0PROFESSIONALISM IS in crisis. 'Professionals have never been more important, nor under more pressure,' according to John Craig in a new collection of essays from Demos. The evidence, although anecdotal, is everywhere. One in five schools has no head in any one year, 40 per cent of those in post will consult a doctor for stress. There are reportedly more qualified teachers outside the profession than in it. Doctors too are under fire. In her weekly FT column, GP Margaret McCartney worries that a new contract and changing conditions leave her feeling 'less like I think a doctor should ... Have we become less dedicated and by extension less professional?' The Work Foundation finds that fewer than half of health service workers think senior managers know where their organisations are going. Police, university lecturers, social workers - all report low morale and insecurity, and have trouble recruiting as a result.
At first sight this seems odd. More of us aspire to, and call ourselves, professionals than ever before. One in seven employees regards him or herself as a manager. In theory, organisations in both public and private sectors should be crying out for responsible self-starting knowledge workers who are committed to the work they do - who 'profess' (promise) to do good work and observe high moral standards. What else, notes Craig, would persuade us to leave children with strangers or allow ourselves to be operated on by someone we've only seen once before?
Yet this is increasingly not the reality of professional experience. Even as technology theoretically frees them from the physical constraints of the office, professional workers find their jobs becoming less autonomous, not more. At the same time, constant change and 'reform' undermine the professional narrative still further. The LSE's Professor Richard Sennett notes that in the essential stories people make of their work, 'they want to use the active voice, to assert "I decided" or "I did" rather than "It happened to me". Their great fear about the current system of institutions ... is that they will be rendered individually passive.'
This was strikingly confirmed in the huge mailbag that followed a recent column here on the university lecturers' pay dispute (the results of the ballot are expected to be close, by the way). In an often moving response, lecturers wrote bitterly of becoming 'second-class citizens in our own institutions'. This is a refrain that is heard across the spectrum of the public sector, as the professional agenda is steamrollered by the managerial one, and clinical or other professional priorities are overridden by targets and official specifications.
Thus in a recent piece, McCartney recounts her discomfort with the new GP contract, even though she will be paid more. What the contract tells GPs is that the government thinks they are motivated by money. Yet the evidence is that extrinsic rewards damage intrinsic motivation - and particularly in the professions precisely because they are vocation-driven. She agonises that 'I will forget my training, experience and critical abilities and instead aspire only to happily ticking the boxes as the contract insists and pays for.' No wonder she is uneasy .
This is surely the crux of the professional crisis. In effect, all professions have come to be judged not in their own terms but on the criteria and rules of another: management.
The irony is that the chosen uberprofession has fewer claims to professionalism than almost any other. There is no accepted body of management knowledge, as there is in, say, medicine, and in practice its accounting calculus is deeply fallible: see Enron or any number of other corporate scandals. On a conservative estimate, any corporate profits statement could vary 10 per cent either way and still remain within the increasingly lengthy guidelines. Not only do managers not take anything resembling a Hippocratic oath, in the authorised version of management 'professed' in the UK and US - shareholder value - they are actually prohibited from taking ethical concerns into account.
In practice, managerialist regulation of the professions has been a disaster, demoralising professionals and disenfranchising their clients. But how could it be otherwise? Just how separate the management factory is from the front line is shown by Michael Bichard's admission in his Demos essay that when he joined the Department for Education and Employment, there was 'only one person in the whole department who had extensive experience of working in schools or in education authorities'. In Freedom from Command and Control , John Seddon suggests that the destructive and expensive apparatus of managerialist regulation should be swept away and replaced with a single question: What measures are you using to understand and improve your work? That means getting to grips with public needs and acting directly on them - that is, giving back professionals their vocation and allowing the public agency in the services they are offered. Crisis, what crisis?
The Observer, 2 July 2006