Medicine and the State

"Medicine and the State" examines the conflict-ridden relations between the medical profession and the systems of government in Australia. It argues that such conflicts are inevitable where the distinctly different goals, values and work practices of professionals and administrators are neither recognized nor understood. It has been written to tell what really occurs when working relations between the state and a powerful profession finally break down, and to advance a wider understanding of the processes which precipitate such destructive conflicts. Ann Daniel draws on the sociology of the professions and the sociology of bureaucracy and public administration to demonstrate that professionals and administrators dwell in worlds of their own. In pursuing their goals and upholding their standards they remain oblivious of other traditions. Trust quickly dissipates between the two spheres of activity. In the absence of mutual understanding, competition for control can drift rapidly into war, and the battle-lines get drawn.
"Medicine and the State" emphasizes the centrality and pervasiveness of state activity in an Australian context and it traces federal and state governments increasing intervention in matters of hospital and medical services. It points to recent reviews of public administration, and alterations in policy and funding for public hospitals, as significant harbingers of the troubles which have disrupted hospital services and caused widespread discontents. The book then moves to a detailed and critical review of debates in the sociology of professions and professionalization, and relates these to medical dominance in hospitals and health-related services. It examines the immediate political history of medicine and medical associations, and discusses trends which threaten to fragment that profession. One section is concerned with nursing's bid for professionalization and with ways those strategies have, so far, been frustrated. In the final chapters of the book, Ann Daniel tells the story of the doctors' disputes with the federal and state governments in the 1980s. That chronicle relies in large measure on the accounts given by many of the participants at the time of the dispute.
"Medicine and the State" is essentially a demonstration of the way that sociological theory - in this case the sociology of professions - can be brought to the task of describing and interpreting human conflict.