The relationship between professions and the state and the importance of professionalism as a facilitator of public sector services and societal development have been key issues in the study of professions for many years. More recently, the traditional focus on ‘professions and the state’ has expanded towards the concept of ‘governance’. Governance marks a policy shift from ‘government to governance’ (Rhodes, 1996) and comprises different sets and operational levels, including the provider organizations of public sector and other services and the actors involved (Newman, 2001). While the professions have always been connected to hierarchical forms of governance like state regulation, the era of new public management (NPM) and new governance has expanded these connections towards new actors and novel forms of professionalism, as, for instance, the emergent connections with management and entrepreneurialism illustrate.
Following from Chapter 2 on ‘governance and professions’ in Part I of this Companion, this collection of articles now provides in-depth analyses of the various ways the professions and professionalism are connected to governance and how these connections are currently created, re-created and newly defined. Opening the box of the ‘professions-and-governance’, the first chapter (Viola Burau) in this series of governance research takes a closer look at the embeddedness of the professions in society and their role as policy experts and direct involvement in policymaking processes. The following chapters focus on the different sets of governance, taking into account the operational dimensions of governance and the ‘hybridization’ processes (Tuohy, 2012) as well as ‘governmentality’ (Johnson, 1995) and discourse approaches to professionalism.
New emergent forms of governing often use financial incentives to influence the behaviour of professionals (Ruth McDonald & Crawford Spence). Similarly, elements of entrepreneurialism and market-based logics are increasingly gaining currency in public sector services, including the service, delivery and organization of professional groups (Seppo Poutanen and & Anne Kovalainen). These developments illustrate important changes in the professions and the concept of professionalism. New forms of governing may further the importance of the organization as well as the creation of emergent forms of more integrated professionalism. This seems to be a general trend as observed in different countries and professional groups, while the impact may vary between professional groups and organizational contexts. Consequently, the assumption of fundamentally different ‘logics’ of professionalism (Freidson, 2001) as opposed to other forms of regulation, as well as the view of professions as inevitably driven by self-interest and social closure, are oversimplified and no longer sustainable.
In contrast to the new developments, which show mixed forms of governance and ‘hybridization’ between the professional self-governing tools and managerial and organizational modes, the remaining two chapters in this part address traditional dimensions of professionalism, namely the importance of trust and formalized knowledge. Trust (Patrick Brown & Michael Calnan) is connected to professionalism in complex ways and ‘embodied’ by a certain type of professional, such as doctors or nurses. Citizens’ trust in the professions and their services comes on the back of more general trust in public policy and functioning in society and, consequently, blatant bureaucratic control does not work as it provokes mistrust in the professional services. Finally, knowledge as the ‘currency of competition’ (Abbott, 1988) of the professions is the fundament of ‘modernity’ and the establishment of ‘knowledge societies’ which enables decision-making procedures based on formalized knowledge, standardization and scientific evidence (see Chapter 10, by Theresa Carvalho & Rui Santiago). The ‘making’ of knowledge and its bonding to the professions is therefore embedded in new governance models, including, for instance, performance management, evaluations and target-setting based on scientific evidence.
Taken together, the chapters in Part II provide a snapshot of contemporary developments in the professions and reveal how these developments intersect with governance changes. The chapters and the related case studies tell their own stories and use different methodological and empirical approaches and tools, but they all reveal a common trend. The authors illustrate an overall growing relevance of more integrative forms of professionalism and new professional roles and areas of expertise in public sector services and society. This, in turn, calls for theoretical approaches and empirical research that are sensitive to contexts and capable of understanding professions and governance as dynamic, intersecting and malleable relationships.
References
Abbott, A. (1988) The System of Professions. Chicago, IL: Chicago University Press.
Freidson, E. (2001) Professionalism: The Third Logic. Oxford: Polity Press.
Johnson, T. (1995) Governmentality and the institutionalization of expertise, in T. Johnson, G. Larkin & M. Saks (eds), Health Professions and the State in Europe. London: Routledge, pp. 2–14.
Newman, J. (2001) Modernising Governance. Bristol, UK: Policy Press.
Rhodes, R. A. W. (1996) The New Governance: Governing without government. Political Studies, XLIV, 652–667.
Tuohy, C. H. (2012) Reform and the politics of hybridization in mature health care states. Journal of Health Politics, Policy and Law, 37(4), 611–632.