ABSTRACT
The origins of what one respondent ruefully termed “a quality culture” can be traced back to advanced industrial practice in the early 1920s. The slow infiltration of the notion of quality from commercial into professional life began in the 1980s and has continued to gather momentum over the intervening years. The general reaction to quality demands among those interviewed both inside and outside medicine, was by no means obstructive. One line of argument was that specialization itself—an increasingly widespread phenomenon—guaranteed a greater measure of expertise, and therefore of quality of provision, than existed in former times. The domination of the quality debate by the medical profession can be explained, at least in part, by the greater penalties for failure in the field of health care. The individual counterpart to regulation, as a formal mode of organizational quality control, is compulsory continuing professional development.
