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PurposeRecent scholarship reveals the imagery of the professional as the "ideal citizen". The linkage between professionalism and citizenship is here approached from the perspective of democratic social justice in order to examine the persistence of gendered inequalities in the health care system. The paper aims to examine the ideas framing professionalism, both in sociological theory and historically, asking what gendered hierarchies mean in modern health care systems, and why and how they persist in the conditions of liberal democracy.Design/methodology/approachThe question is approached through both sociological literature and an analysis of historical framings of professionalism; the Finnish health care system is employed as a case. The reason for keeping the discussion close to a specific case is that different professional fields, countries and historic contexts differ from each other in democratically relevant respects.FindingsTraditional sociological theory assumed that professional privilege was based on essentially neutral expertise that benefits democracy only if protected from bureaucracy and politics. The recent theoretical turn reframes professional knowledge as socially defined, but the destabilisation of professional knowledge claims is not without problems. The paper refers to the persisting tensions between changing governance and gendered hierarchies in health care and argues for new approaches that suggest ways through which professional expertise can be democratically represented in politics.Originality/valueThe interdisciplinary framework uses political theory on social justice to examine how health care politics frame professionalism.

PurposeThis study seeks to examine the reconfiguration of professional groups in welfare service work through the lens of gendered inequalities in order to develop an inclusive research horizon that extends to the middle grade of care workers.Design/methodology/approachThe research design positions workforce change within a wider social and cultural context by highlighting occupational, educational and unionist orders from the viewpoint of Finnish practical nurses.FindingsA weakening anchorage in the welfare state and a differentiation of the patterns of recruitment, employment and industrial relations create segmentation, particular forms of exclusion, and identity instabilities. The article identifies the special vulnerability of the practical nurses institutionally embedded "in‐between" the upper and lower grades, the social and health sector, and the union traditions.Research limitations/implicationsThe national policy agenda on workforce change mainly follows the sectoral split and focuses on the established health professions. The unionist agenda of practical nurses in turn reflects interprofessional relationships and tribalism.Practical implicationsThis analysis of welfare service work provides insight into social and cultural transformations related to workforce change in a segmented and culturally diverse labour force and offers reflections on the changing nature of craft unionism.Originality/valueThis article argues for the added value of historicised, gender and culture sensitive analysis of the tensions between policy aims, educational, occupational and unionist orders for understanding reconfiguration through inequality‐producing processes.

This chapter compares transformations in professional self-regulation in the UK and Germany through the lens of governance. We introduce an expanded concept of governance that includes national configurations of state–;profession relationships and places selfregulation in the context of other forms of governance. The analysis shows that a general trend towards network governance plays out differently. In the UK, a plural structure of network governance and stakeholder arrangements is emerging in the context of stateled change. In Germany, partnership governance between sickness funds and medical associations shape the transformations and act as a barrier towards the entry of new players.

New governance practices associated with the modernization of health systems within Europe focus on equipping health consumers with more information and power in their interactions with clinicians. This article uses material on health care reform in Britain and Germany to highlight ways in which consumerism is refracted through different institutional histories and current political projects. These give rise to different inflections on the meaning of consumerism, including the different associations of `choice', and to different forms of consumer involvement as `stakeholders' in health care systems.

Donna Haraways Cyborg-Figuren und ihre Angriffe auf alle vermeintlichen Gewissheiten (westlicher) wissenschaftlicher Denktraditionen inspirierten die feministische Theoriediskussion nachhaltig und ihre provokativen Thesen stellten alle naturalisierten Grenzen radikal in Frage. Demgegenüber greifen frauenzentrierte Ansätze auf stabile Kategorien von "Frau" und "Mann" zurück. Das ethnologische Konzept der Verletzlichkeit der Frauen beruht auf der Vorstellung fixierter Kategorien und homogener Gruppeninteressen, Lebenslagen und Eigenschaften von Frauen und greift damit gerade diejenigen Ansätze auf, die neuere feministische Theorien dekonstruieren wollen. Diese scheinbar unvereinbaren Konzepte werden im vorliegenden Beitrag - Haraways Aufforderung zum "respektlosen" Umgang mit Grenzen folgend - mit dem Ziel zusammengeführt, die Potenziale einer solchen neuen Synthese auszuloten. Als empirisches Anwendungsfeld wird die HIV/AIDS-Prävention in Afrika und die ethnologische Forschung zu dieser Thematik betrachtet. Die vorgestellten "respektlosen Quergänge" sind als Aufforderung zu verstehen, neue Wege in der feministischen Theoriediskussion um "Differenz und Dekonstruktion" einzuschlagen. (ICI2)

"Seit Foucaults (1977) Entschlüsselung der 'Biomacht' als zentralem Regulativ moderner Gesellschaften wurde die diskursive Konstruktion des Körpers von zahlreichen Autorinnen und Autoren aus unterschiedlichen Perspektiven in den Blick genommen. Der Körper, bevorzugter Austragungsort postmoderner Theoriebildung, fungiert als 'Text', als Schauplatz der Dekonstruktion vertrauter Gewissheiten und Begriffe oder als ein hochkomplexes Informationssystem. Diese Entwicklungen werden kontrovers diskutiert. So finden wir einerseits kritische Metaphern vom 'Verschwinden der Körper', von der 'Entkörperung' und ähnlichem, andererseits aber Versprechungen in neue Einsichten von bisher ungeahnter Tragweite, die an die Versuche der Dekonstruktion, an die Entschlüsselung des 'Bio-Logos' und die artifiziellen Substitutionsmöglichkeiten des Körpers geknüpft sind. Diese Ungewissheiten über den Körper als die Schlüsselkategorie feministischer Theorien stellen zugleich die Kategorie Geschlecht zur Disposition. Die Heftigkeit, mit der die Kontroversen insbesondere um die Arbeiten Judith Butlers (1991a,1995) ausgetragen werden, verweist darauf, dass die Reformulierungen des Körpers einen neuralgischen Knoten feministischer Theoriebildung tangieren. Galten der Körper und die Körperlichkeit in den 70er Jahren als stabile Bezugspunkte und als viel versprechender Gegenentwurf zu einem cartesianischen Geist-Körper Modell, so erweist sich die Suche nach gemeinsamen Bezugspunkten feministischer Theorien nun als weitaus widersprüchlicher und komplexer. Mit der Ausdifferenzierung feministischer Theorien stellt sich auch die Frage nach dem Verhältnis zwischen Frauen- und Geschlechterforschung und Frauengesundheitsforschung neu. Die Frauengesundheitsbewegung und -forschung entwickelte sich synchron mit der Frauenbewegung und -forschung, bisweilen erwies sie sich gar als richtungsweisend. Gordon und Thorne betrachten z.B. das in viele Sprachen übersetzte Buch 'Our Bodies, Our Selves' (The Boston Women's Health Book Collective 1973) ex post als wegweisend: - 'Our Bodies' exemplifies feminism's subversive theoretical influence in its insistance that body and sexual norms are politically constructed - (1996: 323). So eindeutige Impulse sind derzeit kaum auszumachen. Zwar erfasst die Frauengesundheitsforschung insgesamt ein facettenreiches Forschungsfeld, doch bleiben die Arbeiten empirisch orientiert. Neuere feministische Theoriekonzepte werden nur in wenigen Untersuchungen explizit aufgegriffen und systematisch für die Frauengesundheitsforschung nutzbar gemacht. Auf der Ebene der Empirie finden wir allerdings zahlreiche Belege für Verknüpfungen, so z.B. die Differenzierungen zwischen und innerhalb der Genusgruppen (vgl. z.B. Hunt/ Annandale 1999; Klesse et al. 1992). Dieses Verhältnis spiegelt sich auch in der umgekehrten Perspektive wider: die Biologie, das medizinische Versorgungssystem und seine Deutungsmuster werden in feministischen Konzepten verhandelt, ohne jedoch die Ergebnisse und Ansätze der Frauengesundheitsforschung zu reflektieren. Mit dem Infragestellen des einst gemeinsamen Bezugssystems Körper und Geschlecht geht ein Abkoppelungsprozess zwischen der Frauen- und Geschlechterforschung und der Frauengesundheitsforschung einher, der sich bisher allerdings weitgehend unbeachtet vollzieht und in den Körperdebatten nicht verhandelt wird. Ziel dieser Arbeit ist es, diesen Prozess und die dahinter liegenden theoretischen Implikationen in den Blick zu rücken und die Potenziale und Grenzen der jeweiligen Perspektiven auf Körper und Geschlecht zu untersuchen. Welche Implikationen haben die neueren feministischen Körperdiskurse für die Frauengesundheitsforschung als einem Feld, das in doppelter Weise dem Kategoriensystem 'Körper' und 'Geschlecht' verpflichtet ist? Welche Bezugspunkte stehen zur Verfügung? Wie werden diese theoretisch und empirisch konzipiert? In einem Perspektivenwechsel soll ebenso heraus gearbeitet werden, welche Erklärungsangebote die gesundh

This e-book aim to highlight the contingencies and dynamics of new governance approaches and the significance of contexts, thus redefining the universal discourse of managerialism. The findings highlight the significance of institutional configurations in relation to professional agency and importantly both at macro and at meso level: first, the regulatory structure and stakeholder arrangements of national healthcare states and second, the organisational settings of hospitals and other healthcare providers shape professional action. Consequently, a broadly similar trend towards new managerial

PurposeThis article aims to explore the gendered dimensions of the heterogeneous path of non‐native graduates in nursing and medicine in the Portuguese National Health Service, including institutional factors like the process of credential recognition, the professional integration and internal labour market segmentation.Design/methodology/approachBiographical interviews with nurses and physicians (23 males and 35 females) from Spain and from some Eastern European countries who migrated to work in Portugal were conducted, and additionally semi‐structured interviews with 12 institutional participants to contextualise the experiential data.FindingsThe research highlights complex intersections between gender and the resources for action. Institutional conditions, like legal frameworks and the self‐regulatory mechanisms of the professions, and individual characteristics shape successful translation of foreign credentials into a new social and cultural context. The specific configurations may create gender traps that push women into low status professional segments and also new forms of inequality in the professions.Research limitations/implicationsThe development of successful professional action and agency in a socio‐culturally different health care labour market can be differentiated by gender, place of graduation and citizenship status. The factors identified in this small‐scale qualitative study would need further investigation.Practical implicationsThe findings highlight new demands for integration policies for foreign‐trained professionals, such as policies to promote equal opportunities for women and men in the workplace.Originality/valueThe article reinforces women as professional participants in the international migration process and examines the opportunities for successful integration.

PurposeThis article aims to address topical issues in the debate on gender (in)equality in higher education in Europe and beyond, and highlights future perspectives of research and practice.Design/methodology/approachIt is based on a conference report of the 5th European Conference on Gender Equality in Higher Education that was hosted by Humboldt University in Berlin, Germany, 28‐31 August 2007.FindingsNumber matters ("wore women into science"), but quality matters more: more women are needed in top positions in higher education, science, technology and engineering, and more female participation in higher education decision‐making processes. It is necessary to reveal gender biases of recent strategies in higher education. Exclusion happens also among women; an intersectional approach is therefore called for, which includes primary and secondary educations as well as labour market and careers in the academe.Practical implicationsEquality programmes have to consider the diversity of gender in higher education and to strengthen women's lobbying in European education and science politics.Originality/valueThis conference brought together about 350 participants from 56 countries. Thus, it provided an excellent opportunity for knowledge exchange with European scholars and beyond, which is reported in this paper.

Changing market conditions, new modes of labour and decreasing legitimisation of experts, as well as an increasing ratio of women, pose new challenges to the professions. These ongoing dynamics are especially visible in the health care system – a traditional professional field with strongly formalised rules governing entrance, initiation and career paths. In addition, this field is highly segregated according to sexes. How do the bove‐mentioned processes of change present themselves and what economic, social or structural factors cause them? What role does gender play within these processes? What potential lies in the re‐structuring processes of health care systems as far as a gender equal architecture and design of professions is concerned? These and other questions are addressed in this collection of papers. For the main part they grew out of a thematic focus event organised and coordinated by the editors for the 5th Conference of the European Sociological Association (ESA) Research Network Sociology of Professions that was held in 2001 in Helsinki. Inspired by the richness of the research results on professions and gender in health care systems in various European countries and new horizons which opened up from the comparative perspective in different countries, professions, and theoretical approaches, and finally motivated by very constructive ensuing discussions, we decided to continue the discussion with a publication.