The Reverse Politics of Professionalisation in Britain and Russia: A Counterposed Volte-Face By the State

This paper explores the varied relationship between professions and the state over time and place from a neo-Weberian perspective. In this respect, in Britain there has been a volte-face in state policy over the professions in general and medicine in particular since the 1970s/1980s. From being an untouchable and much extolled group, professions became subject to attack following the counter culture and the main political parties in a neo-liberal society thenceforth sought to rein in their independent self-regulatory powers. This was particularly the case in relation to medicine following a series of scandals in medical care, most significantly involving the serial killing Dr Harold Shipman. Perversely, a reverse policy volte-face took place in a parallel time period in Russia where professions had been politically disestablished by the state as class enemies under a socialist regime up to the 1970s/1980s. Since that time there have been attempts to re-establish professionalisation, not least in medicine, following glasnost, perestroika and the deconstruction of the Soviet Union. The political backcloth to these counterposed changes in the two societies concerned is highlighted in this paper, accentuating that trends in professionalisation in medicine and elsewhere involve more than just assessments of the technical expertise involved in knowledge work as they are managed in different ways in different social-political contexts based on diverse conceptions of legitimated power and justice. As a postscript it is intriguing to note that both of the state policy directions in British and Russian medicine have recently stalled to some degree for diverse political reasons, related in part to the willingness of the state to fully take the respective reforms forward.