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 recent years (Willis, 1983; Nancarrow & Borthwick, 2005; Allsop, 2006; Coburn, 2006). Innovative steps to ensure a health care workforce that is 'fit for purpose' are necessary to successfully address a looming crisis in health care provision (Boyce, 2008; Cameron & Masterson, 2003; Sibbald, Shen & McBride, 2004). In this chapter we explore health workforce reform from the perspective of the sociology of the professions and the inherent difficulties that the jurisdictional, boundary and competitive positions that underpin the notion of profession posits for implementing authentic interprofessional education and practice. By examining key features of the international workforce reform agenda together with the motivations of professions that are revealed from a sociological analysis, we show that the division of labour in health care is in a state of intense and dynamic change. These changes create a new challenge for interprofessional education and practice through an increased complexity of the health workforce arising from shifting boundaries, new roles and new types of workers.