Recent transformations within the health-care sector and the advent of the internal market have been accompanied by remarkable changes in terms of expectations of role among those responsible for health-care delivery. Even among the more established professional groups (Watkins et al, 1992), there is an acknowledgement of the challenge to occupational boundaries that have traditionally separated the various disciplines. Coupled with the uncertainty facing the health-care market,this has sparked a resurgence of interest in professionalization. While some disciplines have attempted to ring-fence their existing roles and accountabilities, there has been notable movement by some para-professional groups* to expand and extend their horizons, seeking to establish new professional groups through education, specialization and claimed expertise. This article examines the issues affecting the extension of practice for para-professionals and comments on the effectiveness of efforts currently under way to achieve credible and lasting increased professional status.