NHS Bursary

Jim Cunningham Excerpts

Monday 11th January 2016 Westminster Hall

[Paul Scully]

Of course it would be. The hon. Gentleman is absolutely right; forgive me.

Let me read the petition for Hansard. The title is “Keep the NHS Bursary” and it says:

“At the moment, student nurses do not pay tuition fees, and receive a means tested bursary during their training. We are required, by the NMC, to have done at least 4,600 hours whilst studying, at least half of which are in practice.

Student nurses often work alongside our studies, like most students. But unlike most students, we work full time hours in placement for around half the year, and spend the rest of the time in lectures, without a summer holiday, or an Easter break, as well as completing our assignments. Taking away the NHS Bursary will force more student nurses into working 70 hour weeks, as many already do, it will compromise our studies and most of all, our patient care.”

I am sure that everybody here appreciates the work that nurses do in the NHS. I have had had to go to hospital many times with my family. My daughter was born prematurely and had to have a lumbar puncture within hours of birth; my son had his thumb set after he had dislocated it playing rugby—just opposite the local hospital, fortunately—and nurses tended incredibly patiently to my mother when she fractured her hip after a fall late on a Saturday night.

We know the endless hours that nurses work and the endless patience that they show in tending to us when we most need them, and when we are at our most vulnerable. It is important that we pay tribute to them for the work that they do. We must also pay tribute to those who want to enter the nursing service. They do so as a vocation and out of love; they do not do it for preferment, large salaries or anything like that. They do it to pay back and to serve us as members of the public, and for that we are very grateful.

Nurses do incredible work, which is more complex than ever. Many nurses are taking on more responsibilities, whether in adult nursing, child nursing, learning disability nursing or mental health nursing. Often, these days, they have to tell doctors what to do and how to lead on treatment.

[Mr Jim Cunningham (Coventry South) (Lab)]

I congratulate the hon. Gentleman on securing the debate. Does he agree that we are not just talking about student nurses? We have problems with trainee doctors at the moment, and the situation with the education maintenance grant. There is a big problem, particularly in the medical profession—and outside it, in relation to young people—with the future of care.

[Paul Scully]

We can always talk about the NHS and the future of care, but we have three hours for this debate, and I suspect most hon. Members want to speak, so I will limit my comments to nurses. I will quickly outline the current system and talk about why I believe it needs to change, then we can debate exactly how it might change.

There are various elements to the NHS bursary. There is a non-means-tested grant of £1,000 per year. There is a means-tested bursary to help with living costs of up to £3,191 for students in London living away from home, £2,643 for students outside London living away from home, or £2,207 for students living at home. Other bursary elements include an extra week’s allowance for courses that run for longer than 30 weeks and three days each academic year. As we heard at the event that we held before the debate, the majority of such courses last considerably longer than 30 weeks; they are often up to 42 or 43 weeks a year. Tuition fees are paid directly to the higher education institution by the NHS. Students can also apply for a non-income-assessed reduced rate maintenance loan from Student Finance England of between £1,744 and £3,263, depending on their circumstances. That loan is reduced in the final year of the course.

Why change? The current system, as some, but not all, student nurses, prospective student nurses and those in higher education institutions that train nurses agree, does not always work as well as it might for students or universities.

--- Later in debate ---

[Wes Streeting]

I certainly agree with my hon. Friend. The Government and the NHS underestimate the extent to which staff at all levels are both working beyond their allocated shifts to plug gaps in the service and going without breaks. Given the settings that those staff work in, it is not in the interests of patients, let alone good for the welfare of the staff themselves, for them to be tired and not taking the breaks they ought to take.

[Mr Jim Cunningham]

One critical area at the moment is care in the community. Does my hon. Friend agree that the change to bursaries will have a big impact when we try to recruit community nurses for all sorts of illnesses?

[Wes Streeting]

I am grateful to my hon. Friend for raising that point, which I did not raise in the earlier Adjournment debate. Since that debate took place I have seen an article by Crystal Oldman in Independent Nurse magazine, which expressed concern about our ability to recruit nurses into community-based settings. If we are trying to prevent patients from presenting at accident and emergency, which is important to alleviate waiting times and the burden on A&E departments, it is vital that people can access timely care and support in the community. I do not believe the Government have fully considered that, but I look forward to hearing the Minister’s response.

In my Adjournment debate I also asked the Government whether they thought it was fair that students from the most deprived backgrounds should have their grants taken away while some of the wealthiest people in our society received tax cuts. I am not surprised that I did not receive an answer to that question, but it is a fair one. A lot of people wonder how, in straitened times, it is possible for the Government to find money for tax cuts for the wealthiest, but we cannot find money to ensure that people who perform vital functions in the NHS receive the support they need to get them through their training.

I asked the Minister in that debate how much debt the Government expect to write off because those indebted by the reforms are unable to pay their debts in full. That question was not answered. However, we know that in the case of the tuition fees brought in by the coalition Government, the current Government expect that the majority of students will see their debts written off, at cost to the taxpayer, further down the line.

I wonder about the Chancellor. Following him on economic policy at the moment is a bit like following a drunk driver: one minute he tells us that things are fantastic, and then the next minute he tells us that something called “the global economy” might have an impact on our domestic economy. I am glad that he has finally got that point, but I do not believe that he is currently being straight with the House and the public about how he intends to “fix the roof”, whether the sun is shining or not. It will be no good if some poor Chancellor 30 years down the line has to find huge amounts of money for debt write-off. This Chancellor needs to be clearer about where the money is really coming from.

On that point, I asked in the Adjournment debate which Department—the Department of Health or the Department for Business, Innovation and Skills—would meet the cost of servicing the resource accounting and budgeting charge for student loan debt. That question was not answered, although I am sure the Treasury and both those Departments have a view. It seems that the Government have not reached a clear position, and they really ought to have done so before embarking on this course of action.

I also asked the Minister about the Barnett consequentials for health education budgets in Northern Ireland, Scotland and Wales. He told the House that it was a matter for Her Majesty’s Treasury, but I am afraid that we did not get any real detail about what the impact on those nations would be.

Will the Minister also say how clinical placements will be funded under the current loans system? He tells us that he has started discussions with Universities UK about that, but we would have expected the Government to have those discussions before embarking on a policy of this nature.

I also asked the Government whether they were at all concerned that applications from mature students might fall, given the detrimental impact that the coalition Government’s student finance reforms had on mature and part-time student numbers. The Minister did not give a reply, but we have heard in interventions this afternoon that that is a legitimate concern. We keep being told that all has been well since the coalition introduced the new tuition fees regime, and that student numbers in higher education are excellent. It is true that overall student numbers have gone up, but I do not think that there has been the necessary level of analysis about whether people are being deterred from applying. It is all very well saying that the numbers have gone up, but that does not tell me whether the regime deterred people from applying. However, we know for certain that it has had a particularly detrimental impact on the numbers of mature and part-time students. The issue of mature students ought to weigh heavily on the Government’s mind before they decide to proceed down this course on nursing bursaries, because it is clear that there will be big problems for the nursing profession if mature student numbers fall.