Health workforce reform : dynamic shifts in the division of labour and the implications for interprofessional education and practice

Reform of the health care workforce has become a central component of Government health policy initiatives across many of the Anglophone nations in recentyears (Willis, 1983; Nancarrow & Borthwick, 2005; Allsop, 2006; Coburn, 2006).Innovative steps to ensure a health care workforce that is 'fit for purpose' are necessaryto successfully address a looming crisis in health care provision (Boyce, 2008; Cameron& Masterson, 2003; Sibbald, Shen & McBride, 2004). In this chapter we explore healthworkforce reform from the perspective of the sociology of the professions and theinherent difficulties that the jurisdictional, boundary and competitive positions thatunderpin the notion of profession posits for implementing authentic interprofessionaleducation and practice. By examining key features of the international workforce reformagenda together with the motivations of professions that are revealed from a sociologicalanalysis, we show that the division of labour in health care is in a state of intense anddynamic change. These changes create a new challenge for interprofessional educationand practice through an increased complexity of the health workforce arising fromshifting boundaries, new roles and new types of workers.