Dreams that lie in tatters: the changing fortunes of nurses who left the British NHS to own and run residential homes for elderly people

During the 1980s many nurses left the British National Health Service to own and run private residential care homes for elderly people. At the time, a public policy of guaranteed financial support for residents underpinned the rapid expansion in the sector and residential homes were considered as profitable low-risk business ventures. However, since the introduction of the 1990 National Health Service and Care in the Community Act, this automatic funding has been withdrawn and residential homes have had to compete amongst each other for a finite number of clients funded by limited local budgets. The withdrawal of guaranteed state support and the introduction of social care markets have had negative impacts on many residential home businesses. Indeed, many homes are facing financial difficulties. This paper considers the actions and attitudes of former nurse proprietors under the new conditions based on a three-stage survey in Devon, England. Proprietors are experiencing increased levels of stress and many are unhappy with their current work experiences. The paper concludes that although the small business private sector may seem attractive to nurses, any move into private sector ownership has an associated risk. Social policy conditions may change with concurrent consequences for businesses and business owners.