NHS Bursary

Stephen Pound Excerpts

Monday 11th January 2016 Westminster Hall

[Paul Scully (Sutton and Cheam) (Con)]

I beg to move,

That this House has considered e-petition 113491 relating to the NHS Bursary.

As of this morning, the petition had 154,390 signatures, which shows the depth of feeling and the concern that student nurses have about the proposed policy. Before the debate, we had a fantastic listening exercise, which involved a number of student nurses and other representatives of the health industry, many of whom are here in the audience. Having filled the Public Gallery, we even have an overspill room elsewhere on the estate where the debate is being shown on television. It is a testament to the importance of the matter that so many Members of Parliament are attending the debate.

[Stephen Pound (Ealing North) (Lab)]

I am in no way being critical of the hon. Gentleman, who deserves a great deal of credit for what he has done, but does he agree that instead of using the expression “the health industry”, it might be better to say “the health profession”?

[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.

--- Later in debate ---

[Paul Scully]

The hon. Gentleman might not be surprised to know that I cannot answer that, so I will pass it on to my hon. Friend the Minister, who I am sure will cover it when he sums up.

As I said earlier, I ask the Minister whether there will be an exemption for loans taken out to cover a second degree. Also, what arrangements will be made for placement expenses, which are a concern for many people going through the process? In Parliament a few years ago, there was some discussion about unpaid parliamentary interns, and a number of changes were made. Greater accountability through the media has led many Members of Parliament to change their practices so that, rather than just getting unpaid interns to do a load of work, they are paying a reasonable wage, even if it is not the full-on salary that someone else might get.

As I have mentioned, the people doing placements are largely not supernumerary. They mostly do full-on nursing work, to our benefit as patients. I will be grateful to hear what the Minister has to say about placement expenses.

[Stephen Pound]

The hon. Gentleman is being extremely generous. I am sure that I am not the only person to congratulate him on bringing this extremely important matter before the House. On the basis of my 10 years’ experience working at Middlesex hospital, may I say that nurses are in an exceptionally unusual position? They cannot simply come and do five days and then go home. Accommodation is an issue. Nurses’ homes such as John Astor House at the Middlesex are long gone. How on earth can we ask student nurses or potential student nurses to come to one of the major five teaching hospitals in London—there are now four, obviously, since the Middlesex is gone—without giving them any support or assistance with accommodation? Nurses’ homes do not exist anymore. With respect, nurses need more at the moment, not less.

[Hon. Members]

Hear, hear!

--- Later in debate ---

[Maria Caulfield]

I will not, if the hon. Lady does not mind, just because I know that so many Members want to speak.

Although not all of those 37,000 will have been rejected because of a lack of places, a significant number of them will. The current system restricts the number of student nurses that enter the profession so, in theory, the changes should increase the numbers of qualified nurses in a few years’ time. From my clinical practice I know, however, that what works in theory will have the opposite effect in reality.

My main concerns about moving from a bursary scheme to a student loan scheme are, first, that many nurses go into a degree system simply because there is no other way to become a nurse. They do not necessarily want a degree in nursing; they want to be a qualified registered nurse. If we commit to a student loan scheme, we are committing them to take on debt for years to come. As we have heard, many of them—more than 30%—are mature students, and by mature students we do not mean people in their 40s and 50s. They are people in their mid-20s and early-30s. They have young families; they are single mums; and they have a first degree and have to take on a second one just to become a nurse. It is a crazy situation. For someone who already has a student loan, and/or a mortgage and/or childcare to pay for, the thought of taking on more debt will definitely put them off entering nursing, and to say otherwise is madness.

The difference between student nurses and other undergraduates is that the starting salary for a nurse is £21,000. Most nurses will only ever be a band 5 or 6, and the maximum they can earn as a band 6 is £34,000—that is if they do not have a break to have children or go part time for some other reason. They will never be in a position fully to pay off their student loan. Student nurses are different, therefore, from other undergraduates, and that has not been recognised in the debate. An issue in the wider debate about graduates is that a graduate is, on average, £100,000 better off than a non-graduate, but that is not the case with nurses. Other graduates earn, on average, more than £40,000 a year, but nurses do not earn anything like that and that difference needs to be recognised when decisions are made.

We have heard how much time student nurses spend on clinical placements—more than 50% of their course, including nights, weekends and evenings—which makes it almost impossible for them to get any other income from part-time work. We must recognise that. Being dependent on a loan is not a great way of life either, but other students are able to supplement their loans by working in pubs and shops, and doing other evening work. Student nurses are not in a position to do that.

My second concern is that, if I am completely wrong and we suddenly have a huge increase in the number of student nurses, the placements will not be able to cope. To qualify as a student nurse, not only does someone have to pass their exams and essays and do the required hours, they also have to be clinically assessed by a registered nurse—not just any old registered nurse, but someone who has done their mentoring and assessing course. I know that there are student nurses now who struggle to find placements because there are not enough qualified nurses able to assess them. That needs to be taken into account as well. It is not just about increasing the numbers; it is about having the support services in place.

When I met the Minister, I was hugely reassured by what he said about other schemes that are being proposed. My plea is that he outlines those schemes so that student nurses are reassured that, in order to qualify, they will be able to use schemes other than the student loan system. Routes such as nursing associates and nursing apprenticeships are being proposed. I am probably getting a little old now—

[Stephen Pound]

No!

[Maria Caulfield]

I thank the hon. Gentleman for his intervention. Those routes sounds like the state-enrolled nurse or state-registered nurse route again, and they worked pretty well in years gone by.