Transformative Education
for Health Professionals

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Key Policy Issue #1: Why regulate practice and accredit courses?

Market failures in the health workforce are well known and not correcting them may result in severe harm to populations: for example, if there were no minimum qualification requirements to entering the health labour market, populations would be exposed to incompetent providers and to individuals misrepresenting themselves as qualified health-care providers.

Also, an unregulated market would not respond to the needs of the poorer sections of the population, or to health-service needs that are not financially attractive, such as primary care, public health or diseases more prevalent among the poor. Training institutions would have an incentive to give priority to professions and specialities more sought after by potential students. There would be little interest in recruiting from minority groups or training for underserved regions.

The rapid growth of private-for-profit actors in the health sector, not only as health-service providers but also as trainers of health professionals has made these concerns increasingly acute. For example, in India, 147 of the 191 new medical schools established in the last 30 years are in private universities (Uys & Coetzee, 2012). As guardian of the public interest, the state has a responsibility to ensure that citizens are protected against poorly qualified or unqualified providers of health services, and therefore should act as a facilitator of the quality of education of health professionals, as well as insuring that sufficient health professionals are being trained and that their training meets the needs of the community.

In human services, such as health, the need for protection is enhanced by the information asymmetry between provider and patient, and regulation is needed to guarantee that health professionals do not take advantage of the relative dependency of their clients