NHS Bursaries

Margaret Greenwood Excerpts

Wednesday 4th May 2016 Commons Chamber

[Margaret Greenwood (Wirral West) (Lab)]

I am pleased to hear that the hon. Member for Sherwood (Mark Spencer) values the NHS so highly, but he might like to reflect on the fact that the coalition Government legislated to allow all NHS hospitals to make up to 49% of their money from private patients. Perhaps he will review his opinion of his party’s performance when he starts to see the number of private patients in his local hospital increase and the number of NHS patients decrease.

The Royal College of Nursing and the Royal College of Midwives are concerned that abolishing nurse bursaries and free tuition will break the historic link between the NHS and trainee nurses. I share their concern, and I believe that the Government’s proposal is part and parcel of wider changes that they are seeking to make to the culture of the NHS. They are turning the emphasis away from training people to be part of the NHS family, in which they can work with dedication throughout their working lives, towards training them to work in a fragmented health marketplace. If the plans go ahead, the nurses of the future may no longer feel the same obligation to work in the NHS and could be more inclined to work abroad or in private hospitals to pay off their debt. Who could blame them? They will feel that the Government have deserted them.

The Minister was unable to tell us what the average repayment would be, so I will let the union Unison give him the answer. It states that debt repayment will effectively mean a pay cut of more than £900 a year. The question arises of whether the changes will deter people from training to be nurses in the first place. The Royal College of Nursing and other bodies such as the Royal College of Midwives, the College of Podiatry and the Royal College of Speech and Language Therapists think that they will. The Government’s own consultation document estimates that a trainee nurse who takes out the maximum tuition and maintenance loans for three years will graduate with debts of between £47,712 and £59,106. Who would want to embark on a lifetime of caring for others with a debt of that size?

That brings us to the concern that the measures will lead to further shortages. We are all aware of the shortages in our hospitals. The coalition Government allowed the number of training places to fall from more than 20,000 to just 17,000 in 2011 and 2012, the lowest level since the 1990s. As a result, over 8,000 fewer nurses were trained in the 2010 to 2015 Parliament compared with 2010-11. Those cuts in training places have meant that nurse numbers have failed to keep pace with demand. According to calculations by the House of Commons Library, the number of nurses per 100,000 population has fallen from 679 in 2009 to 665.

There are real concerns that removing NHS bursaries will only make matters worse. As was mentioned by my hon. Friend the Member for Scunthorpe (Nic Dakin), the independent NHS Pay Review Body has said that

“the removal of the incentive of the bursary could have an unsettling effect on the number and quality of applications for nursing training places in the early years. In addition, the reduction of net pay in the early years, as nurses repay their loans, will make the employment package and medium to long term reward offer an important factor in attracting high calibre students who are choosing between courses and career options.”

The Secretary of State should definitely focus on that.

The Royal College of Nursing is also concerned that there is a risk that the changes could result in an uneven distribution of students across nursing specialties and geographically across the UK. Health Education England currently commissions student places for four branches of nursing: adult, children, learning disabilities and mental health. Without workplace planning by a central body, there could be insufficient numbers across the four branches, as some may be more popular than others. There has been no indication of whether there will be any control over which sectors nurses train for in future or whether that will simply be determined by—of course, under this Government—the market. That could leave some sectors with even greater shortages than at present.

Tuition is currently paid for by Health Education England. Under the current system, no students have to pay tuition fees and fees are not means-tested. Students also receive a non-means-tested grant of £1,000, or £1,000 pro rata for part-time students. Students also qualify for a maintenance grant or bursary, which is means-tested, as well as additional allowances when a term lasts longer than 30 weeks, and help with the costs of clinical placements. I believe that that is the appropriate way to deliver NHS nurse training. If we are to continue to have a state-run public NHS, free at the point of need, we must continue to provide bursaries for our NHS nurses. It is the very least that we owe them.