Education (Student Support) Debate
Full Debate: Read Full DebateAngela Rayner
Main Page: Angela Rayner (Labour - Ashton-under-Lyne)Department Debates - View all Angela Rayner's debates with the Department of Health and Social Care
(6 years, 3 months ago)
Commons ChamberI beg to move,
That an humble Address be presented to Her Majesty, praying that the Education (Student Support) (Amendment) (No. 2) Regulations 2018 (S.I., 2018, No. 443), dated 28 March 2018, a copy of which was laid before this House on 28 March, be annulled.
I thank the Leader of the House for scheduling this debate, which marks an important moment. In this Parliament, Members have had to assert our right to decide the law of the land—a right that some Ministers have tried to avoid by denying us votes on statutory instruments. In this case, the Government let the 40-day period lapse without providing time. They have now agreed to the step, which I think may be unprecedented, of revoking their own regulations and relaying them to allow us a binding vote. Whatever the decision tonight, I hope that we have established the right of the Opposition to secure votes on the Floor of the House. The Government cannot simply legislate by the back door.
On the regulations, the Government’s actions once again seem to defy basic sense. Just last week, they rejected our motion to implement their own guarantee and manifesto commitment on school funding. Now, they are ploughing ahead with their plan to scrap bursaries for yet more nursing students, despite knowing full well the disastrous consequences that will follow.
Two years ago, the Government ignored the Opposition and those who work in the health sector when they scrapped the undergraduate bursary. The results were predictable. In 2016, before the abolition, there were more than 47,000 nursing applicants in England. In 2018, the figure fell to about 31,000—a fall of over 15,000. It is clear that this is the reason why we have seen the sharpest ever decline in nursing applications. I know what the Minister will say. He will say that the number of applications is less important than the number of acceptances; he will say that the Government have committed to create more trainee places for nurses. They promised an increase of 5,000 nursing places and said that the nursing bursary had to be scrapped to make that possible, but what have they delivered? Seven hundred fewer students training to be nurses.
Does the hon. Lady agree that what is important is that we train more nurses and that there are more applicants than the number we need to train, so that there is good competition that ensures we get the best candidates? It is not necessary to have masses more than we need; we just need enough.
I agree with the hon. Lady that we need to ensure that we have not only more applicants, but more people in training. However, 700 fewer students have been training to be nurses since 2017.
Once again it is women who are being hurt, particularly adult women who have brought up a family and want to take up a new career in nursing. They are being denied that opportunity or being forced into debt.
Forced debt for students and nurses of whatever gender is a really important issue, which I will come on to. My hon. Friend is absolutely right to highlight that we need to encourage both genders to see nursing as a legitimate career.
I mentioned that there are 700 fewer students training to be nurses. That is the first fall in close to a decade.
Does my hon. Friend agree that the bottom line is that without applications we cannot train nurses? That is just all there is to it.
My hon. Friend is absolutely right and I congratulate her on her outstanding dedication to nursing.
The Government said that they can fill the gap with nursing apprentices. They promised 1,000 of them, yet it has now been revealed that just 30 apprentice nurses have started the course. To miss a target may be unfortunate, but to miss it by 97% and carry on regardless just seems reckless. The shortfall is not the only problem with relying entirely on apprenticeships. A nursing apprentice will take four years to become a registered nurse. Even if there is a miraculous surge in apprentices starting this summer, we would not see any new qualified nurses on our wards until 2022.
I am not sure the hon. Lady understands what life is like on a bursary as a student nurse. There is just £400 a month to live on. Apprentice nurses are paid. They are a member of a team and they have a guaranteed job at the end of it. That is a very different system, which is a step forward in progress towards getting more nurses into the profession.
I respect the hon. Lady and I pay tribute to her for her work in the NHS as a nurse, but the figures show that not only is this change making it difficult for trainee nurses, who do an excellent job on our wards, it is contrary to what we need. Applications fell by 33%, with a 42% drop in mature students. In contrast, an undergraduate nursing course can take three years and postgraduate courses, referred to in the regulations, can take two years, making them some of the quickest ways to tackle the shortfall in numbers.
The same is true with the nursing associates suggested by the Government as another solution. The Government’s policy is not only unfair, it is failing completely on their own terms. They have pushed ahead with a policy that has reduced the number of people training to work in our NHS and now they are trying to do it again. I should add that trainee nurses in any of these routes have to do the day job as well. I pay tribute to our nurses for the fantastic job they do every single day in our NHS. Trainee nurses do not get paid the going rate. Those affected by the regulations actually have to borrow money for the privilege.
I hope the Government are clear that simply having more trainees on wards is not a solution to staff shortages. They are there to learn their job, not to do someone else’s. There is clear evidence that using support workers or trainees as replacements for qualified nurses has potentially disastrous consequences for care. I hope the Minister will confirm that that is not the Government’s intention.
This measure does not make any financial sense. Tuition and a bursary for a postgraduate or diploma student could cost less than the average premium the NHS pays for an agency nurse for a single year. Providers have suggested that they could expand their courses by up to 50% if funding was available. This comes at a time when there are 40,000 nursing vacancies in the NHS. The Government’s failure to fill vacancies is so severe that the Migration Advisory Committee has placed nursing on the shortage occupation list, even as potential recruits in our constituencies are denied the support that they need to serve in the NHS.
Does the hon. Lady agree that in the end, the only people we must care about are the patients? In Oxfordshire, in the John Radcliffe Hospital, 170 beds were closed primarily because there was a staff nursing shortage. These measures are not going to fix the immediate problem. Why are the Government continuing to do something that is not evidence-based and will not work?
I absolutely agree with the hon. Lady. She is absolutely right to point out that all our focus has to be on making sure that the jewel in Britain’s crown—the national health service—has the qualified staff to do the job and keep our patients and loved ones safe.
I have talked about the failure to fill the vacancies in the NHS at the moment, and that is even before we consider the impact of Brexit on the 21,000 brilliant nurses who have come from EU countries to serve in our national health service. Only two months ago, the Health Secretary said that the winter crisis in our NHS was “probably…the worst ever”, but if he carries on like this, there will be worse to come.
It is one thing for Ministers to push ahead with policies against the warning of the Opposition. It is quite another for them to ignore their Departments’ impact assessments, yet that is precisely what Ministers have done. The Department for Education’s assessment of the changes to the bursary said that it would disproportionately affect women and ethnic minority students, yet Ministers have wilfully pressed ahead. Then the Department of Health and Social Care found that the change could make women, older students and students with lower incomes less likely to participate in postgraduate nursing courses. Again, Ministers pressed ahead, and we have seen the consequences not just in the number of applications, but in who has applied. Just as they were warned, the profile of our future nurses has become less representative. In particular, there has been a 42% fall in applications from mature students.
This is not simply a matter of fairness or even just about the benefit of a diverse workforce providing frontline care to a diverse population. Older nursing graduates are more likely to stay longer in the NHS and are more likely to choose areas such as mental health or learning disability nursing, which are facing severe staff shortages. Just yesterday, campaigners warned of the impact that the abolition of the bursary has had on those areas.
The hon. Lady is making a very powerful point, but we need to be very focused with our intervention. I represent an area that has a nursing school. Although applications have dropped, we still have five applicants for every place and 30% more qualified applicants for every place, so if we are to take measures, we need to make sure that they are very targeted in the areas in which we intervene.
I absolutely agree that we have to make sure that we target interventions and make sure that they work, but part of the reason I have brought the motion before the House today is that the interventions are simply not working. Since 2017, we have 700 fewer students training to be nurses, so the impact is absolutely clear, and I hope that Government Members will support our motion.
Some universities are even looking at closing down specialist courses entirely. If today’s regulations pass, there is every reason to believe that this will get worse. Nearly two thirds of postgraduate nursing students are over 25, more than a quarter are from ethnic minorities and 80% are women, so the impact of today’s regulations will surely be even worse than the previous cuts. Even if the Government are determined to make the change, there are good reasons not to make it now. This policy would move postgraduate nursing students over to the main student finance system, which means dealing with the Student Loans Company.
There is every reason to believe that the Student Loans Company is not yet ready. In recent weeks, the Government have been dealing with an error by the company that has led to 793 nurses being hit with unexpected demands to repay accidental overpayments they were unaware of. The Government’s response was a hardship fund of up to £1,000 per student, yet the Minister for Universities, Science, Research and Innovation, the hon. Member for East Surrey (Mr Gyimah), admitted in a written answer to my hon. Friend the Member for Blackpool South (Gordon Marsden) that the majority of students were overpaid by more than £1,000 and will be left short. Perhaps when he responds, the Minister will tell us how he can possibly expect nursing students affected by this policy to have any faith in the system they will be stuck in.
With the Government finally embarking on their flagship review of higher education, they could have allowed this issue to be considered as part of the review before going ahead with this change today. Ministers have insisted that this change is necessary now to make how we fund training sustainable, yet there is little reason to believe that it will achieve this. The average NHS nurse earns just over £31,000 a year and the average graduate now leaves university with £50,000 of debt. A new nurse with a postgraduate qualification will take 86 years to repay their undergraduate debt on the average NHS salary—that is before we add interest—which is nearly triple the current repayment period before debt is written off, meaning they will not even begin to repay the debt. How many postgraduate students affected by this policy will repay any of, let alone all, their additional loan, and how much of that debt will simply be written off by the taxpayer in decades to come?
Does the hon. Lady not agree it is completely wrong to talk about debt in the way she is—in this place—as though it is some sort of credit card debt? It completely misrepresents the situation for young people from disadvantaged backgrounds thinking about going to university. Her words will be putting them off.
I am not sure it is my words that are putting people off; I would say the thought of having £50,000 of debt hanging over them for a very long time is putting people off going into education.
I started my nurse training in 2000 as a single mum. When I finished, I had £15,000 of debt—and that was with a bursary. It took me five years to pay it off. People say we should not talk about debt, but we have to talk about it—debt is debt. Students come out with debate. I came out with debt. I sit here listening to people who know nothing about this talking as if they do. It simply is not true.
The passion from my hon. Friend reflects how people feel up and down the country. It is funny because we all know what happened at the general election—and the verdict was clear on the Government’s position on education and student debt and tuition. [Hon. Members: “You lost!”] And of course the Government lost their majority at the same time, and the weak and wobbly Prime Minister has done nothing to make anyone in the country feel more confident about her future—but I digress.
How many postgraduate students affected by this policy repay any of, let alone all, their additional loan? Will the Minister explain how this is sustainable? How much will really be saved in the long run? Or is this another example of what the Treasury Select Committee has called the fiscal illusion—in this case, of a student finance system that allows the Government to pretend they have made a saving when they are simply passing the bill down to the next generation? It is no wonder that all the devolved nations have maintained their own NHS bursaries.
The hon. Lady talked about the general election and promises on education and education funding. Will the Labour party be keeping its education promises to repay the debts of students who have already incurred them?
I should have thought that Conservative Members would have read what was a great manifesto. They have hidden theirs now—I cannot see it, because it is hard to find—but ours was absolutely clear, and we continue to be clear about the fact that we would abolish tuition fees. The debt that our students face at the moment is the result of a tripling of student debt on the Conservatives’ watch.
I hope that Conservative Members will support our motion, not least given the financial consequences of Government cuts for their own budgets, but also because I believe that we should welcome nursing students from all over the United Kingdom. If we do so, the whole country will benefit. If the House votes for the motion, that vote will be a clear call for the Government to rethink the cuts, restore the bursary, and respect the will of the House.
A few months ago, the Health Secretary said that the NHS was “nothing without its nurses”. I support that sentiment tonight, but the sentiment without substance is not enough. I am sure that there is not a single Member in the Chamber who would not acknowledge the urgent need for us to recruit more nurses, so I ask all Members to put their votes where their voices are. I commend the motion to the House.