Changing realities: an analysis of the British Health Care system and the implications for nursing

The British health care system is undergoing dramatic change as it moves from a management system based on scientific management principles towards a management system based on internal market principles. This restructuring, outlined in the British Government's White Paper, "Working for Patients" (1989), will have a significant impact on the practice of nursing. The changes will seriously affect, not only the nurse at the bedside, but also nursing management roles, practices and responsibilities. Ultimately these changes will require the radical restructuring of nursing education as British nurses know it today. This restructuring is essential if nurses are to meet and surpass the difficulties they face as their present role in the health care system is challenged, and in some areas seriously undermined. Similar problems are already being faced by Canadian nurses as they struggle to redefine the goals of their profession in light of new government strategies and policies on health care. An objective analysis of the problems faced by our British counterparts may offer insight into our own difficulties, and generate some solutions.