Student Nursing (Finance)

Jess Phillips Excerpts

Monday 14th December 2015 Commons Chamber

[Wes Streeting]

My hon. Friend speaks with great experience. The Government should heed the points she makes.

I will turn to the other questions I have for the Minister. How will clinical placements be funded under the student loans system? The Government talk about the number of places they can expand, but it is not like expanding a history undergraduate course because occupational placements need to be arranged. The Government should explain how they intend to fund them.

Given the number of mature applicants for nursing, midwifery and allied health subjects, what assessment have the Government made of the likely impact of the reforms on applications from mature students? Are the Government at all concerned that applications from mature students may fall, given the detrimental impact that the coalition Government’s student finance reforms had on mature and part-time student numbers? Given that many people choose healthcare as a second degree and may not be willing to take on more than £100,000 of debt, how will the Government ensure that this route is not closed to such students? Have the Government conducted any evaluation at all that might give us a clue as to the extent of the risk that these reforms pose to recruitment?

The Government suggested in the spending review that half of all applicants to nursing courses are turned away. Do they have any evidence of what stage they are turned away at? If it is really the case that people are flocking to these professions, will the Minister explain why my local NHS trust has been so reliant on temporary and agency staff, including nurses who have been flown over from Portugal, to address the recruitment and retention challenges facing the NHS?

Additional allowances are currently available for students with different circumstances. Will the Minister inform the House whether any changes will be made to additional allowances, such as the extra weeks allowance or the dependants allowance? If so, what are those planned changes and what assessment have the Government made of their potential impact?

Given the press speculation over the weekend that the Government plan to increase the overall cap on university tuition fees, what assurance can the Minister give the House that students studying nursing, midwifery and allied health subjects will not see their tuition fees and debts hiked up even further than is being suggested? Given that the Government seem content to shift the goalposts for existing students and graduates, does the Minister really expect current or future students to believe that the terms and conditions they sign up to will not be changed and applied retrospectively further down the line? At the very least, I hope the Minister will confirm this evening that the NHS will continue to fund the tuition fees for existing students for the remainder of their studies.

When the coalition Government chose to increase tuition fees in 2010, the move was subject to a debate and a vote in this House. Given the media speculation that Cabinet Office Ministers are busy trying to find ways to avoid proper debate and scrutiny of a possible increase in the overall cap on tuition fees, will the Minister give the House an assurance that we will have a full debate and a vote should the Government choose to extend tuition fees to nursing, midwifery and allied health subject courses? Many students have already written to Ministers in the Department of Health and are awaiting a reply. Will the Minister commit to meeting student representatives to discuss their concerns?

It is not hard to understand why the Government’s shift in policy is generating so much concern and anxiety. In recent days I have heard representations from, among others, Unison, the Royal College of Nursing, the National Union of Students, the University of Hertfordshire, the Royal College of Speech and Language Therapists, and the Chartered Society of Physiotherapy. I have been contacted by student nurses and midwives in my constituency, and received messages of support for this debate from those in the constituencies of other right hon. and hon. Members.

Before I conclude, I would like to share with the House some of the stories that I have heard, and I will finish by making a few points about nursing and midwifery students. These are exceptional people and their dedication to others is truly remarkable. They work long hours, often in difficult situations, and they take a direct role in caring for patients when they are at their most vulnerable. Nursing students have told me how immensely challenging their work can be. They hold the hands of patients in their final moments, and comfort them as they pass. They are the face of reassurance to patients, and a bedrock of support for families.

[Jess Phillips (Birmingham, Yardley) (Lab)]

My hon. Friend is making a powerful speech, and I wanted to share my thoughts as someone whose son’s life, and whose own life, was saved by a student midwife. Does he agree that making those people not just work for free but even pay to save the lives of people like me and my son, is simply despicable?

[Wes Streeting]

I wholeheartedly agree with my hon. Friend, and I am grateful to her for sharing her difficult personal experiences.

Nurses care for us in some of our darkest and most painful moments, and the weight of their responsibility carries with it a heavy physical and emotional load. The same is true for our nation’s midwives. One spoke of the difficulties that she faced when a baby was stillborn and she had to comfort the mother, while also taking hand and foot prints so that the parents would have memories of the baby they lost. She will never forget the shift when she spent 12 and a half hours with a mother who miscarried twins. She had five hours of rest, and then came back to do another 12 and a half hours with the same woman. She has supported the delivery of 10 babies, and she feels immense pride in being part of the wondrous moment of childbirth.

As the saying goes “Save one life and you’re a hero; save 100 lives and you’re a nurse.” These people are seeking to qualify into these difficult professions and form the NHS of tomorrow. They deserve our respect, admiration and support, as well as the right incentives to continue or even commence study in the first place. Ministers should listen to the students who are protesting, and to the nearly 150,000 people who have signed the petition to keep the NHS bursary. The Government owe it to patients and students to think their proposals through properly, and I ask them to pause this process. It would be a tragedy if the next Florence Nightingale or Edith Cavell were discouraged from the profession because of these changes. I look forward to the Minister’s response, and I hope that in the coming days, weeks and months, he will listen carefully to the voices of those who form the backbone of our national health service.

--- Later in debate ---

[Ben Gummer]

It is simply because I wish to see the same advantages that accrue to those already on the new finance system accruing to those who are not. I want to see an expansion in the number of places and I want to see the effects of the changes made by the Office for Fair Access to university admissions in the rest of the sector applied to nursing, so that we see not only an expansion in the numbers of nurses being trained, but a broadening of the backgrounds of those going into nursing, exactly as has happened in all other areas of higher education.

I want to explain, I hope quickly, how this change forms part of a wider reform we are making in student access to nursing. The hon. Member for Ilford North framed his entire speech, understandably so, around the university route into nursing, but he omitted to reflect on the fact that the Government have stated that we will introduce an apprenticeship route into nursing to degree level—level 6. That will provide an alternative route into nursing, whereby nurses will be able to earn while they learn from healthcare assistant level all the way to a full nursing qualification at degree level. It will be possible for them to do so as mature students, which means it might take a bit longer, but they will be able to earn all the way from an existing job to gaining a nursing qualification—an innovation that should be welcomed on both sides of the House and which will mark a real expansion of opportunity for the current NHS.

[Jess Phillips]

rose—

[Ben Gummer]

Before I give way to the hon. Lady, I should also explain that there are many people working as healthcare assistants at the moment who do not have the opportunity to progress to a nursing position unless they leave the workforce to do so. That puts many of them in an impossible position, because they have families to support and other duties and responsibilities. For the first time, we have been able to give that group of people an opportunity to progress, through the apprenticeship route, to a full nursing position. That will expand the whole area of career progression to include one of the larger cohorts in the NHS workforce, in a way that no Government have previously been able to do.

[Jess Phillips]

I wonder whether the Minister can clarify whether people will be paid for doing that apprenticeship and, if so, at what rates they would be paid. He rightly referred to getting mature students with families into work, so will he also say whether that cohort will fall foul of the rule that people must be doing 16 hours of work, and not be in training, to receive the Government’s 30 hours of free childcare? It was made clear in the Childcare Public Bill Committee that those nurses currently studying would not be able to access the 30 hours’ free childcare because that would not be considered work. When they saved my life, it looked like work.

[Ben Gummer]

The hon. Lady speaks with authority from her own personal experience—I have noticed that recently she has spoken her mind without holding back. We are in detailed discussions with the Nursing and Midwifery Council about precisely how the apprenticeship route will work. The council is the independent regulator and has to certify that the qualification matches the existing degree/university route. The qualification has to have complete equality of both esteem and rigour. Of course we envisage the apprentices earning a salary. We envisage opening the route to existing healthcare assistants to give them the opportunity to progress to a nursing grade while continuing at a similar salary point as an apprentice. However, because the hon. Lady’s question about maternity care pertains to student nurses rather than apprentices, I will ensure that I write to her in detail.

The hon. Lady clearly sees why this is an idea with strength, so I hope that in asking her question she realises that there will be two routes into nursing: the university route and the apprenticeship route. I think this is potentially one of the most exciting innovations in the workforce of the NHS for several decades, because it opens up nursing to a whole range of existing workers who have not had an opportunity before, and provides a wholly different route into nursing, but with the same rigour and robustness that the existing university degree route provides.