NHS Bursaries

Alistair Burt Excerpts

Wednesday 4th May 2016 Commons Chamber

[The Minister for Community and Social Care (Alistair Burt)]

And where has the hon. Member for City of Chester (Christian Matheson) been during the debate? [Interruption.] Oh, I beg your pardon, but that is not as good as being here in on the Floor of the Chamber in real life.

Thank you very much, Mr Deputy Speaker, for this opportunity to respond to the debate. I thank the hon. Member for Lewisham East (Heidi Alexander) for raising the important question of the development and expansion of nurse training in England. I thank colleagues for a good debate, with discussions informed by those with close connections with the NHS, either personally or through family.

I pay tribute to all those who work and train in hospitals, who fill the posts that we have been speaking about, and who are the subject of our debate. They are not only nurses and midwives; several colleagues made specific references to allied health professionals, such as those in dietetics, occupational therapy, orthotics and prosthetics, physiotherapy, podiatry and chiropody, radiography, speech and language therapy, operating department practice, dental hygiene and dental therapy—all important components of the NHS. We recognise the importance of the work done in our hospitals, and we thank them for their effort.

This has been a not unusual debate in which the Government propose changing something and the Opposition react with horror. Whether the Government’s arguments are good or bad, that is how it goes. There have been a variety of Opposition arguments—some good, some less good—but whenever change is proposed, there is a set of reactions. As for the poorest reaction, I say this to the hon. Member for Lewisham East with great sincerity: please do not go down the class route. It was absolutely unnecessary to try to pick out what people might have heard in various places as they were growing up and graduating. I am the son of a doctor and a teacher, so there were public health workers in my household. The sense that I got of public service and commitment was possibly shaped then. I do not think that the experience was any different from that of the hon. Lady, or of the hon. Member for Liverpool, Wavertree (Luciana Berger), who had a private education at Haberdashers’ Aske’s School for Girls. I see no evidence in the hon. Lady’s obvious commitment to mental health and everything else that her conversations shaped her poorly in any way. To suggest that the Under-Secretary of State for Health, my hon. Friend the Member for Ipswich (Ben Gummer), may not have picked up the same sort of information, and that that may have impacted on his care and work as a Health Minister, was pretty low. The hon. Member for Lewisham East should not go down that road again.

The two main arguments presented today against what we are trying to do have been about deterrents, or the idea that the occupations are somehow unpalatable and that people will not go into them. On deterrents, I am old enough to have been here for the original debates on the introduction of student fees. Everyone protesting against them at the time said that no one would ever go to university again, and that people from poor backgrounds would never go to university. The same arguments come up every time the subject is raised, and the same arguments have been proved false time and again. What is not false is the damage done at the time of the debates when it is suggested to those who want to aspire to higher education, and to take themselves in a different direction, that it will somehow be made impossible, and that they should not want to do it. Those arguments have been used time and again, and they have been used again today. They were wrong then; they are wrong now.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

What is unique about this situation, as has been mentioned several times, is that a disproportionate number of the nurses using the bursary scheme enter as mature students, including three of my nieces. If bursaries were not available to them, they would not have gone on to train as excellent nurses.

[Alistair Burt]

If the hon. Lady had been here for the entire debate, she would have heard people speak about the problems of hardship following bursaries; that was referred to by the hon. Member for Ilford North (Wes Streeting) and by Government Members. People want access to more funds, which might help those whom the hon. Lady just mentioned, but the assumption is that, because it will be a student loan and because it is a change, people just will not want to do the courses. There is no evidence to suggest that that is correct. Using it as a scare story is unhelpful for the recruitment that we want.

[Nic Dakin]

Does the Minister accept that the royal colleges and others are genuinely anxious about the proposals? If he does, will he commit to engaging with them as fully as possible?

[Alistair Burt]

That is a good question. Yes, of course. At a time of change, there is a degree of uncertainty. My main point is about how the matter has been blown up yet again, as it was for student loans originally. The idea that people would be deterred from ever going to university, and that no one would go from disadvantaged backgrounds, has been proved false. Of course, the concerns are very much being addressed by the consultation that the Under-Secretary of State for Health, my hon. Friend the Member for Ipswich, is undertaking, and he is listening extremely carefully. The consultation process is very wide and genuine, and he is listening particularly to ideas on alterations and proposals. The consultations are not complete and the scheme is not complete, and he is keeping a close ear on those consultations.

There is recognition that there are different characteristics for those who go into nursing, midwifery and allied health professions, which is why we want to make sure that appropriate support is available. Department for Business, Innovation and Skills student support regulations give more support than the bursary; the Secretary of State retains the power to give discretionary funding in exceptional cases; and in the consultation, respondents can give examples of unique characteristics, so that the reforms can reflect that. Our position recognises that, as my hon. Friend the Member for Faversham and Mid Kent (Helen Whately) said, more of the same will not do the job. The need for change is there. We need more nurses, and we need more nurses domestically trained. We are going to do something different, recognising what changes there might be. That is why we have the consultation. Unique characteristics will be reflected in it; that is what the consultation is about. Keeping the current system is not working and will not work in the future. That is why we need change.

[Paula Sherriff]

My local Mid Yorkshire Hospitals NHS Trust is, by its own admission, in the midst of a nursing crisis, with about half the wards staffed at below the minimum staffing level for nurses. Does the Minister think these proposals will help or hinder that?

[Alistair Burt]

I say in all honesty to the hon. Lady, who is knowledgeable about health matters and has been to see both me and the Under-Secretary of State for Health, my hon. Friend the Member for Ipswich, that the proposals help. At the moment, the problem with nurse training in this country is that it is limited. The universities cannot take all the people who want to be nurses; they have to turn them away—37,000 of them. This scheme opens up the opportunity for more people to train, and for more people to come into nursing through the nursing associates route. If the hon. Member for Dewsbury (Paula Sherriff) is looking for a straight answer on whether this will provide more nurses and help her local hospital, I can say: yes, it will. That is why these proposals are being made.

I wish to set out briefly the details of the basis for the reforms, just for those who were not able to attend the whole debate, and then answer one or two questions that were raised. To deliver more nurses, midwives and allied health professionals for the NHS, a better funding system for health students in England and a sustainable model for universities, we need to move nursing, midwifery and allied health students from grants and bursaries on to the standard student loans system. Putting more funding into the existing system was not a sensible or viable option for the Government, if we are also to increase the number of student places, live within our budget, and ensure that the NHS can use the extra £10 billion-worth of additional investment for front-line care by the end of the Parliament.

The subjects that we are talking about are extremely popular with students. In 2014, nursing registered as the fifth most popular subject on UCAS, and in that year there were 57,000 applicants for 20,000 nursing places. Rather than denying thousands of applicants a place to study health subjects at university, surely it is better that the new proposals ensure enough health professionals for the NHS, while cutting the current reliance on expensive agency and overseas staff, and giving more applicants the chance to become a health professional. Part of the reason why we need to modernise the funding system is that student nurses, midwives and allied health students currently have access to less money through the NHS bursary than students using the student loan system do. Under a move to the loan system, these health students will receive an increase of about 25% in the financial resources available to them for living costs during the time they are at university.

It is not possible to pick out all the speeches made today, but I would like to make reference to some. The hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) discussed issues affecting postgraduate students, which are important. The majority of healthcare students undertaking these courses will be able to access a BIS postgraduate masters loan, although we acknowledge in the consultation that some courses currently fall outside the BIS postgraduate loan package. We are working with BIS and the Treasury on their higher education and lifelong learning review, and we will address these matters in the Government’s response to the consultation, so she is right to raise that issue.

My hon. Friend the Member for Totnes (Dr Wollaston), the Chair of the Health Committee, said straightforwardly that we need to train more nurses. That is our bottom line; it is what we are trying to do. On transition, she said that it was important to listen to needs, and she spoke about getting more professionals away from the acute sector and into primary care. As she knows, that is a major interest of this Government, and these proposals will help in that regard.

My hon. Friend the Member for Morecambe and Lunesdale (David Morris) was straightforward. He talked about his trust recruiting from abroad, but said that it would like to recruit more at home. It will be able to do so under these proposals.

My right hon. Friend the Member for Hitchin and Harpenden (Mr Lilley) talked about what he discovered when he spoke to his local university and trust. He discussed the morality of taking more nurses, and student nurses, from overseas. It is important to recognise that our proposal will ease that situation to some degree. He also spoke about the important issue of the Ministers’ dilemma: of whether to put money into training now, knowing that the benefit will come some years later. It is important for any Government to recognise that more money must go into the training of doctors and of the people about whom we are talking today. There will be a return later.

I am conscious of time, and I am sorry that I cannot cover more speeches. Let me say this: the NHS never sleeps or stays still. As our country changes, so does the NHS; it must. It is always comforting to resist change, even when the status quo is not good enough; however, the need for innovation, which will be challenging and resisted, is imperative. This Government have given the NHS that commitment, and we will promote the finance, planning and innovation that were denied by the Opposition. We will not allow so many people to be denied the opportunity of becoming a nurse. We will not allow those on hardship funds and bursaries to fail to get access to more finance. We will not allow them to be—

[Mr Alan Campbell (Tynemouth) (Lab)]

claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.

Question agreed to.

Question put.