EDITOR, - I agree with David Jewell and Pat Turton that practice nurses should be encouraged towards greater professionalism.1 However, their assessment of the practice nurse's present role was a glossy representation of the York census,2 and they failed to suggest radical enough solutions to the problems of how to create and fund this change.

At present practice nurses spend much of their time performing predominantly simple tasks; grade F or G nurses are overtrained to do these tasks. Their expensive time is a resource which should be being used to run health promotion and chronic disease management programmes. The York survey …