NHS Bursaries

Andrew Murrison Excerpts

Wednesday 4th May 2016 Commons Chamber

[Heidi Alexander]

Thank you, Mr Speaker. I will leave my comments on that matter there.

In the past few months, Ministers and I have had a number of exchanges across the Dispatch Box about the unnecessary and dangerous fight the Government are picking with junior doctors. You might think that having totally alienated one section of the NHS workforce, Ministers would think twice about doing it again, but you would be wrong. Not content with junior doctors, the Government are now targeting the next generation of nurses, midwives and other allied health professionals: podiatrists, physiotherapists, radiographers and many more. Instead of investing in healthcare students, and instead of valuing them and protecting their bursaries, which help with living costs and cover all their tuition fees, the Government are asking them to pay for the privilege of training to work in the NHS: scrap the bursary, ask tomorrow’s NHS workforce to rack up enormous debts, and claim that this is the answer to current staff shortages.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

The hon. Lady is making a spending commitment. Why then, only a few months ago, did she stand on a manifesto that opposed the Government’s £10 billion investment in the NHS?

[Heidi Alexander]

The Labour party has always made it clear that it would have given the NHS every penny it needs.

Given the approach to healthcare students I have outlined, most people would think the Government had taken leave of their senses. They would be right.

--- Later in debate ---

[Dr Andrew Murrison (South West Wiltshire) (Con)]

May I start by declaring my interest as a member of a healthcare profession allied to nursing?

Two thirds of those who apply for nursing school places are rejected and have to look at other trades or professions—that is tens of thousands of people every year. Despite the comments of some hon. Members, those are good, high-quality applicants. I took the trouble of looking at the entry requirements of the three universities that accept adult candidates on to general nursing degree courses in the south-west—Bournemouth University, the University of the West of England and Plymouth University. The typical offer is 300 UCAS points—three Bs at A-level—so there is not a shortage of applicants who are academically well-qualified and, indeed, qualified in every way. Lots of young men and women who wish to study nursing and to be nurses are being turned away.

That is a double tragedy because we have a gross shortage of nurses in this country, and nothing I have heard from the Opposition gives me any confidence that they have any plan as to how we are to satisfy the two imperatives of allowing those who want to study nursing to do so and of plugging the shortage in our national health service. At the moment, I am afraid, we are able to deal with that issue only because nurses from overseas are prepared to come here—nurses, very often, from countries that can scarcely do without them.

Historically, student nurses have been an intrinsic part of the NHS workforce. My hon. Friend the Member for Totnes (Dr Wollaston) will remember, as do I, that they were essential to the working of hospital wards, and one or two of the good points made by Opposition Members revolve around that issue. The question is whether, in this day and age, we are still heavily reliant on that workforce for the proper functioning of hospital wards. If we are, there is a good case to be made for allowing for that in the bursary arrangements for student nurses, because it is simply not right to expect those people to do service work and not be compensated in some way for it. I hope very much that that strand of thought will be taken up as part of the consultation.

However, the fact remains that as part of Project 2000 in the 1990s, the nursing profession decided to move away from a hospital-based training structure to a structure based around universities—that was driven by the profession itself. The debate we are having today is part of that process—the process by which nurses become graduates, in exactly the same way as anyone else, including those who are preparing, for example, to teach in schools.

When we design the finances for student nurses, it is of course important that we understand the difference between a nursing degree course and a normal degree course, as it were. We must also accept that this is a graduate profession, and that it is not right to try—as I think the hon. Member for Lewisham East (Heidi Alexander), who speaks for the Opposition, did—to distinguish between graduates and to say that one graduate is more worthy than another. She may have in mind a view of a typical graduate, but those graduates are also potential teachers, engineers, biomedical scientists, and all the rest. We start down a very difficult path if we try to hold up one graduate as being superior morally, or in some other sense, to others. That is a very difficult thing to sustain.

I very much support the notion of a nursing associate. I am old enough to remember state-enrolled nurses. These were nurses who would not satisfy the entry criteria for a course leading to state registration but wanted to be members of a caring occupation. Naturally enough, nursing associates will not be SENs revisited, because we now live in a very different age, but there is surely a place within healthcare and our national health service for a group of people who may not want the academic rigour that goes with a nursing degree—or indeed be fitted for it, at their stage of life—but who nevertheless want to nurse, and to enter an intrinsically hands-on, caring occupation. The important difference, though—this is where SENs, I am afraid, suffered so badly all those years ago—is that there must be a sufficiently pervious system to allow nursing associates, if they want to and have the necessary skill sets, to enter a professional nursing stream. It was a tragedy that so many well-qualified SENs were unable to develop their careers in that way. I hope that as we design the future for nursing, we keep that very much in mind.

A few hon. Members have commented on workforce planning. Historically, the NHS has been absolutely abysmal in this regard, and we need to do much better in future. We need to avoid unintended consequences of the changes that we are making. We need to ensure that the £21,000 threshold that would apply for nursing graduates does not mean that people are inclined to avoid it by working part time where they might otherwise work more full-time hours. That would be a great disservice to the overall workforce.

The 10,000 new places created must not be denuded by our offering them to applicants from overseas, because that would not be in the interests of our national health service. We need to understand that nursing graduates may be tempted to migrate as a result of the introduction of these fees. I ask the Minister, in his consultation, to think of all the unintended consequences that may develop, given our general historical tradition in this country of doing health workforce planning so abysmally.