Introduction

The chapters of Van der Veen and Hupe & Van der Krogt explored professionals and professionalism in general, as well as the nature of the pressures they face. In this chapter, we explore the pressures faced by professionals when implementing public policy programs. This is relevant, as many of the pressures exerted on professionals are related to the policies that are implemented (Duyvendak et al. 2006; Freidson 2001). In terms of Newman's knowledge-power knots (chapter 3), this chapter will specifically focus on the public professional in his relationship with the government. It will also illustrate how this unilateral relationship of government and professional is complicated by influences exerted by the occupation, the organization and the public.

Many public professionals have difficulties identifying with the policies they have to implement. For instance, Bottery (1998: 143), examining the experiences of professionals with new policies in education and healthcare in Great Britain, states that ‘many professionals in both of these sectors would argue that they felt the pressures of legislation designed to produce a greater degree of responsiveness to clients, and to increase competition with other institutions’. The introduction of this legislation resulted in identification problems for professionals. As one teacher states: ‘The changes have been outrageous, and have produced a culture of meritocracy and high flyers, there's massive paperwork because the politicians don't believe teachers are to be trusted’ (cited in Bottery 1998: 40).

Another example is the introduction of a new reimbursement policy (called Diagnosis Treatment Combinations, see also chapter 7) in Dutch mental healthcare. One large-scale survey showed that nine out of ten professionals wanted to abandon this new policy (Palm et al. 2008: 11). They could not align their professional values with the contents of the policy.

When public professionals cannot identify with the policy they have to implement, this can have serious consequences. Indeed, many scholars examining policy implementation processes state that a minimal level of identification by the implementers is a prerequisite for effective implementation (Ewalt & Jennings 2004; May & Winter, 2009; Peters & Pierre 1998; Sabatier 1986). It might also affect the quality of interactions between professionals and citizens, which may eventually influence the output legitimacy of the government (Bekkers et al. 2007).