Healthcare Students: Pay and Financial Support

Andrew Gwynne Excerpts

Monday 20th November 2023 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Fovargue. I welcome the Minister to his latest position on the Government Front Bench. I hope he enjoys what remaining time the Conservatives have in government in the Department of Health and Social Care. I wish him all the best over the next few months.

I am grateful for the opportunity to respond to the debate on behalf of the shadow Health and Social Care team. I thank my hon. Friend the Member for Battersea (Marsha De Cordova) for her powerful speech, and my hon. Friend the Member for Sheffield Central (Paul Blomfield) for his wise contribution. I also thank the Petitions Committee for its work in preparation for the debate.

Being a student nurse during the cost of living crisis is tough. We know that valuing our NHS workforce through fair pay and conditions is crucial to tackling vacancies, yet according to the RCN’s 2023 summer survey, almost nine in 10 student midwives in England—89%—worry about the amount of debt they are in, and 74% of them expect to graduate with debts of more than £40,000.

[Paul Blomfield]

My hon. Friend is making a very important point, and I am sure that he will come on to say that the experience of midwives also applies to nurses and others on healthcare courses. The report by the APPG for students, which I mentioned a moment ago, highlighted the way in which the student funding model was broken, not least by pointing out that, according to Save the Student, the average loan now falls short of living costs by £439 every month. Most students are dealing with that by taking on ever-increasing amounts of paid employment, which is raising some concerns. One Russell Group university told us that a significant number of its students work more than 35 hours a week. Does my hon. Friend agree that that option is not available to most nurses, midwives and other healthcare students on similar courses, because of the structure of their courses? The Government are failing to address that issue.

[Andrew Gwynne]

My hon. Friend hits the nail on the head. We are talking about student nurses and student midwives, who do not have any spare time to dedicate to other forms of paid employment: it is physically and mentally impossible for them to do so. There needs to be greater recognition of the unique nature of these kinds of students. Many students—including me, many years ago—rely on extra support to make ends meet, but people studying in the caring professions, including nursing and midwifery, do not have that same ability. That was one reason why there was always additional support for those groups of people.

Fifty-eight per cent of respondents to the survey conducted by the Petitions Committee for this debate said that it was difficult or very difficult to afford energy, including gas and electricity, 19% said they had visited a food bank, and 26% said they were considering using one. That is a national scandal—a cost of living scandal that is having a devastating impact on our ability to recruit and retain staff in the national health service. Over nine in 10 student midwives in England—91%—know someone who dropped out of their midwifery studies because of financial problems.

The Conservative Government abolished NHS bursaries for student nurses, midwives and allied health professionals back in 2017. Students undertaking their degree since then have had to pay to train to work in the NHS. As a result, not surprisingly, the number of applications to study nursing in England fell, with applications down by almost 30% by 2019. It is not rocket science to work out what caused that. Labour said at the time that the decision to remove the NHS bursary was the wrong one, and the Public Accounts Committee, in its September 2020 report, agreed that the decision

“failed to achieve its ambition to increase nursing student numbers.”

That is just another example of a Government who have time and again failed to plan for the long term.

In this NHS workforce crisis, we have deteriorated to the point where we now have over 100,000 vacancies, including 40,100 nursing vacancies. We have waited so long for the NHS workforce plan, and now we finally have it. Labour has been calling for a workforce plan for years, and I am glad that the Government pinched the plan of my hon. Friend the Member for Ilford North (Wes Streeting). Since its publication, though, not much has happened. It makes clear the scale of the neglect—a wasted decade of drift and inaction, impacting not only on staff but on trainees.

Placements are an important part of nursing and healthcare courses. They provide the vital supervised training that allows students to gain the necessary skills and experience to meet education outcomes and work in clinical settings. Labour knows the value of placements, which is why increasing them is an important part of our plan to expand the NHS workforce. We will focus on ensuring we have the roles, trainees and senior professionals needed to tackle the challenges we face and seize opportunities, drawing on a diverse range of skills and inspiring people around the country to pursue a career in the NHS and caring professions. We will also work with health staff and their trade unions to review existing training pathways and explore new entry routes to a career in the NHS, including high-quality apprenticeships.

The childcare sector is under huge strain. While some healthcare students may be eligible for parental support from the NHS learning support fund of £2,000 a year, that is dwarfed by the ever-increasing cost of childcare. It leaves many studying parents vulnerable to childcare costs, particularly considering the hours needed to fulfil placement requirements. It has been reported by openDemocracy that some nursing students considered leaving their courses because of financial pressures related directly to childcare costs. That is, sadly, a trend across our economy. The cost of childcare is pricing parents, especially women, out of the professions they love.

Does the Minister agree that adequate support for a profession as critical as nursing or midwifery should not depend on where a person studies but should be the same across the board? What assessment has he made of support at all stages of training for studying parents, in order to build an effective and inclusive workforce in our NHS? The 11,000 people who signed the petition will be looking for a response from the Government, so does the Minister regret the decision to abolish NHS bursaries? What additional support can healthcare students expect, given the current cost of living crisis?

Two in five student nurses and three in five student midwives said that they considered leaving their course last year, so we must take this seriously, especially given the threat to the future of the NHS workforce that it poses. Already students have cited the placement experience and lack of support as major factors in their leaving their course. The Conservative-made crisis in the NHS only makes this worse. We might have expected in this month’s King’s Speech to hear of something to deal with the worst NHS crisis in its history, but there was virtually nothing.

The energy price cap has increased by half this Parliament, the cost of living crisis is hammering healthcare students, and we have a flagship energy Bill that

“wouldn’t necessarily bring energy bills down”.

Whether we are talking about the NHS or the cost of living crisis, this Conservative Government look like they have thrown in the towel. They are divided, weak, out of ideas and out of time. Every day that goes on, it is British people, our public services and our patients who pay the price. For Labour’s part, we know that our healthcare staff are our national health service’s most valuable asset, and we know how vital it is to ensure that there is a pipeline of future talent coming through. That is why the next Labour Government will put their workforce plan at the heart of their plans to restore, renew and rejuvenate our national health service.