Abstract

Professional regulatory bodies are key mediating institutions between the state and individual professionals. In the UK, incremental changes in the governance of the health care professions have occurred over the past two decades. Most recently, the pace of change has been more rapid with radical reform in prospect. The article examines the social forces leading to changing relations between the state, health care consumers and professional regulators. As well as the government's concern to achieve cost effective health care, research on avoidable adverse events, the emergence of new occupational groups and the in-depth inquiries into cases of unethical behaviour and incompetence by health care professionals has increased the focus on weaknesses in the traditional self-regulatory model. While the sharpest public focus has been on the regulation of the medical profession, any reform will affect all the health professions. Research has shown that current arrangements reflect diverse practices and barriers to public protection. The authors suggest that a state and health consumer alliance heralds reform to achieve greater transparency, consistency and accountability. These are likely to lead to increased consumer representation in health professional governance and greater partnership between regulatory bodies.