The first part of the 20th century can be called the era of the professions. As governments in high-income countries in the Global North developed different variants of the welfare state so they drew on and incorporated the expertise of the professions. For example, in the United Kingdom when the post-war government decided to set up the National Health Service, the Minister of Health, Nye Bevan, negotiated the structure of the new service with the leaders of the medical profession. The government gave the medical profession carte blanche to run the new service.

As the chapters in this book clearly show, the hegemonic role of the professions and their symbiotic relationship with governments has been undermined in the later part of the 20th century. A number of pressures have contributed to the development of a more hostile environment to professions. These pressures include rising costs, the development of neoliberal ideologies and evidence of professional failures.

The expansion of governments’ spending on health, welfare and education in the 1950s and 1960s was facilitated by post-war economic growth in the Global North. This growth ended relatively abruptly in the 1970s with conflict in the Middle East that led to a major increase in the price of oil and associated disruption. In the UK there was a period of stagflation culminating in a financial crisis and run on sterling during which the Chancellor of the Exchequer had to initiate emergency measures including negotiating a standby loan with the International Monetary Fund and controls on public expenditure. Like most economic recessions, this one was time limited and was followed by economic recovery which, in turn, was terminated by the major banking crisis of 2008. As Malin observes in the first chapter, these economic crises created a major challenge to the funding of the welfare state as governments across the Global North sought ways of reducing expenditure. In the UK this search for cost-cutting was formalised by a coalition government elected in 2010 as a programme of austerity in which there was a sustained long-term reduction of public expenditure.