Professions, Leadership and the Public Interest: The Case of Healthcare
Vice Chancellor's Office University of Lincoln Lincoln, UK
The issue of leadership is attracting increasing attention in a European and more global context in an era of change and complexity. This paper considers this issue with reference to claims by professions to serve the public interest, using healthcare in the UK as an illustrative case. In this respect, it specifically examines the leadership challenges posed by professional power and dominance. The paper begins by outlining the legally-defined power base of professions from a neo-Weberian perspective - as highlighted by the case of medicine compared to nursing, midwifery and other allied health professions. In the traditional social scientific literature on this subject, professions are typically presented as different from other occupations, altruistically taking a lead in serving the public good as a result of their regulatory bargain with the state. Historical and contemporary cases from the health domain are given to illustrate how their leadership can be seen to have been exercised in this way. However, in the more critical climate that has emerged in recent times, the public, politicians and social theorists have become more sceptical about how far leadership in healthcare has been driven by the public interest, as opposed to professional self-interest. This has been accentuated by the growing attention given to such areas as human rights in the UK and wider European context. A number of cases that have shaped this perception in healthcare are outlined, based on the exercise of professional power and dominance. The implications of the analysis are highlighted at a number of levels for future patterns of leadership in relation to the professions - from the imposition of more stringent national and transnational policies to leadership development in the professions themselves.