glossary of Definitions', April 1992: p. 10).
I don't see myself as a care manager, I see myself as a social worker. Whenever I write letters I always sign myself as 'X, Social Worker', not Care Manager.
you are generally the best person to do the work, because you're the person that's seen the child, done the investigation of the crisis and you're the person that the child's really...got a lot of trust in. So the idea of care management, that you do assessment and the care plan and write it up for other people to do the work isn't what happens and it's a lie really because it's not what goes on.
It worries me really because anybody can pick up the phone, I mean I've got colleagues in my office who are unqualified and they can pick up the phone to another professional and say 'I'm so and so's care manager' and obviously the person the other end doesn't know their status and that worries me somewhat. Obviously with the more complex pieces of work, not that my colleagues are... unable or what have you, it's just that we're all lumped together and I feel that our qualification as a professional is being undermined by this new care management umbrella.
I feel more de-skilled as each month goes past. The skills that I have is direct work with children and families...and I'm really being asked to be a business manager more and more.
To assume the full range of managerial responsibilities to ensure the needs of clients are assessed effectively and that the care of those clients is secured, delivered and maintained in a way which balances the need for cost effectiveness with care packages most beneficial to clients, within available resources (finance and people) (Establishing Care Management - Phase 2. 10/3/93).
Contribute to professional practice excellence through the provision of casework monitoring, consultation and development (Establishing Care Management - Phase 2. 10/3/93).
I think the newer managers are...just better in tune with care management and all the rest of it, but they seem much more on the ball you know, the paperwork has to be, you know, really tight. They are really working to the book, because I suppose I come from a team where things were flexible, you know 'get the people seen' you know, 'catch up on that later'. I think the emphasis has changed and I think a lot of workers have found that quite hard to adjust to.
I think they're (the new Team Managers) being encouraged to be apart and to get all their information from the practice supervisor as opposed to being a presence ... it's put a block on communication.
I've very little confidence in consultation or sharing, it's all about 'you will do'. The last example is the cost cutting exercise we've had...Senior Management Group (SMG) has seen it as a success because there's been no compulsory redundancies, but it's devastating to us - we've lost a Team Manager, we've lost a massive amount of support, we're having to chase around for Team Managers that are all over the place. They must be run ragged and it makes you quite wary of your own practice 'cos in some cases you need a bit of support now and then and that's not there any more...I think for SMG (Senior Management Group) the cost cutting exercise was seen as an end in itself, but that was a beginning for us...all that makes you feel you're not coping with the work any more.
There's a new layer (practice supervisors) and the new layer is personified by X who is business like in her approach, so the personal support and clinical supervision I felt I benefited by from Y (old supervisor) has been lost.
It worries me if I've got lots of visits on a Friday afternoon because I know there's no way I can get the paperwork done 'til Monday, and then if a crisis happens on Monday, you're looking at Tuesday or Wednesday. So I try to plan my day so that I do all my visits in the morning so that I come back and do all my paperwork in the afternoon. But if you've got more than three or four visits then you're snookered, that's in a day, because you just can't cope with the amount of paperwork you have to do for those visits and the phone calls coming in and crises happening and what have you.
We are expected to negotiate (prices) and we are being sent on a negotiating course. It's like going into Marks and Spencer's for something that costs five pounds...'well, I'll give you three!'...and of course, what you do, you beat down the price. So, okay, there you are, you're a skilled negotiator, you've been on a course, you've beaten them down. What sort of service are they now offering the clients?
I can understand why we've got limited budgets. I mean yes...we can't be all things to all people, but it seems to me that if you're setting up procedures which say this is the tack that we should go down, if you know damn well that you're restrained by budgets you're leading people into false aspirations and false hope.
We used to sort of manipulate people into a category A position so they can receive a service. A lot of it depends on how you view a category A client. I mean we very much take into account the carer's perspective and the way of looking at it that if you didn't provide respite for this client then the situation would break down and then there wouldn't be a carer and then the client would be a category A. We looked at the thing very broadly to try and get people the services whereas other districts worked a lot tighter...I think that again depends on your Team Manager.
I think in terms of social work it started to become quite restrictive because initially you could be so creative, do all these wonderful care packages that we were all supposed to be doing, and then suddenly, the reins came in and choice and creativity went out the window.
You don't talk to your colleagues any more, you communicate through forms. There's a hierarchy that's built up and growing, it feels like there's a massive weight, it's getting harder and harder to get to people, okay, individual departments in here are creating their own boundaries...' this is what we do and what we don't do'. You don't know what the hell they are, so you're having to double guess all the time. You've got agencies out there which are far more governed by grants...it's incredibly difficult now to try to tap in and try to refer people on. What's your responsibility then? You just stop your bit and pass it on, it's a minefield, it really is, it's just an absolute mess.
the replacement of the existing bureaucratic hierarchy with one dedicated to 'process'. Instead of being a comfortable reward for past efforts, management posts and their occupants should be continuously reassessed in terms of fulfilment of targets and achievement of strategic objectives (Langan and Clarke, 1994: p. 79 - 80).
professionals, whilst attending to technological aspects of their work, typically ignore the wider social issues. In this respect they are vulnerable to deskilling and erosion of control over their work (Shaw, 1987: p. 775).
What makes power hold good, what makes it accepted, is simply the fact that it doesn't only weigh on us as a force that says no, but that it traverses and produces things, it induces pleasure, forms knowledge, produces discourse (Foucault, 1980: p. 119).
if the fight is directed against power, then all those on whom power is exercised to their detriment, all who find it intolerable, can begin to struggle on their own terrain and on the basis of their proper activity (or passivity) (Foucault, 1989: p. 81).
2 This group will be defined as 'front-line workers' because they are in daily contact with the people for whom the organisation is meant to serve (see Lipsky, 1980; May, 1991a).
3 For example, Mary Richmond's (1917) book 'Social Diagnosis', originally published in 1917, was reprinted 16 times up to 1964.
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