Chapter 3
The Professional Dimension:
Professional Regulation in
Nursing, Midwifery and Health
Visiting
Reg Pyne
In one sense, the preparation of this chapter for a new edition of this book was ill-
timed. Examination of the previous edition reveals that the legislative system it
describes and the regulatory processes that flow from them remain in place. So
also do the associated statements about the statutory regulatory body's
expectations of its registered practitioners and guidance on aspects of professional
practice to which reference was made The only change in the law since 1995 to
have become operative has been the simple consolidation of the Nurses, Midwives
and Health Visitors Acts of 1979 and 1992 into the 1997 Act of the same name.
During the same period the United Kingdom Central Council for Nursing,
Midwifery and Health Visiting .UKCC) has added to the range of documents
providing guidance for its registered practitioners and seeking to enhance
standards of professional practice. The temptation is therefore simply to refer the
reader to the first edition for a description of the system as it currently operates.
Conversely, however, the timing was opportune, since it provides an opportu-
nity to refer to the challenges to that system, to the measures taken and still being
taken to replace it with something that the Government intends to be more
effective, and to offer some proposals for an eventual form of regulation of not only
nursing, midwifery and health visiting but of all the health professions, that would
be constructed so as to genuinely serve the interests of the public.
It is, perhaps, not without significance that, unlike some other countries that
have introduced regulation of health professions more recently, the laws estab-
lishing organisations for the purpose of regulating the various health professions
in the United Kingdom do not commence with an unequivocal statement of the
purpose to be served. It is left to be inferred that it has something to do with
serving the public interest and allows the regulatory bodies to claim that this is
what they are doing. But the absence of a statement to that effect has possibly
contributed historically to those bodies operating in such a way that their role has
sometimes been perceived as that of enhancing the status of the persons on the