A central element of the dilemma facing the caring professions with respect to their role in social welfare is the question of professionalism itself. As has been argued in the preceding chapters of this book, any claims which nursing, the remedial therapies and social work might have to a voice in determining the objectives of their work are based on a particular interpretation of profession alism. Reference to bodies of skills and knowledge in themselves have been demonstrated to be insufficient to support the more traditional views of professions as independent in their internal organisation or their relations with service users (Johnson, 1972; Friedson, 1983; Cousins, 1987; Hugman, 1991). The classic professions, having made much of self-government or responsiveness to patrons, also find themselves under similar threat where they too are involved in social welfare which is paid for by public funds, through the state. All professions can be seen as being sustained by the social relations of contemporary forms of democracy. Independence is a relative concept which has to be understood as socially grounded. To paraphrase John Donne, ‘no profession is an island entire of itself, but each a part of the continent’. This continent is comprised of service users and other fellow citizens, other professions and the state. As has been argued throughout the above discussion, it is from this (inevitable) location within social structures that the challenges to professionalism emerge.
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