Discussion on the public sector professions at Middlesex University

We have just held a symposium on how the university can respond to changes to the public sector professions that come as a result of government policy and professionalising moves. Here is my introduction to the event.

1 Introduction

The ‘semi-professions’ have long been the subject of research, at least from the late 1960s when Amitai Etzioni published the eponymous landmark collection of work on nurses, teachers and social workers. As part of the sociology of the professions the interest of the contributors was in their status, autonomy and organizational power compared to the more established professions of medicine and law.

2 Government policy

However these professions are interesting for other reasons: because as public sector professions they deliver public services, on behalf of the government you could say – or on behalf of society as a whole. This immediately opens them to significant government attention in three main ways.
i) from the point of view of their costs, particularly in times of financial stringency when public sector spending comes in for particular attention
ii) reputational issues as the government of the day needs to respond to and be seen to respond to various scandals, e.g. the death of babies at the hands of their parents, a rise real or imagined—in hospital acquired infections
iii) how different governments envisage the role of the state and its agents e.g. governments of the right and left tend to have different approaches to state provision. Right wing governments have been more impatient with welfare provision and history shows their often combative approach to dealing with the professions in question.

So how is this relevant to universities, to us as a School? I think for two main reasons:

i) because much government attention to these professionals concerns the training of these groups: sometimes it is simply the increasing and decreasing numbers commissioned for training we need to respond to but often it is much more complex changes to how training is commissioned and delivered and regulated, crucially. This can involve the introduction of different workforce models, different training models like apprenticeships (and some professions have been trying for the last 30 years to distance themselves from the apprenticeship model) and the introduction of different grades of worker, or skill mix, to use a term common in the NHS of the 1990s. Training, or should I say education, and at high level, has been one of the hallmarks of the professions. So these aspiring professions have worked hard to improve their status by raising the level of preparation for entry. This is part of their professionalizing project. And, of course—this is so obvious that we fail to notice it—most of those who educate entrants to these professions are themselves members of the professions and so likely to be committed to this professionalizing project.

So this is an imperative for us – unless we decide to walk away from this area of work altogether and for a university like ours, a collection of former vocationally orientated colleges this is unlikely.
ii) secondly, and this goes to the heart of why we are here today, one role and responsibility that universities have traditionally taken up in society is as commentator, critic sometimes, of government policy, as well as contributing to shaping that policy. This contributing can be either relatively directly by membership of formal groups though all policy influence from what we might call ‘science’ is indirect; or by contributing to public discourse around these important matters: by raising questions like ‘how can a society deliver law enforcement most effectively or social care, or education for children?’, ‘what is the impact of changes in hospital skill mix on patient outcomes?’ This is where research comes in. Good research is a powerful necessity, part of society’s checks and balances with governments who relentlessly and unsurprisingly promote the decisions they have made or want to make and typically don’t consult with the professions involved – or do so in an unrealistic way. However, having said that, we shouldn’t overestimate the influence of research on government activity. The pressure of the press, of public opinion and ideology are probably more powerful motivators of government policy. The policy analysis of the evidence about the link between smoking and tobacco control policy or about HIV health education are well-known examples from UK policy research. Nevertheless, the research is needed, of course.
So, in a nutshell this symposium is an attempt to bring together two major aspects of our work in the School:
i) our imperative to continue to train public sector professionals and respond to changes largely made by others
ii) to examine, research, critique, speak about the effect of government policy on the professions and crucially on the publics they serve (for example research on safe staffing in the NHS would fit this category)

Its too easy for those of us with differing roles regarding these two activities to work separately and this symposium is an attempt to break down those separations. (We could talk about some ways to do this in the discussion later.)
Finally, if this weren’t enough, changes to the university sector itself are a further piece in this puzzle that can’t be ignored because higher education itself is a large public sector project, subject to change by governments that, some would argue, attempt to change the nature of what universities are – from, to put it crudely a 19th century (or earlier) idea of dealing with useless knowledge that ennobles the mind of men who received it (and it would have been men) to a post world war two and certainly post-Dearing view of universities as there to meet the needs of industry and international competitiveness. We have certainly seen so called massification of higher education in the UK even since the 1970s when I went to university. (I have some figures to show you later). And vocational subjects like nursing have contributed to this significantly.
The gradual introduction of student fees and loans that individuals have to take out is at odds with a more collectivist idea of education. The beginnings of this were longer ago that we might think. Society is seen by some governments as a market place of individuals each seeking to maximize their utility. So we ourselves have been marketised. We are expected to brand ourselves in a way that might attract a bigger market share of customers. How might that affect how we respond to these questions and act?

3. This afternoon’s event

Today we have three case studies if you like, three reflections from speakers with huge experience in the design and provision of education for initial teacher training, nurses, midwives and social workers as well as research in these areas. They will give us something of the history of these professions, how governments have sought to shape them over the years and how they – or we as a School – have responded and perhaps, where we have been able, attempted to shape implementation of government policy at local level.

It is a great opportunity to discover common concerns across these three areas as well as nuanced differences in the context and challenges around initial teacher training, nursing and midwifery, and social work. These three talks will draw on both the personal experience of the speakers and research in their fields to summarise what for us as a School are the main issues.
We will finish the afternoon with discussion about future, possible and on-going research projects on this broad theme and, hopefully, the work of some of our PhD students who are working in this area. The outputs of the event could be proposals for a journal special issue; collaborations for research grants, or understanding our own field that much better by comparing it to other fields and so acting differently when we are involved in the training of these three professional groups.
So please enjoy the talks. Make a note of questions and discussion points for the sessions after the break. At the end of the event we have a chance to carry on our conversations and plans fuelled by an input of peanuts and Chablis.

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