The Changing Natures of the Medical Register: Doctors, Precarity, and Crisis

Abstract

This article interrogates the relationship between registration, the professions, and modern crises, using the Medical Register as an illustration. We start by surveying briefly the history of the regulation of health workers in the United Kingdom to contextualise the mechanisms of registers and registration. Under the initial model of registration, one could be in or out of the ‘principal list’, and various routes enabled health practitioners to obtain full registration and its ensuing privileges. That model still influences ordinary understandings of registration, but the paper identifies other categories of registration emerging in the middle of the 20th century, starting with the international crisis of the Second World War and up until the recent coronavirus pandemic. Drawing on historical and contemporary work, we show that there are multiple ways one can be on the Register, with some more precarious than others. In turn, we debunk the idea of the Register as a document immune from political choices and instead shed light on the details of its intimate engagement with modern forms of governance.

Registering the Everyday: Documents, Bureaucracy, and the Socio-Legal

“…Whilst states may conceive registration as a technology of regulation orientated towards extracting data and creating enduring and stable facts from which to govern, does this 'bureaucratic logic' (Trabsky, 2022) follow through into the everyday? Is there space to disrupt the 'form of forms' (Ryan, 2023) or to reveal the inherently instrumental and fragmented nature of the register itself (Jacob and Saksena, 2023)?…”

“…Whilst the papers draw on a range of methods across socio-legal inquiry, design theory, and legal history, each of the papers explore the state's perspective on registration. The papers, as a collective, provide insights into how registration is regarded by state actors: as an ocular tool of regulation (Tessaro, 2023 , a malleable instrument to manage crises (Jacob and Saksena, 2023), and in relation to the form, they invite us to explore what registration and legal documents might need to become, if they are to have any role in advancing social justice (Ryan, 2023). What roles can be played by narrative, flexibility, and sensitivity to the relationship between the material everyday and the abstraction compelled by the register?…”