The new public management and the new nursing: related by rhetoric? Some reflections on the policy process and nursing.
The importance of health policy in terms of its effects on nursing is now recognized as an issue of concern for nurses; however, the essentially dynamic character of policy requires that consideration of its nature and consequences is continuous. This paper addresses the parallel development of the New Public Management (NPM) and the New Nursing as a means of demonstrating the perceived disjunction between events in nursing and the wider policy arena. The nature of policy is discussed and the relationship between the NPM and the New Nursing is explored. An examination of the unintended consequences of policy implementation and the role of rhetoric in the development of the NPM and the New Nursing demonstrates that these contrasting ideologies have emerged from a similar set of circumstances and have developed along a broadly similar timescale. The final effects of this process, however, are not yet clear. It is suggested that although the processes of policy formation and implementation are inherently complex there is an opportunity for nurses to exert some influence over them. Finally it is argued that if nurses become skilled in the art of rhetoric and combine this with a thorough understanding of the policy process they may be able to shape policy directly when and where it is implemented.
Hewison
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School of Health and Social Sciences, Coventry University, Priory Street, Coventry CV1 5FB, UK.
D018166:Health Care Reform; D006801:Humans; D009729:Nursing / Q000458:organization & administration*; D010687:Philosophy, Nursing; D011050:Policy Making; D013222:State Medicine / Q000458:organization & administration*; D006113:United Kingdom