Health care regulation: some global trends

This timely volume focuses on the regulation of professional groups involved in the delivery of health services internationally. In so doing, it brings together leading authors from Australasia, Europe, India, North and South America and Russia who share a concern with how occupations with highly specialist forms of expertise are regulated, the role that members of the public play within this and, relatedly, whose interests are best served by the arrangements in place. Indeed, it is important to highlight a core common theme that underpins the chapters presented here – namely, that it is possible to ascertain from an international perspective that the academic analysis of the professions and their regulation is gradually moving away from solely focusing on advocating greater ‘outsider’ involvement in the regulation of occupations classified as professions, towards also recognising the need to capture and critically scrutinise what exactly is meant by the term ‘public interest’. Therefore, it is necessary to first provide some conceptual background on current developments globally in the regulation of health care practitioners, before moving on to introduce the contributions that follow in subsequent chapters.

It is necessary to begin by stating unequivocally that how professional groups are regulated varies considerably across international jurisdictions, as the chapters in this volume illustrate. Nonetheless, it is possible to discern, albeit in the broadest of brushstrokes, important similarities between countries worldwide (Giarelli et al, 2014). Certainly, rising running costs associated with the delivery of increasingly complex health and social care services, have led countries as diverse as China, India, Japan, Russia and the United States (US) to act in the past two decades to embed non-medical involvement in the delivery of health care services and their quality assurance (Bismark et al, 2015; Pan et al, 2015; Saks, 2015; Toth, 2015; Walton-Roberts, 2015). Although significant national variation exists in how this state of affairs both presents itself and plays out, the key result, particularly in Western nation states, has been an intensification and expansion of bureaucratic and managerial discourses and practices shaping the activity of the health care system and monitoring the performance of professional work (de Vries et al, 2009; Risso-Gill et al, 2014).