Professions and Professional Organisation in UK Public Services

The purpose of this chapter is to describe the main features of professional service organisation that emerged in the UK during the post war era. We argue that the institutions of the state became sites that the professions colonised and gradually developed over much of the last century. This process gathered pace with the founding of the welfare state after the Second World War. Professions occupied public services with different motivations: either, as in the case of medicine, by moving into them somewhat reluctantly; or, as in the case of social services, because they provided the opportunity for significant development of an occupation. In so doing, however, public organisations were thoroughly adapted to the orientations and practices of the professions that colonised them. The result was a particular kind of institutional regime, founded on an ‘organizational settlement’ between professions and the state (Clarke and Newman, 1997). This ‘settlement’ was neither entirely stable nor conflict free. But it did ensure that, within the confines of the welfare state, professional groups were able to secure varying degrees of occupational closure and institutional autonomy (Evetts, 2002; Flynn, 1999). It also reinforced a unique form of ‘custodial’ organisation at local level. As we shall see a key feature of this mode of organising was that — within broad constraints — welfare professions were able to exert considerable de facto control over both the means and (to some extent) ends of service delivery.