Nursing: Higher Education Investment

Paul Blomfield Excerpts

Wednesday 21st November 2018 Westminster Hall

[Paul Blomfield (Sheffield Central) (Lab)]

I congratulate my hon. Friend the Member for Wolverhampton South West (Eleanor Smith) on securing this debate, and the RCN student nursing campaign, “Fund Our Future”, on putting the issue firmly on the agenda. I cannot speak with her authority from experience, but I am chair of the all-party group on students and also represent a significant number of student nurses, midwives and allied health professionals in training at Sheffield Hallam University.

It is disappointing that we have to be here debating this issue again, because we have been over the argument several times. I remember the debate that we had in this Chamber in January 2016 when the Government first proposed to end the previous funding system and introduce loans and fees. I remember a powerful speech from the hon. Member for Lewes (Maria Caulfield). She talked about how hard it was to be a student nurse; how she bore the scars of her nurse training; and how nurses had to learn, take exams and also go through placement changes every eight to 12 weeks, which presented significant challenges for mature students. She also clarified that when we talk about mature students, in many cases we are talking about people not in their 40s and 50s but in their 20s and 30s—people with young families and single mums.

One of the students from Sheffield Hallam University who contacted me ahead of today’s debate was Clary Manners, who echoed many of those points from her current experience. She said she gave up a well-paid job to train as a mental health nurse. She currently does 37 hours a week on placement and has a three-hour round drive there and back each day for the placement. She pays £10 in parking charges when she gets to the hospital. She takes no holidays. She has little spare time because she takes bank nursing jobs to boost her family income, but still her four children are on free school meals because of the struggle to get by on her income.

In the debate in 2016, the hon. Member for Lewes said—this view was echoed throughout the Chamber—that encouraging people to take on debt would

“definitely put them off entering nursing, and to say otherwise is madness.”—[Official Report, 11 January 2016; Vol. 604, c. 217WH.]

The then Health Minister, Ben Gummer, assured us that what the Government were trying to do—you could not make this up—was to share the benefits of the funding system for other students with nursing, midwifery and allied health students. Some of us questioned in what way a £50,000 debt was a benefit, but he was insistent that we would see an increase in applications. Now we know he was wrong. UCAS figures published earlier this year show that applications for the current year were down by a third on the same point in 2016—it is a continuing trend—and by 13% in the past year alone.

The changes have been a particular barrier to those from lower-income families, which is hugely important because nursing and midwifery has been one of the channels of social mobility available for many who do not enter conventional university. We have heard how the profession has traditionally been dominated by mature students, who have been particularly hard-hit in the fall-off in numbers. Overall, compared with when the changes to nursing degree funding were made in 2016, we have almost 1,800 fewer nurses due to start at university. I remind Government Members that although they talk about the 13,000 extra nurses now on the wards, many of them started their training before 2010 under a Labour Government. There is a pipeline for nursing supply, and the current system benefits from the pipeline that we put in place.

There are almost 42,000 nursing vacancies in England. Without action now, that could rise to 48,000 in the next five years. The Government have a responsibility to fix that, and they can do it by introducing a student funding system that is fit for purpose and that can reverse the drop in applications and encourage people to take up nursing in the way that they did previously.

--- Later in debate ---

[Stephen Hammond]

I will talk about that issue in more depth later, but if the hon. Lady wishes to write to me, I will look at her constituent’s case. I will point out that the learning support fund already offers a number of opportunities, including child dependants allowance, travel costs and an exceptional hardship allowance. I hope her constituent knows about and is taking advantage of those opportunities.

The hon. Member for Ellesmere Port and Neston (Justin Madders) asked whether the Government will publish an update on the impact of the reforms. That is currently being worked on with education and health organisations and stakeholders. We will look at the most appropriate way of making sure that, following receipt of the proposals by the RCN, and in the context of the long-term plan and the chapter on workforce planning, the higher education funding review takes place and feeds into that update. We will set that position out in due course—I dare say that the hon. Gentleman and I will debate it in due course as well.

My hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson) described what an excellent training scheme should look like, which was very helpful and powerful. My hon. Friend’s experience as a clinician is invaluable, and hopefully my speech will address a number of the points that she raised. I listened carefully to the asks of my hon. Friend the Member for Chelmsford (Vicky Ford). Some are in my power and some are not, but she made a point about mature students, and the Government recognise that the number of mature student applications has dropped across the wider higher education sector as well as in nursing. We are working with organisations in the sector to see how we can attract more mature students and whether specific funding can be targeted more effectively towards those students via the learning support fund.

It does not really need saying that, at the national level, the Government understand how important nurses are. We are committed to making sure that the nursing workforce are properly supported and funded. In her contribution, the hon. Member for Wolverhampton South West made the point that funding to the NHS is increasing: by 2023-24, it will receive £20.5 billion a year more than it currently does, and the Government expect the long-term plan to set out a strategy for the NHS to ensure a sustainable supply of nurses, rolling that supply across the whole range of pathways. We expect NHS England to clearly set out its commitment to the nursing workforce in the long-term plan, and ensure that there is a clear way for that plan to be implemented. A number of significant interventions are already in place to boost the supply of nurses, including training more nurses, offering new routes and enhancing reward packages. As my hon. Friend the Member for Sleaford and North Hykeham pointed out, there are over 11,900 more nurses on our wards than there were in May 2010.

However, the Government, and I as the new Minister for Health, should never be complacent, so I will set out a few other things that I regard as priorities. Our priority is to get more nurses on to our wards. As has been referred to, the education funding reforms, which moved student nurse funding into the student loans system, were introduced to unlock the cap that constrained the number of pre-registration nursing training places. Those reforms allow more students to gain access to nurse degree training courses. We have announced funding for 5,000 more clinical training places to make sure that those placements can be put in place. We have also increased midwifery training places by more than 3,000 over the next four years, and in 2017, there were 22,575 acceptances—the second-largest number since nursing became a degree-only profession.

It is also important to note that the loans system gives more cash when compared with the bursary system—effectively, up to 25% more. A mature student with two children will receive up to an extra £7,500 a year. I recognise that a number of other things need to be, and should be, put in place and known about more widely. The Government have also targeted support for healthcare students on courses through the learning support fund, which provides additional non-repayable grants. Up to £1,000 is available for eligible students in childcare allowances and hardship funding provisions. None of that, of course, was available under the bursary scheme. More nurses are in training, and the Government are working with Health Education England and the university sector to ensure that students continue to apply for nursing courses up to the end of clearing this year. I am pleased to say that, this year, we have seen a 6% increase in the number of 18-year-olds applying for courses and being accepted.

As an hon. Friend pointed out, there continues to be strong demand, specifically for younger people. I have made the point that we need to address the issues faced by more mature students who wish to enter, or re-enter, the profession. That should be a key priority in the long-term plan. The Government, and I as the new Minister, recognise that we need to do much more to continue to encourage people to apply for nursing courses, particularly more mature students. Therefore, my officials are actively engaging with the Royal College of Nursing, the Council of Deans of Health, and Universities UK—all of those organisations have a role to play. The Government will be consulting on the detailed proposals on future funding for higher education that the RCN has put forward today. I said this earlier, but I want to recommit and make it clear that we regard those as serious proposals, and will be writing to the RCN to engage on those proposals. We will start that work straightaway.

[Paul Blomfield]

I appreciate that the Minister is new to his post, and that it may be more appropriate for him to write to me in response to this point. I wonder whether he will address the attrition rates question asked by my hon. Friend the Member for Ellesmere Port and Neston (Justin Madders). There is a relationship between the falling number of applications, the funding regime, and the higher attrition rates. Does the Minister have numbers on that, and what consideration are the Government giving to it?

[Stephen Hammond]

Inspiration has just reached me. As the hon. Gentleman will know, Health Education England recently published a report on attrition rates on nursing courses—I made the point earlier that the rate of attrition among all people applying for university places has gone down. However, I will write to the hon. Gentleman. The report published by Health Education England describes how attrition rates on those courses have fallen considerably over the past few years, but I will write to him to be absolutely clear. He may then choose to make that letter available.