National Health Service

Lord MacKenzie of Culkein Excerpts

Thursday 14th January 2016 Lords Chamber

[Lord MacKenzie of Culkein (Lab)]

My Lords, I, too, thank my noble friend Lord Turnberg for securing this important and timely debate, and join in the welcome of the noble Baroness, Lady Watkins of Tavistock. It is good that we have another nurse in this House. In my memory it is the first time in some 16 years that we have had three nurses speak in quick succession in a debate. If anyone with any influence out there is listening, we need even more nurses in this place.

It goes without saying that unless we have a highly skilled and well-educated nurse force there are implications for the future of the health service. But now, without any consultation whatever with the Royal College of Nursing, the Royal College of Midwives or UNISON, we are hit with the Chancellor’s CSR announcement. It is the same sort of attitude that my noble friend Lord Winston referred to so far as the medical profession is concerned. There was no reference whatever to the nursing and midwifery professions about the changes to the pattern and funding of nurse education. That announcement has come out of the blue and provides that, from 2017, student nurses, midwives and others will have to pay their university tuition fees and that, at the same time, their bursaries will be scrapped. Thus will end free education for nurses and midwives. The justification is to allow more applicants to get into university—to allow more to get past the so-called cap on places. Listening to the Chancellor’s announcement, you would have thought that the dreaded cap was nothing whatever to do with the Treasury and the restrictions on funding for university places for student health professionals.

There are few, if any, graduate professions as ill rewarded as nursing, so I am not sure how the Chancellor thinks that his plans can work if potential nursing students are to be faced with what for many will be career-long indebtedness of perhaps up to £50,000, to be paid back immediately on qualification from a miserable starting salary of about £21,000. Quite clearly the Chancellor and the Department of Health have been seduced by the Council of Deans of Health and Universities UK because the whole plan seems to be more about income for universities and, at the same time, savings for the Government than it ever has to do with workforce planning and the alleged possibility of more university places.

In a Written Answer to me the Government admitted that they do not collect data on how many student nurses leave university because of financial reasons, yet they now pray in aid the fact that there will be more money available from loans, as if the bursary system was a primary retention problem. To look at the figures, if the present percentages at universities are replicated, then many of the 10,000 so-called extra places will go to increasing numbers of midwifery and other health profession students. It will leave probably 6,000 extra places for nurses—2,000 per annum. Unless my maths is badly wrong, we will potentially have some 22,000 nursing students per year. That is the better part of nearly 3,000 fewer places than we had under Tony Blair’s Government of some 10 years ago. As with so much, we had the numbers right then, and we need to get back to that Labour figure if we are serious about tackling nurse staffing in the NHS.

Very close to home, a member of my family who has a number of degrees, is a skilled practice educator and teaches at university from time to time was until very recently still paid as a staff nurse. That is not a reward for 30 years’ continuous practice and education that will encourage nurses to take on a huge debt to come into our profession. With the greatest respect to the Minister, for whom I have the highest regard, we have either to start to pay nurses properly for their duties and responsibilities or else we have to do a quick U-turn if we are to get more students into university. We have to look carefully at what we are doing here and we have to work with those who represent the nursing and midwifery professions, which at the moment the Government have manifestly failed to do.