Types of Profession-State Relationship

This presentation shows a comparative study of profession-state relationship. The method of managing the qualification of profession varies among countries. In Japan, the Ministry of Health, Labour and Welfare, the governmental ministry, manages the medical register (Iseki) and hands out administrative punishments such as withdrawal of medical licence or suspension of practising medicine, and conducts the national examination for medical practitioners. On the other hand, the General Medical Council, the statutory regulator out of the government, manages the medical register and hands out punishments such as withdrawal of medical licence or suspension of practising medicine, and monitors and checks the curriculum of medical schools in UK. This difference is properly explained by Freidson’s discussion (2001). He presents the typology of profession-state relationship. The reactive-hierarchical state suggests the bureaucratically organized state ministries staffed by professionally trained officials who themselves establish and administer regulations and institutions designed to serve the interests of professions. The professionals are “in” the government. On the other hand, the reactive-coordinate state represents the circumstances of officially recognized private interest groups exercising powers delegate to them by the state. The professionals are “out” the government. According to this typology, Japan is the reactive-hierarchical state while UK is the reactive-coordinate state. We should try to find appropriate health human resources policies and plans in accordance with types of profession-state relationship.