The Royal College of Nursing is to produce new guidelines on nurse sponsorship as worries grow about the expansion of commercial activity within the profession.
The guidelines will cover not only sponsorship of nursing posts but also the ethics of accepting freebies such as T-shirts and biros or of taking up free study trips paid for by commercial companies.
The sponsorship of stoma nursing posts is the most controversial example of these public-private "partnerships" but in recent years, sponsorship has also been extended into continence nursing, epilepsy, Parkinson's disease, MS and many other chronic conditions.
The aim of the guidelines, which are expected to be agreed early next year and will go to all trusts as well as college members, is to clarify what is and is not acceptable, and to stamp out some of the worst excesses of past sponsorship deals.
In stoma nursing these have included offering inducements to nurses such as company cars, mobile phones and even free air miles. One manufacturer ran a loyalty card scheme complete with free gifts for patients who stuck with its products.
In another case, one of the companies bidding for a sponsorship deal reportedly offered a trust £100,000 a year - £40,000 of which would pay for a stoma care nurse while the trust would be free to spend the remaining £60,000 however it wished.
Partly as a result of these abuses, many sponsorship arrangements in other areas of nursing aim to keep nurse and sponsor at arm's length.
Innovex NHS Solutions is a health organisation, largely funded by drug companies, which employs a large number of nurses in chronic disease management such as MS and obstructive pulmonary disease.
But although drug companies are the "sponsors", they have no direct influence on the nurses themselves. Innovex admits some companies have tried to push it "over the line" but it has successfully resisted these pressures.
In a different model, the Parkinson's Disease Society has linked up with drug companies to fund a total of 100 Parkinson's disease nurses around the country.
The idea is that they provide pump priming for these specialist nurses over a period of two years, at the end of which it is hoped the trust will pick up the tabs. As a result 57 nurses have now been assimilated into the NHS.
The drug companies gain from such schemes, says RCN nursing policy and practice adviser Sue Thomas, because the disease is getting a higher profile and prescriptions are being dispensed to patients who might otherwise not have been identified.
At the same time the health service benefits because none of these posts would have existed without sponsorship. "In the past many patients with chronic disease had a very poor service," said Ms Thomas. "We can't get away from the fact that sponsorship has helped to bring very real benefits - and we wouldn't want to lose them."
Julia Breeze, who chairs the RCN gastroenterology and stoma care nursing forum, is also clear about the symbiotic nature of the relationship: "We need the companies just as much as they need us."
Ironically, at a time when sponsorship in general is growing, there is now a real threat that some companies could withdraw their funding of stoma care posts - a trend that has helped concentrate minds among both nurses and patients.
The threat has emerged because the Department of Health is looking to cut back on the money stoma companies currently earn from their dispensing service.
Such a move, warns one of the main patients' groups, the Ileostomy Association, would almost certainly lead to a sharp fall in sponsorship deals.
Said association secretary Bruce McKenzie: "I don't care who pays for the nurses, I just want to make sure they're there. They make such a big difference to our lives. Our fear is that if these people go the effect on patients will be massive."
