English nurse education and the reform of the National Health Service

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Abstract
Although nurse education is now a mainstream activity in English universities, its penetration into the education literature is limited and there has as yet been little dispassionate analysis of recent policy development in this area. Yet nurses are the most significant occupational group in the provision of direct patient care in the National Health Service (NHS). In 1992, for example, over 200 approved institutions in England were providing basic nurse training to around 50,000 student nurses at a cost of over ,£600 million a year. This paper reviews and analyses the development of policy in relation to nurse education between 1985 and 1996 and argues that current arrangements for the funding, coordination and provision of nurse education constitute a novel and complex quasi‐market In contrast to recent assertions in the nursing literature, the development of the market is not positioned simply as the result of an explicit neo‐liberal agenda for nurse education. Rather it has emerged incrementally as a secondary or incidental result of other major policy agendas during the decade. In particular the paper attempts to show how two distinct policy processes have interacted, one dominated by the professional nursing establishment which has primarily informed the nature of the supply‐side of the education market and the other driven by the imperatives of NHS reform which has determined the demand side. It is argued that the resulting dispensation is unique in the extent to which universities are receiving funding from non‐DFEE/Funding Council sources, and unprecedented in terms of the direct powers over university provision given to employers (who increasingly are acting collectively as purchasers).