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.

Global research collaboration: the UKIERI India-UK initiative – lessons from practice for sustainable international partnerships

As knowledge development is claimed to underpin the development of globalisation, interest in research collaboration and its internationalisation has become more widespread. This paper looks at the motivations behind, and development of, higher educational collaborations with a focus on research collaboration, and also compares some of the key issues surrounding academic collaborations. It employs current thinking on strategic alliances and in particular on social network and social capital theories to judge how collaborations can best be encouraged and managed. The paper uses the specific case of India-UK relationship as an example and looks at the context and motivation for collaboration in these two countries. It presents the UK India Education and Research Initiative (UKIERI) and reviews how this initiative deals with the issues discussed by current writers in relation to collaboration, as well as drawing lessons from the initiative for research collaboration more widely.