Debating the division of labour in healthcare in France and England

As Larson (1990) states, professions are historically specific and ‘there is no pattern of social closure around an occupation that is not inflected by the latter’s past, its specific activity and typical context of performance or…the political context in which closure is obtained.’ Larson’s work focuses particularly on the differences between the establishment of professions in France, where there was considerable state intervention, with that in the US and UK, both of which were more market-oriented. This paper is based on data from an evaluation of a large European exchange programme of staff between Kent and Lille, from 2005 to 2008 and discusses the division of labour in healthcare between two occupational groups, medicine and nursing, in England and in France. This division of labour has been extensively discussed in the UK, particularly since from the mid 1990s the nursing role has been extended and innovations such as nurse prescribing have been introduced, whereas such extended roles have not been introduced in France. The paper draws particularly on interview data from mental health practitioners, in which it is argued that whilst the English nurses may on the surface seem to have a wider range of competences and autonomy, in reality they are more constrained, as they operate under protocols and therefore do not exercise professional judgement. Not only do these data illustrate the centrality of professional judgement in discussions about practice, they also demonstrate the circularity of many debates on extended roles.

The benefits of a health impact assessment in relation to fuel poverty: assessing Luton's affordable warmth strategy and the need for a national strategy

The links between fuel poverty and poor health are well documented, yet there is no statutory requirement on local authorities to develop fuel poverty strategies, which tend to be patchy nationally and differ substantially in quality. Fuel poverty starts from the perspective of income, even though interventions can improve health. The current public health agenda calls for more partnership-based, cost-effective strategies based on sound evidence. Fuel poverty represents a key area where there is currently little local evidence quantifying and qualifying health gain arising from strategic interventions. As a result, this initial study sought to apply the principles of a health impact assessment to Luton’s Affordable Warmth Strategy, exploring the potential to identify health impact arising – as a baseline for future research – in the context of the public health agenda. A national strategy would help ensure the promotion of targeted fuel poverty strategies.

What is the value of technology? Toward a labour theory of technology change

Economic analysis of technology treats it as given exogenously, while determined endogenously. This paper examines the conceptual conflict. The paper outlines an alternative conceptual framework. This uses a 'General Vertical Division of Labour' into conceptual and executive parts to facilitate a coherent political economic explanation of technological change. The paper suggests that we may acquire rather than impose an understanding of technological change. It also suggests that we may re-define and reassess the efficiency of technological change, through the values inculcated into it.

The emotional costs of caring incurred by men and women in the British labour market

This study investigates whether men and women in caring occupations experience more negative job-related feelings at the end of the day compared to the rest of the working population. The data are from Wave Nine of the British Household Panel Survey (1999) where respondents were asked whether, at the end of the working day, they tended to keep worrying or have trouble unwinding, and the extent to which work left them feeling exhausted or “used up.” Their responses to these questions were used to develop ordinal dependent variables. Control variables in the models include: number of children, age, hours worked per week, managerial responsibilities and job satisfaction, all of which have been shown in previous research to be significantly related to “job burnout.” The results are that those in caring occupations are more likely to feel worried, tense, drained and exhausted at the end of the working day. Women in particular appear to pay a high emotional cost for working in caring occupations. Men do not emerge unscathed, but report significantly lower levels of worry and exhaustion at the end of the day than do women.

What Education Studies is and what it might be

Education Studies at the University of Greenwich is presented as an example of what Education Studies is – at least at one Higher Education Institution. As a field of practice to which a body of knowledge can be applied, Education Studies shares common features with other disciplinary fields of study. It is also unique in that its field – learning, is also what its students do – learn. What Education Studies isn’t is then discussed in relation to studies of schooling, the psychology of learning, sociology of education, traditional education degrees and teacher training. Lastly, what Education Studies could become is presented with reference to Ranson’s (1993) argument for the centrality of education as the common focus of all HE study. It is suggested that the subject could then contribute to expanding critical space in (higher) education through making research/ scholarship and creation an integral part of the Independent Study of all students at all levels of learning. This would be a necessary complement to the wider democratic transformation now demanded for human survival. It would also accord with what Marx called humanity’s “species being” as a “learning animal” (Morris). Such a social theory of learning can discriminate between information and competence at one level of learning and (corresponding terms) knowledge and skill at another more generalised level in relation to new divisions of knowledge and labour. Potentially these levels can be combined to create a new form of polytechnic learning, relating theory to practice, education to training and further to higher education.