(8 years, 10 months ago)
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It is a pleasure to serve under your chairmanship, Mr Pritchard. I am grateful to be able to make a contribution to this important debate. I congratulate the 154,000 people who have signed the petition and brought this issue to the House for discussion.
I declare an interest: I am a Unite member and an ex-Unite workplace rep in the NHS. I used to work as a healthcare scientist in the NHS. I did not receive a bursary for my training; I was employed in a supernumerary position. I was privileged to be able to do that. In my day, it was recognised that I was making a contribution to the NHS while being trained. The Government should perhaps go back a few decades and have a look at how NHS staff were treated in the 1980s, when I trained.
Members have quoted various figures about the proposed changes. From the reading I have done, I believe that under the proposed changes, students could be burdened with up to a staggering £65,000 of debt by the time they finish their training. Under the current system, the bursary allows those without financial means to study as nurses, midwives and, importantly, allied health professionals—I am grateful that a lot of Members have mentioned AHPs, because it is important that we do not forget them and their contribution to our NHS. Many trainees already struggle to make ends meet, even under the bursary system. As Members have said, the system is not perfect, and we need to look at it, but let us do it properly and put in place a system that actually works, rather than one that appears not to have been tested or consulted upon.
[Mr Nigel Evans in the Chair]
Many Members referred to the difficulty of getting part-time jobs. It was a pleasure to listen to the hon. Member for Lewes (Maria Caulfield) talk about her own experience. Given the number of hours that NHS trainees—nurses, midwives or AHPs—are expected to work during clinical placements or at university, plus all the extra hours on assignments, exams, practicals and study, there are not enough hours in the day for them to take on a part-time job.
I was interested to hear the hon. Member for Sutton and Cheam (Paul Scully) refer to Martin Lewis’s MoneySavingExpert.com website. I had a look at it during the debate to see the advice that he gives about NHS bursaries. I could not find anything particularly relevant, but I noticed that, to help students financially, he advises them to get a part-time job. That is obviously not suitable in this situation. The hon. Member for Lewes highlighted the relatively low pay that nurses on band 5 or 6 can expect to earn. Under a loan system, those people, once qualified, will be paying back that debt for their whole career. I urge the Government to consider those points, which have been well made.
My hon. Friend is making an excellent speech. Does she agree that the pressures will be all the more acute in high-cost housing areas such as Oxford, where nurses are already struggling, which will be a further disincentive to recruitment and retention in services that are already under enormous pressure?
I thank my right hon. Friend for his important intervention. Housing costs must be borne in mind in any discussions about changes to NHS bursaries. The days when cheap accommodation was available to NHS trainees are long gone. I can remember staying in a tower block in Greenwich at a reasonable rate during my training, but those tower blocks were sold years ago and are now privately owned.
Replacing bursaries with loans will reduce the diversity of those able to access a career in healthcare. I noted with interest that the hon. Member for Sutton and Cheam claimed when challenged that that would not be the case, but was then unable to quote any equality impact assessments. I would be interested to hear from the Minister what assessments have actually been performed. The NHS bursary is not a cost but an investment in the health and wellbeing of our society. To lose the bursary would affect not only prospective students but each and every citizen of this country, by which I mean England, because the proposals apply to England only.
In the Budget debate of July last year, I spoke against the change from maintenance grants to loans for young people hoping to go to university. The withdrawal of NHS bursaries, as announced in the comprehensive spending review, directly mirrors that change. As a result of the Budget proposals, our students will be saddled with even more debt. I said at the time that there was a real risk that the Government were experimenting with the future of the current generation of secondary school students, but it now appears that they are also experimenting with the future of current and potential nursing and health trainees. In short, it is an experiment on the future staffing of our NHS that has the potential to go badly wrong.
I put out a simple statement on Twitter regarding the views of the Royal College of Midwives, which opposes the proposals to remove NHS bursaries, and received this response:
“My daughter a single parent budgeted carefully b4 becoming a student nurse, may not be able to complete studies.”
That is an appalling situation into which the Government have put that student nurse. Again, that gives the lie to their oft-repeated claim to be the party of working people. Simply repeating the same line over and over again does not make it true, although that does seem to be this Government’s modus operandi on so many issues.
As with the Government’s conversion of maintenance grants to student loans, I would be interested to read an equality impact assessment, should such a thing exist, of the removal of NHS bursaries. The Government’s claim that cutting the bursary will encourage more prospective students into nursing is ludicrous, and even some Government MPs are saying so publicly. I was pleased to hear the hon. Member for Lewes on Radio 5 live yesterday stating that she would have not been able to train as a nurse without an NHS bursary. Today she hinted at alternatives, including apprenticeships and maybe even a return to the days of state-enrolled and state-registered nurses, and I hope that the Minister will be able to elaborate on them.
The Royal College of Midwives believes that the NHS workforce deserves a better future and says, interestingly, that the Government have
“taken money away from other parts of the health system, including student education, to be able to give ‘the NHS’ more money. According to the King’s Fund, spending on health activity that falls outside NHS England’s budget will decrease by more than £3 billion in real terms by 2020/21—a reduction of more than 20%.”
The RCM then quotes the King’s Fund, which states that
“it is clear that a large amount of the additional increase in NHS England’s budget has come at the expense of other areas of health spending.”
The Royal College of Nursing is similarly opposed to the plans and refers to them as “ill thought out”. As the RCN celebrates its centenary, it calls upon the Government to listen to its knowledge and expertise, stating:
“The future of nursing must be protected. Our patients deserve nothing less.”
Unite the union also opposes the plans, highlighting the other health professions covered by the NHS bursary, including occupational therapists, physiotherapists, radiographers and speech and language therapists, to which other hon. Members have referred. Those professions are the backbone of our NHS, and we cannot allow entrants to them to train at their own expense while racking up debt. To do so would be disastrous for our NHS and for future patient care. I urge the Government to reconsider the proposals and, more importantly, to take advice from the professional bodies.