Falling from a Tightrope: Doctors and Lawyers between the Market and the State

Abstract

The organization of the medical and legal professions in Britain has depended heavily on ideologies of self-regulation, and on different institutional creations inspired by those ideologies. Self-regulation balances professions between the market and the state. In recent years both medicine and the law have been subjected to greater competition in the market, and greater control by the state. Part of the explanation for change lies in conditions particular to medicine and law but the similarity in recent regulatory experiences can only be explained by the working of common external forces. Two are identified: the impact of long-term cultural change on a regulatory balancing act originally created in an undemocratic and hierarchical society; and the impact of a modernizing elite in British government seeking to use state power to reverse the decline in British competitiveness.