As integrity fades, new forms of motivation must be created. This means the introduction of incentives. Incentives in their turn can operate only if the job in hand can be rationalised into a discrete set of tasks, and these tasks in turn prioritised so that some of them become targets, attracting benefits if they are achieved. No activity can survive such rationalisation without loss. Bonus payments — available both to individuals and to institutions — come to supplement, and in some cases entirely replace, the integrity that previously governed the activity. One consequence is that the work is not as well done as it was before, because we no longer have professionals making situational judgments of what ought to be done. The distortions attendant on a system of targets have been widely discussed, especially in the police force and in the NHS. It is clear that if the police are given a set of targets, the achieving of which will bring promotions and higher funding, they will clearly concentrate their energies on those targets rather than on other duties.

What is the result of the steady transformation of professionals into employees? There is certainly a difference between consulting a specialist, on the one hand, and the expectation of a perfect service, which the state promises, on the other. Consulting a professional requires, rightly or wrongly, trust. However, people who have been told that they have a right to perfection become extremely re sentful if things go wrong. Furthermore, to fulfil this promise of perfection, surveillance techniques are widely used to guarantee the performance of targets. The Department of Health used random telephone calls to check whether doctors were opening their surgeries more frequently in response to new arrangements. Teachers are subject to inspections, while university dons and (so we are promised) GPs are threatened with surveys in which their "clients" report on their satisfaction. New developments in the law of negligence have facilitated this attitude.

One consequence is a steady decline in the level of trust between "service providers" and those who benefit from it. And since governments have learned to extend their surveillance techniques further, they have set up "hot lines" through which follow citizens may report on "welfare cheats" or tax avoiders. The general level of trust between strangers in society is declining. Societies vary in the level of trust they exhibit and it is much better living with a high, rather than a low, level of general trust. Years ago, in a radio interview, Noël Coward, talking about the English, described them as the "only people I ever really trusted." He was, of course, referring to "his" England, which he had serenaded in plays and films. His was a charming, hierarchical, old-fashioned England, quite beyond our current reach or indeed most of our desires today. But his attitude illustrated the kind of social cohesion found in most settled European states early in the 20th century. Much has gone, and where trust goes, regulation follows. Or is it the other way round? Is it that where regulation comes in, trust flies out the window?

State regulation promises us perfection, or at least an end to specified imperfections, and that makes the client/professional relationship more edgy than it used to be. After every well-publicised calamity, governments are expected to "do something" and they offer procedures promising that lessons have been learned, stating that this kind of thing can never happen again. This cannot, of course, prevent new calamities, so that we find ourselves with a rising level of regulation and control. The inventiveness of human folly is constantly underestimated. In other words, the move from professionalism to state regulation results in a system whereby when we discover that the last set of regulations has failed, we uncover more and more things that must be regulated. Each new abuse discovered becomes a demand that the government should do something, and that particular something (whatever its immediate benefits) necessarily leads to further degeneration.

The decline of general trust is perhaps the most serious consequence of the emerging conditions we are describing, but there are others. One is a collapse of sophistication that users of any professional service exhibit in having recourse to professionals. To expect a perfect service is something different from consulting a professional and leads to a much more edgy relationship. The intention of regulations is often to protect the vulnerable, yet it is generally the vulnerable who most need the best professional attention. The system of rewarding those who hit the target spreads the idea that the only reason for doing one's duty is to enjoy the reward. School truants have sometimes been rewarded with vouchers for merely turning up, obese patients in Scotland given incentives for consulting a doctor, and so on. The idea spreads that the unrewarded virtue is not worth performing.