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Tim Dartington is a social scientist, researcher and consultant who has spent his working life thinking about and working with organizations that deliver our health and social care services. His research is informed by his study of British object relations psychology and group dynamics in organizations as described by Lewin, Trist, Rice, Miller and Jaques. Menzies Lyth's thinking about social defences and Bion's understanding of groups have also been very influential. But he is by no means only a researcher. In 2000 his wife Anna, who worked as a psychotherapist in the Adolescent Department of the Tavistock Clinic, was diagnosed with early onset Alzheimer's and the researcher now became a user. The nightmare illogicalities of the systems he had been studying for years now invaded his home, his marriage and the care that was provided for his wife.
This book has come out of that experience and asks the question how do we look after those who cannot look after themselves, in the context that those who neither die nor get better pose a huge challenge to health and social care systems. This is a challenge which is not well met by the State - a State that promotes different policy objectives for health and social care, separates their budgets and creates incentives in each to move costs from one organization to the other instead of encouraging them to act as partners sharing a common problem.
For the vulnerable in our society much has changed for the better in the last 40 years yet we continue to treat the dependent with scant respect, with the consequence that they frequently find themselves caught between the competing pressures on health and social services; between the hospital with its task of intervening to make the patient better, and the community-based services trying to alleviate the despair that comes with the chronic problems associated with dependency. Dartington in his consultancy work has tried to find a way of facilitating inter-agency cooperation in the man