Paraprofessional development in the UK Ambivalences and contradictions
Since 1979 when the Conservative government took office, the UK Health and Social Care (HSC) sector has undergone a radical redesign. When New Labour came to power in 1997 it did not return to the long-standing model of centralised command and control which had been dismantled under the Conservative government but rather introduced an era of almost hyperactive intervention and redesign (Appleby and Coote 2002). Grounded in neoliberal ideology, the welfare sector has been revised and revisioned along a number of recurring themes. Mooney and Law (2007) present a thorough analysis describing an increasing concern with efficiency and effectiveness in both administration and clinical practice, coupling a drive for cash savings with increasing levels of intervention in professional practice. Service users have been reconceptualised as customers and services reconfigured around their needs, bringing increased monitoring, review and audit as well as a considerable blurring of the traditional occupational and professional boundaries.