Nursing a grievance

We were saddened and angered by the emotive and ill-informed attacks on nursing, nursing shortages and higher education ("V-cs defend nurse training", THES, January 15). We are surprised that community health - the centre of care for most users and over six million carers - has been forgotten in the debate.

The final move of nursing to higher education was less than two years ago in 1997, not even long enough for students to have completed a pre-registration course. The move heralded opportunities for 46,000 people, mainly women, predominantly from social groups underrepresented in HE. It is within this context that we note the following issues.

* Nursing in HE is unique in the options it offers, at entry and in further development

* At least 25 per cent of those recruited to pre-registration courses do not have GCSEs or A levels, so to argue that people who are not academic are excluded is inaccurate

* Nurses spend 50 per cent of the 4,600 hours of their pre-registration course (a European Union requirement) in practice, during which time service staff, working in collaboration with HE colleagues, are responsible for teaching and assessing students' competencies to practise - skills also addressed in university classes and skills laboratories. Without achieving these competencies a student cannot register as a nurse or graduate

* Courses can be validated only if they demonstrate unequivocally to professional bodies (the national boards) that practice is integral to all stages of learning and that caring, compassionate patient care is part of a commitment to high-quality nursing.

* The previous government deliberately reduced nursing numbers in 1991-93 while introducing competition and the marketplace into nursing education. Schools of nursing were closed and staff made redundant. Fifty per cent of council members now report they have no extra capacity because of lack of practice placements, inadequate space for students and inability to recruit staff. Regrettably, there are no quick-fix solutions

* It is recognised that nursing, like medicine, engineering, law, teaching and social work, has a long history of criticism about interconnecting practical competence with the critical analysis that must underpin any quality service. Health service employers cannot agree on their expectations of newly qualified nurses, let alone predict future requirements. A major review of nurse education is already under way and will report in June.

We support government agendas that recognise the impact on health of social inequality and improvement through collaborative, evidence-based, multidisciplinary services. As a council we support the opportunity to work with government to address concerns.

Tony Butterworth Chair, Council of Deans and Heads of UK University Faculties for Nursing, Midwifery and Health Visiting