The Role of the Medical Profession in the National Health Services of Western Europe

On the basis of a recently published book (Giarelli & Saks, 2024), the paper critically analyses the role played by the medical profession in the national health services (NHS) of Western Europe (UK, Scandinavia and Mediterranean countries) in the face of the challenges posed by neo-liberal policies during the last four decades. By a neo-Weberian and neoinstitutionalist perspective it looks at similarities and differences in the actions played by medical profession in various contexts in relationship with the other major actors of a health care systems, namely the state, the public, and the medical industrial complex.

Across the range of countries considered in the three Western European macro-regions, the interest-based agendas of the medical professions have recently been increasingly challenged by the emergence of the New Public Management: this has been linked to the rise of managerialist, corporatist and consumerist logics which have often been pitched – with medical workforce consequences – against professional logics in countries with an NHS. For all this, the evolution of the medical professions in the societies considered remains dynamic with both convergent and divergent trends.