Nursing: Higher Education Investment

Stephen Hammond Excerpts

Wednesday 21st November 2018 Westminster Hall

[The Minister for Health (Stephen Hammond)]

It is a great pleasure to serve under your chairmanship, Mr Davies, as I make my first speech in what I regard as one of the most important ministerial roles in the Government. I thank the hon. Member for Wolverhampton South West (Eleanor Smith) for securing the debate. It has been a passionate debate that has reflected the importance that so many people—including, clearly, everybody in this Chamber—place on NHS professionals. It has recognised that high-quality education and training for nurses is fundamental to ensuring that the highest level of nursing care is given to patients. I obviously recognise that the hon. Lady, having served in the NHS for more than 40 years, has first-hand knowledge of the difference that nurses can make to individuals and families.

The hon. Lady raised several points in her speech, many of which I will address. However, she quite rightly opened by saying that we need and must have staffing that is safe for effective care. No one in the House would move from that. She asked several questions, including on bursaries, mature students and the number of people in training, which I will come to, but also made several points about the long-term plan, which it is important to talk about at the beginning.

The long-term plan will contain a chapter on NHS professionals and workforce planning, which I recognise will be the most important chapter. The hon. Lady will know that Health Education England undertook a consultation on the strategy for the workforce, which was published in draft last year. HEE also undertook a full consultation on the priorities for the health and care workforce, which concluded in the summer. The “Talk Health and Care” platform has been introduced, which the Government particularly expect to inform the work that NHS England is leading on the long-term plan.

It is also particularly important—it is potentially by accident—that the debate takes place on the day that the RCN produced a document, to which the Secretary of State and I have committed to respond. The shadow Minister is right: I deliberately took the time before the debate to meet a number of the students. I heard at first hand a number of their concerns, and I said to them—the hon. Gentleman will perhaps understand this, given his remarks about retention at the start of his speech—how important I think retention is, not only of nurses but of Ministers as well.

[Vicky Ford]

I am delighted that the Minister met the RCN and nursing students this morning. Will he confirm that hearing the voices of students themselves is absolutely vital in making decisions on the future?

[Stephen Hammond]

Of course it is important. As my hon. Friend will know, as Members, and particularly as Ministers, we get all sorts of briefings, which are very helpful and contain lots of numbers, but not real-life experience.

My hon. Friend the Member for Henley (John Howell) talked about the experience of nurses at his hospital. He made the point quite powerfully that there are several common issues that we need to address, but several other issues that are not necessarily common to every experience. It is right that we consider the issues they raise.

[Janet Daby]

One of my constituents who is a student nurse has been to see me. She is struggling with her student nursing loans. She has two children, and she was literally in tears while telling me her stories about how difficult it is for her—the Student Loans Company is demanding the money back. She is working and has children, and cannot afford to pay back those loans. Does the Minister think that situation is tenable?

[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.

[Dr Caroline Johnson]

“The nursing workforce” report, which was published by the Select Committee on Health in January, identified that 30% of students due to complete in 2015-16 or 2016-17 did not complete within that period. Significant variability between different training institutions was also identified. Will the Minister commit to looking at why some institutions have such high attrition rates compared with others?

[Stephen Hammond]

That is an extremely important point. There is not necessarily a universal reason why particular institutions have worse attrition rates than others, and that may well be key to retaining people who wish to stay in the profession.

In my last minute, I will finish on this point: NHS England, NHS Improvement and Health Education England are all working with trusts on a range of recruitment, retention and return-to-practice programmes. Some of those have met with some success: NHS Improvement’s retention programme works directly with trusts to support improvements in retention. However, I want to make clear that, as the newest member of the Government and of the Department, I regard the retention of our NHS professionals as a priority, and I am looking forward to making a contribution not only to things like the “Talk Health and Care” platform, through which there has already been positive engagement, but on this matter more generally. Retention is key, and we want to make sure nurses understand that we recognise how important they are. The long-term plan will set out a strategy to ensure a more sustainable future supply of nurses. They work incredibly hard, and it is absolutely right that this Government will commit to ensure that funding is dedicated to the supply—

Motion lapsed (Standing Order No. 10(6)).