Скачать книгу

      The brief histories of three health professions explored above demonstrate an evolving picture in the UK. The professions’ view of the appropriate level of regulation has varied across centuries, and the role and influence of the public has changed immeasurably.

      A consultation by the UK government (Department of Health 2017) recognized that while there was a large number of health and social care regulators, there was an inconsistency in approach to regulation and in particular to how fitness‐to‐practice issues are handled. The number of regulatory bodies remains an issue yet to be resolved. Any future proposals to change by amalgamating bodies will be subject to further consultation. One might argue consulting that includes the bodies is not likely to provide a definitive answer.

Regulatory body Professions covered Number of registrants 2017/18
General Chiropractic Council (GCC) Chiropractors 3255
General Dental Council (GDC) Dentists Dental technicians Dental nurses Dental hygienists Dental therapists Orthodontic therapists 101 128
General Medical Council (GMC) Medical practitioners 281 018
General Optical Council (GOC) Optometrists Dispensing opticians Student optometrists Student dispensing opticians Optical businesses 30 097
General Osteopathic Council (GOsC) Osteopaths 5239
General Pharmaceutical Council (GPhC) Pharmacists Pharmacy technicians Pharmacy business premises 78 625 pharmacy professionals 14 348 pharmacy businesses
Health and Care Professions Council (HCPC) Art therapist Biomedical scientists Chiropodists/podiatrists Clinical scientists Dieticians Hearing aid dispensers Occupational therapists Operating department practitioners Orthoptists Paramedics Physiotherapists Practitioner psychologists Prosthetists/orthotists Radiographers Social workers (England only) Speech and language therapists 361 061
Nursing and Midwifery Council (NMC) Nurses Midwives Nursing Associates 690 773
Pharmaceutical Society of Northern Ireland (PSNI) Pharmacists (NI) Pharmacy premises (NI) 2479 pharmacists 548 pharmacies
Social Care Wales (SCW) Social workers (Wales) TBC

      The three examples, nursing, physiotherapy, and medicine, then evolved, and with the advent of science, statistics, modern techniques and technology became well defined, but with continuing overlaps in skill and competencies such as the ability to prescribe medicines. The scope and hence status of all health professions is constantly evolving. A number of new professions in the sector (with Physician Associates as an example) has led to further blurring of professional boundaries.

      It could be argued that recent consultation and the agreed recommendation does move health regulation further along the continuum from entirely self‐regulated with no oversight, as was the case circa 50 years ago (Neighbour 2005), to a position of more rigorous governance where the voice and needs of the “public” play a bigger part.

      If one reflects on the history of health professionals, clear silos existed in the 1700s, and although the origins can be traced back in history, they are very much alive today (McCarthney 2016).

      1 Bate, L., Hutchinson, A., Underhill, J. et al. (2012). How clinical decisions are made. British Journal of Clinical Pharmacology 74 (4): 614–620.

      2 Chan, S.W., Tulloch, E., Cooper, E.S. et al. (2017). Montgomery and informed consent: where are we now? British Medical Journal 357: j2224. https://doi.org/10.1136/bmj.j2224.

      3 Cruess, R.L. and Cruess, S.R. (2008). Expectations and obligations: professionalism and medicine’s social contract with society. Perspectives in Biology and Medicine 51: 579–598.

      4 Cruess, S.R. and Cruess, R.L. (2011). Medicine’s social contract with society. In: Psychiatry’s Contract with Society (eds. D. Bhugra, A. Malik and G. Ikkos), 123–146. Oxford: OUP.

      5 Cruess, S.R., Cruess, R.L., and Steinert, Y. (2010). Linking the teaching of professionalism to the social contract: a call for cultural humility. Medical Teacher 31: 357–360.

      6 Department of Health (2017). Promoting professionalism, reforming regulation. A paper for consultation. Department of Health. https://www.gov.uk/government/consultations/promoting‐professionalism‐reforming‐regulation (accessed 6 May 2021).

      7 Green, B. (2017). Use of the Hippocratic or other professional oaths in UK medical schools in 2017: practice, perception of benefit and principlism. BMC Research Notes 10: 777. http://doi.org/10.1186/s13104‐017‐3114‐7.

      8 Hunt, J. (2015). New social contract between the public, health and care services. https://www.gov.uk/government/news/new‐social‐contract‐between‐the‐public‐health‐and‐care‐services (accessed 6 May 2021).

      9  Kalisch, P.A. and Kalisch, B.J. (1995). American Nursing: A History. Philadelphia, PA: Lippincott, Williams and Wilkins.

      10 Larson, A.S. (1978). The Rise of Professionalism: A Sociological Analysis. Berkeley, CA: University of California Press.

      11 McCarthney, M. (2016). Breaking down the silos walls. British Medical Journal https://doi.org/10.1136/bmj.i5199.

      12 Neighbour,

Скачать книгу