Nurse training is up in the air again following remarks by health secretary Frank Dobson suggesting that entry to the profession will be shifted from an academic route.
The Department of Health said: "Ministers are aware that there are a lot of people who want to go into nursing who are put off by the academic weight of nursing qualifications these days. We are looking at more flexible entry but it's too early to speculate."
The DoH will be consulting with professional nursing bodies such as the Royal College of Nursing and Unison but it seems unlikely to find consensus. The RCN - which spearheaded the shift from hands-on nurse training to college-based courses - is convinced that nurse training remains fit for its purpose.
RCN's education advisor Sue Howard said: "we would argue we need good sound education in order to nurse." She accused the government of suffering from "amnesia", saying that academic training had been brought about to meet the "huge changes in the way people are nursed".
Unison appears to be more in line with the government and keen on a less academic approach. Unison's professional officer Paul Chapman said: "The balance has been tilted too much. We are turning out people who are more academically able but don't have the clinical expertise to do the job in the workplace.
"There's a cadre of the upper echelons of the nursing profession that is very much bent on professionalising nursing by having the training as close to the doctor model as possible."
The RCN is keen for an all-graduate profession, but Unison points out that most nurses are not. When student nurses were moved out of apprenticeship training a new grade of healthcare assistant was developed to take on a lot of the hands-on clinical work.
Many of these are frustrated at not being able to progress, without moving into academic training.
Unison is arguing for a shift towards assessed clinical competence so it would be easier for healthcare assistants to move into pre-registration nurse training. It also says that nurse training needs to reflect clinical competence.