Nursing in the new NHS Modern, dependable?

This was on my reading list before I was invited to review it, and my expectations were high as I know more than a little about the author's somewhat illustrious nursing career.

The ability to publish a book on nursing in the world of the new NHS is truly impressive, given the embryonic state of the reforms. Legislation is still in bill form, the National Institute for Clinical Excellence and the Commission for Health Improvement have still to be established, primary care groups kick off properly on 1 April, and while NHS Direct continues to spread, most of the public are still without access to it.

The title is therefore misleading, but the book is well worth reading, mainly on account of Fatchett's well-informed critical analysis of what happened to nursing and healthcare during the 1980s and 1990s.

Much of the book is taken up with the 1990 reforms and the impact they had on nursing and nurses.

It is indeed timely for the profession to take stock and acknowledge how uncomfortable it was for many nurses to be employed by organisations which were heavy on cost, volume and productivity and failed to acknowledge, let alone value, the art and science of nursing.

The fact is that the internal market was not good news for nursing and the profession is pleased to see its demise.

Fatchett has succeeded in bringing together several themes, all of which have had a direct impact on the nursing profession and patient care - consumerism, collaboration, professional development, health need, The Health of the Nation and Our Healthier Nation.

Both the past and hopes for the future are explored with considerable skill and knowledge.

The optimistic feel at the end of the book is most welcome and many would believe it to be realistic.

Nurses, with their own health and that of their patients in mind, need to believe that better times lie ahead.

Fatchett ends her book with a heartfelt plea. 'In their own interests, nurses have to be engaged in the changes that are taking place, and which will shape their role, and the way in which (the role) interacts with others in society.

'Passive indifference or sullen opposition are not options: only through constructive engagement can the nurse's role be extended and enhanced, and the profession of nursing achieve greater esteem.'

Amen to that.

Lynn Young, Community health adviser, Royal College of Nursing