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«A Literature Review of Welfare State Restructuring in Education and Health Care in European Contexts: Implications for the Teaching and Nursing ...»

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A Literature Review of Welfare State

Restructuring in Education and

Health Care in European Contexts:

Implications for the Teaching and

Nursing Professions and their

Professional Knowledge

Research Team: The ProfKnow Consortium (ProfKnow)

Editors: Ivor Goodson and Caroline Norrie

October 2005

PROFESSIONAL KNOWLEDGE IN EDUCATION AND HEALTH:

Restructuring work and life between the state and the citizens in Europe

EU SIXTH FRAMEWORK PROGRAMME

PRIORITY [Citizens] Contract no.: 506493 A Literature Review of Welfare State Restructuring in Education and Health in European Contexts: Implications for the Professions and Professional Knowledge ProfKnow Consortium Members Göteborg University in cooperation with University College of Borås, Sweden Sverker Lindblad Dennis Beach Rita Foss Ewa Pilhammar Andersson Gun-Britt Wärvik.

University of Brighton, United Kingdom Ivor Goodson Caroline Norrie.

National and Kopodistorian University of Athens. In cooperation with Athens University Medical School, Greece Evie Zambeta Giannis Skalkidis Dimitra Thoma Nasia Dakopoulou Areti Stavropoulou.

University of Joensuu, Finland Ari Antikainen Erja Moore University of Barcelona, Spain Fernando Hernández Juana M. Sancho Jörg Müller Verónica Larrain Amalia Creus Max Muntadas Xavier Giró.

University of the Azores, Portugal Jorge Ávila de Lima Helder Pereira St. Pat’s, DCU: St. Patrick’s College, Dublin City University, Ireland Ciaran Sugrue, Maeve Dupont Stockholm University, Sweden Peter Sohlberg Magdalena Czaplicka A Literature Review of Welfare State Restructuring in Education and Health in European Contexts: Implications for the Professions and Professional Knowledge Table of Contents Chapter 1

International Research Review on Restructuring in Education and Health Care: Implications on Professions and their Professional Knowledge Caroline Norrie and Ivor Goodson Chapter 2

Research Review of Restructuring in Health and Education in Finland Erja Moore, Ari Antikainen and Tony Kosonen Chapter 3

The Swedish Report Gunn-Britt Wärvik Chapter 4

Research Review on Restructuring of Education and Health Care Institutions in Greece: the Social Construction of Teaching and Nursing Evie Zambeta, Yannis Skalkidis, Dimitra Thoma, Areti Stavropoulou and Nasia Dakopoulou Chapter 5

State Educational Policy and Teachers’ Work in Portugal (1960-2004): A Review of the Research Literature Jorge Avila de Lima (Re)Constructing the Profile of Nurses in Portugal: A Review of some Research Results Helder Rocha Pereira Chapter 6

The Spanish Case Study: Teacher/Nurses Research Review Jörg Müller, Isaac Marrero, Amalia Creus, Max Muntadas, Fernando Hernández and Juana Maria Sancho Gil Chapter 7

A Brief Literature Review of the Periodisation of Restructuring in Teaching and Nursing in Ireland Ciaran Sugrue and Maeve Dupont Chapter 8

Research Review of Educational and Health Care Restructuring in England and Implications for Teachers and Nurses and their Professional Knowledge Caroline Norrie and Ivor Goodson

Chapter 9

Bibliography

Appendix

A Literature Review of Welfare State Restructuring in Education and Health in European Contexts: Implications for the Professions and Professional Knowledge Abstract This literature review is produced as part of an EU Sixth Framework Programme

research project entitled Professional Knowledge in Education and Health:

Restructuring work and life between the state and the citizens in Europe (ProfKnow). It aims to present research from seven European countries on restructuring in education and health care and the implications for the professional knowledge of teachers and nurses.

This review presents literature from Northern European welfare states (Sweden and Finland) and compares it with Southern European welfare states (Greece, Portugal and Spain) and offshore countries (England and Ireland). The Northern European social democratic outlook is contrasted with the Southern European subsistence model with its increased reliance on social capital. Meanwhile, Ireland appears to be an anomaly, situated in the North but having retained its religious heritage and high levels of social capital while England can be seen as the advance guard of the Neo-Liberal zeitgeist in Europe.

Examination of the different national trajectories in health and education partly explains the crisis in Europe over the failure to ratify the EU Constitution (EU Summit 16-17 June in Brussels). The argument can be read as a conflict over restructuring between those who favour the ‘Anglo-Saxon’ model with liberalisation of markets, long working hours and flexible employment against those who favour the continental model with its more regulated labour markets.

Meanwhile the inconclusive result in the recent German general election (18th September 2005) can be seen as uncertainty of the electorate over restructuring policies.

An international research review of welfare restructuring in education and health care and the professions and professional knowledge finds there is disagreement in the literature over the extent of convergence of welfare provision internationally and within Europe with some commentators seeing the NeoLiberal agenda as having a worldwide impact on professions and others envisaging it more as a rhetorical discourse.





Periodised national reviews of literature on the restructuring of education and health care of ProfKnow countries demonstrate the dramatically different development of the teaching and nursing professions over time and highlight how professional knowledge is deeply dependent on national and local contexts.

This literature review is the first work package (WP1) of the project and will be followed by national case studies (WP2), surveys of teachers and nurses (WP3) and life history interviews and ethnographic work (WP4 and 5). The life history interviews will be inter-generational with the aim of uncovering information about how teaching and nursing professional personas have changed over time and so elicit information about how restructuring is influencing professionals and their knowledge.

A Literature Review of Welfare State Restructuring in Education and Health in European Contexts: Implications for the Professions and Professional Knowledge Briefing Paper

• The aim of Work Package 1 (WP1) is to achieve an integrated view of the current state of research on welfare state restructuring in education and health care with a focus on professional actors, their positions and experiences and implications of restructuring in terms of professional knowledge.

• Objectives are to achieve and compare descriptions and analyses of current research knowledge within different national cases on the effects of restructuring in education and health care with a focus on (a) professional positions and experiences and (b) implications for practical and professional knowledge. Deliverables are 7 national reviews and one international literature review.

• This review aims to compare the research perspectives, approaches and findings on restructuring in education and health and professional knowledge of Northern European welfare state models (Sweden and Finland) with Southern European welfare state models (Greece, Portugal and Spain) and offshore countries (England and Ireland).

• In all the ProfKnow member states there is more literature on the teaching profession than on the nursing profession. In Portugal and Ireland, research into the nursing profession is a new phenomena and literature is especially sparse. Ireland is also lacking in research in the education sector and much of the literature is based on government sources. In comparison, in England, restructuring in health and education has been extensive as has been the literature it has generated.

Meanwhile in the Nordic countries, restructuring has been less dramatic but is still a feature in the literature.

• The international literature review finds there is disagreement about the extent of convergence of education and healthcare systems across Europe with some seeing Neo-Liberalism prevailing globally and others seeing it as more of a rhetorical discourse.

• Periodised summaries of literature on the histories of the restructuring of education and health care systems of ProfKnow consortium members are examined in detail. For Finland page 25, Sweden page 48, Greece page 74, Portugal page 99, Spain page 153, Ireland page 195 and England page 227.

• The national literature reviews reveal huge differences in the trajectories and social construction of the teaching and nursing professions across the ProfKnow countries. However common issues can be noted in the literature, including decentralisation, privatisation, marketisation, labour supply, secularism, new public management and the use of information technology (IT). Feminisation of the teaching profession and gender relations in the nursing profession are common themes across the ProfKnow members’ literature. In health care, issues such as interA Literature Review of Welfare State Restructuring in Education and Health in European Contexts: Implications for the Professions and Professional Knowledge collaborative working and the increase in primary care are also present in literature across ProfKnow countries.

• The concluding chapter compares the international and national literature reviews in terms of periodisations, generations, contexts and professions.

From this, it can be evidenced in the period following 1980 but with increasing force since 1995 there is a convergence in Neo-liberal patterns across the ProfKnow countries at the level of government discourse. The degree to which Neoliberal ideology has moved from rhetoric to practice varies with each country following its own idiosyncratic course, refracting or mediating the discourse according to its own national context. There is a lack of literature comparing generations of teachers and nurses and the ProfKnow project aims to explore this issue.

• There is a significant amount of literature especially in education to suggest that reforms are having an adverse effect on the morale of teachers and nurses in the countries studied. This problematic conclusion suggests consideration of how world movements of restructuring and performativity need to be negotiated and mediated according to the distinctive and widely supported social priorities of the European Model is long overdue.

• This literature review is the first deliverable of the ProfKnow project. It will be followed by inter-generational life history interviews, ethnographies and surveys aiming to uncover information about how teaching and nursing personas have changed over time and so uncover information about the effects of restructuring on the two professions.

A Literature Review of Welfare State Restructuring in Education and Health in European Contexts: Implications for the Professions and Professional Knowledge

Chapter 1

International Research Review on Restructuring in Education and Health: Implications on Professions and their Professional Knowledge

Caroline Norrie, Ivor Goodson

Reviewing literature on restructuring of education and health care and the implications for teachers and nurses is a substantial undertaking and involves huge reductionism. The methodology of this literature review was: To carry out an international literature review including searching for information available from the websites of organisations such as the World Health Organisation (WHO) and Organisation for Economic Co-operation and Development (OECD) as well as using electronic databases and on-line journals1.

• To ask each consortium member to review national literature on restructuring and the implications for teachers and nurses and their professional knowledge in a periodised way, with emphasis on the most recent years.

• National results and international results were then analysed and compared (see final summary – chapter 9).

This literature review includes works from multiple disciplines including education, nursing, medicine, history, anthropology and social sciences as they are all relevant to the study. Research is defined widely, including theoretical studies, post-graduate and doctoral dissertations, research project reports, articles in journals and newspapers, national and local government resources such as websites, policy documents, papers and statistics as well as documents produced by unions, charities, professional bodies and private organisations.

The following international research review of welfare state restructuring in education and health care and implications on professions and their professional knowledge is divided into three sections. The first section presents an international literature review of definitions and histories of the conceptualisation of the key areas – restructuring – and education, health, professions and professional knowledge. The second section presents literature on the implications of restructuring specifically on teachers and then nurses.

It should be noted that the search engines of Ingenta, ERIC and WoS that were used for this search are predominantly made up of literature published in English so present a globally and culturally biased outlook. Consequently this literature review is not in reality an international research review, but rather a review of literature published in the English language. Added to this, the role of transnational statistics such as those produced by the WHO, OECD, Eurostat and See appendix 1 for databases and searches used A Literature Review of Welfare State Restructuring in Education and Health in European Contexts: Implications for the Professions and Professional Knowledge CERI, is also controversial due to the problematic nature of data collection, and the exagerated influence these indicators can wield.

Restructuring Restructuring is not an easy concept to define and can be used on many levels.



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