The Chronic Disease Self-management Programme (CDSMP) is a psycho-educational programme designed to increase the capacity of people with chronic conditions to self-manage. This initiative forms an integral part of the 'Expert Patient Programme' in the UK and the 'Sharing Health Care' programme in Australia. The aim of this paper is to critically appraise the principles of the CDSMP as a national self-care policy initiative in the context of existing formations and ideological approaches to self-care. Although the CDSMP appears to promote a 'social model' of disability, particularly in its generic manifestation, the use of the notion of self-efficacy as a primary marker of change means that it ultimately falls back onto an individualistic approach. The latter ignores pre-existing traditions of self-help embedded within advanced welfare societies.. We argue that state sponsored polices about self-management would benefit from greater recognition of existing social knowledge and theories about how people respond to being diagnosed with a long-term condition.