Interpreting Professional Self-Regulation: A History of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting PDF
Preview Interpreting Professional Self-Regulation: A History of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting
Interpreting Professional Self-Regulation Regulation of professions is coming under increasing scrutiny. There has been serious questioning of medical performance recently and doubt about how far it is in the public interest that professions regulate themselves. Government is introducing new forms of inspection and monitoring, and client groups are increasingly calling for greater protection for vulnerable service users and for participation in decisions about standards of education, practice and conduct in the health field. This book provides a history of the UKCC – the body that maintains a register of nurses, midwives and health visitors – from its inception under legislation in 1979 to the present day. It covers the decade of battle before the legislation, and tells the story of major reform of pre-registration education and pioneering work to set standards for demonstrating competence to stay on the register. It also analyses the disciplinary work of the UKCC in removing people from and restoring them to the register. Interpreting Professional Self-Regulation provides a deeper understanding of what regulators do than has been available previously. It lays bare the tensions between different groups within the professions and notes how the powers of National Boards and Central Council have come into question. It shows just how much behind-the-scenes negotiation there has been in contexts where the public debate in parliament has been minimal and calls for much wider debate on professional accountability. This is an important text for all those who teach on professional and policy issues in nursing, giving them a factual background that has never been brought together before, enabling them to bring discussion of post-registration education, discipline and other professional matters more firmly into the curriculum. Celia Davies is Professor of Health Care, School of Health and Social Welfare, The Open University. Abigail Beach is Research Fellow, School of Health and Social Welfare, The Open University. 234x156 HB Interpreting Professional Self-Regulation A history of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting Celia Davies and Abigail Beach London and New York First published 2000 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon, O14 4RN Simultaneously published in the USA and Canada by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group © 2000 Celia Davies and Abigail Beach Typeset in Galliard by BOOK NOW Ltd All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data Davies, Celia, 1945– Interpreting professional self-regulation : a history of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting / Celia Davies and Abigail Beach. p. cm. Includes bibliographical references and index. 1.United Kingdom Central Council for Nursing, Midwifery, and Health Visiting—History. 2. Nurses—Licenses—Great Britain. 3. Nursing—Law and legislation—Great Britain. 4. Nursing—Standards—Great Britain. 5. Midwives—Licenses—Great Britain. 6. Midwives—Legal status, laws, etc.—Great Britain. 7. Midwifery—Standards—Great Britain. I. Beach, Abigail. II. Title. RT11 .D38 2000 610.73(cid:1)02(cid:1)1841—dc21 00-027211 ISBN 0 415 23033 0 Contents List of figures vii Foreword ix Acknowledgements xi Abbreviations xiii Introduction xv PART I The importance of context 1 1 ‘All is not well with nursing’: the Briggs Committee and a new statutory framework 3 2 Legislation and its aftermath: making a reality of the Council, 1979–83 24 3 Three Councils, 1983–98 40 PART II The agenda develops 73 4 The reform of pre-registration education: hopes, fears and realities 75 5 Upholding standards of professional conduct 97 6 Standards of professional practice: PREPP and after 120 PART III Stakeholders and standards 141 7 Holding the professions together 143 vi Contents 8 Widening involvement in the work of regulation 168 9 Professional self-regulation in question 189 10 Conclusion 204 APPENDICES Appendix 1: Chairmen, Presidents and senior officers 212 Appendix 2: The work of registration 215 Appendix 3: Professional conduct: procedures, cases and Appendix 3: statistics 219 Appendix 4: UKCC publications 231 Appendix 5: Notes on sources 234 Index 241 Figures 3.1 Strategic objectives of the First Council 42 3.2 Strategic objectives of the Second Council 49 3.3 Strategic objectives of the Third Council 58 5.1 Common types of misconduct case 1990 102 9.1 The National Consumer Council Framework for Regulation 199 10.1 Transitions across three Councils 206 Foreword The 1979 Nurses, Midwives and Health Visitors Act heralded far-reaching changes in the regulation of these three professions. The new Act brought together nine bodies previously responsible, in whole or in part, for separate regulation of the three professions within the United Kingdom. The United Kingdom Central Council for Nursing, Midwifery and Health Visiting and four National Boards established by the new Act created, by far, the largest regulatory body for any health care profession. Following implementation of the new legislation, the profundity, frequency and pace of change in health care management and provision was unparalleled in the history of health care. The extent of critical focus on professional regulation by consumers, government, the three professions and the national and professional press also could not have been expected. The ‘shadow’ and subsequent consecu- tive three Councils spanning an eighteen-year period – the period of this historical review – had different challenges to anticipate and respond to. These included, by the time of the Third Council, implementing significant changes arising from the 1992 amending Nurses, Midwives and Health Visitors Act and contributing to the Government’s second quinquennial review of non-departmental public bodies in 1997. In 1996, the Council commissioned a history of its achievements and a review of its activities in setting standards for education and conduct, the results of which are recorded in these pages. Given the size of the three professions which the UKCC regulates and therefore the mammoth volume of activity within the organisation, together with the major projects undertaken throughout the eighteen-year period, the authors Celia Davies and Abigail Beach were presented with a diverse and complex task. The result of their work is a detailed, factual analysis and record of events, captured in a way that reveals the different and significant contributions which the ‘shadow’ and three Councils have made to professional self-regulation. In doing this they have highlighted in a constructive manner the strengths and weaknesses, ‘warts and all’, and have given due and fair consideration to the ten- sions that surfaced from time to time, particularly between nurses and midwives. But the text is much more than a factual record. It is balanced by critical scrutiny and reflection on events of professional self-regulation. The authors pose signifi- cant challenges at a time when fundamental questions are being raised about the
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