ABSTRACT
In the twentieth century a close alliance has developed between the state and the professional complex. The state has fostered the development of professionals, especially those involved in social welfare, and provided substantial funding for the activities of these professions. In exchange professionals have allocated state funding by identifying appropriate forms of client need and allocating resources to meet that need. The inexorable rise of state expenditure on welfare and the recessions of the 1980s have placed a strain on the relationship between the state and professionals. In the United Kingdom, the general election in 1979 resulted in the formation of a Conservative government heavily influenced by the rhetoric of the New Right and hostile to the public sector and public expenditure. The desire to reduce public expenditure has resulted in a substantial restructuring of the relationship between the state and professionals with the introduction of greater competition and the development of internal markets where full markets were not feasible. This chapter examines the ideological and practical background to this process and illustrates the developments by focusing on the changes in three professional groupings, the medical profession, nursing and social work.
