Education and the professionalization of nursing: non-collective action and the erosion of labourmarket control

Abstract

It has been argued earlier in this journal that from the formation of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) in 1984, until the initiation in 1989 of NHS reform by the third Thatcher administration, nurse education policy development was dominated by a nursing establishment located largely within the UKCC. During this period, in the context of an educational reform, a non-collective professional project emerged which left around 30% of the nursing workforce marooned in an obsolescent occupational group. Drawing on documents from UKCC archives, this paper analyses that professional project in terms of professionalization theory, and argues that by following a non-collective agenda, UKCC eroded nursing's labour market position in relation to the provision of care in the National Health Service (NHS). It is further argued that this eroded labour market position has subsequently been exacerbated by government-led policy developments concerning vocational education and NHS reform, with a consequent weakening of nursing's influence on important aspects of caring work in the health service. Explanations for these aspects of the professional project are proposed relating to the fact that although wide-ranging in terms of the nature and practice of nursing, Project 2000 was positioned and conducted as an educational reform. While education provided the ‘political space’ (i.e. free from the immediate priorities and direct involvement of the NHS) for UKCC to assemble and promote its radical professional project, that project as a consequence was uninformed by cost and workforce planning issues. Late stage engagement between professional aspirations and service needs demonstrated the likelihood of an eroded labour market position for nurses, and high levels of risk for the NHS in terms of the supply of nurses, but by that point UKCC was already committed to the key elements of its original proposals.