Planning the size of the nursing workforce is a serious and complex business. Medical workforce planning has been a highly centralised activity undertaken by a series of ad hoc committees, Royal Commissions and, since July 1991, a standing advisory committee. The absence of a national nurse workforce planning strategy for nurses was highlighted by the Briggs Committee in its 1972 report, and by the 1979 Royal Commission on the NHS. The NHS reforms held up the possibility that the costs of non-medical education and training could put trusts and other healthcare providers at a cost and price disadvantage when competing for contracts. Working Paper 10 was one of a series of papers produced by the Department of Health following the Review of the NHS. The National Balance Sheet Exercise was to 'ensure that regions are making a fair contribution to the education and training of staff groups covered.