King's College London

Research portal

Austerity and Professionalism: Being a Good Healthcare Professional in Bad Conditions

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
Pages (from-to)157-170
Number of pages14
JournalHealth Care Analysis
Issue number3
Early online date5 Jun 2019
Accepted/In press20 May 2019
E-pub ahead of print5 Jun 2019
Published15 Sep 2019


King's Authors


In this paper we argue that austerity creates working conditions that can undermine professionalism in healthcare. We characterise austerity in terms of overlapping economic, social and ethical dimensions and explain how these can pose significant challenges for healthcare professionals. Amongst other things, austerity is detrimental to healthcare practice because it creates shortages of material and staff resources, negatively affects relationships and institutional cultures, and creates increased burdens and pressures for staff, not least as a result of deteriorating public health conditions. After discussing the multiple dimensions of austerity, we consider the challenges it creates for professional ethics in healthcare. We highlight three mechanisms - intensification of work, practitioner isolation, and organisational alienation – which pose acute problems for healthcare professionals working under conditions of austerity. These mechanisms can turn ‘routine moral stress’ into moral distress and, at the same time, make poor care much more likely.

While professionalism clearly depends on individual capabilities and behaviours, it also depends upon a complex sets of social conditions being established and maintained. The problems caused by austerity reveal a need to broaden the scope of professional ethics so that it includes the responsibilities of ‘role constructors’ and not just ‘role occupiers’. Austerity therefore presents opportunities for health professionals and associated ‘role constructors’ to contribute to a reimagining of future models of healthcare professionalism.

Download statistics

No data available

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454