Surprise surprise, George Osbourne didn’t help the NHS in yesterday’s Autumn Statement. In fact he’s probably made the situation a whole lot worse. He may have pledged to increase the NHS budget by £10billion in real terms by 2020-21, but he’s also completely overhauled the way in which we fund the training for our prospective nurses of the future.
This is what he set out:
The Spending Review reforms the funding system for health students by replacing grants with student loans and abolishing the cap on the number of student places for nursing, midwifery and allied health subjects.
The current grant system means that there is a cap on student nurses and over half of all applicants to nursing courses are turned away. This reform will enable universities to provide up to 10,000 additional nursing and other health professional training places this Parliament.
Creating 10,000 more places on nursing courses? Great. But this poses a fundamental question. Quite simply – is there the capacity? Let me explain. Nursing students spend half of their course out in clinical practice in a host NHS Trust where they have their placements. This is a requirement set out by the Nursing and Midwifery Council in order to qualify and register as a nurse. They are supernumerary and are given a mentor who teaches, guides and assesses the student nurse through everything they do. This is a qualified, often experienced, nurse who is largely accountable for the student nurse’s actions, whilst also providing quality patient-centred care and being everything we expect as a society a nurse to be. It’s all well and good increasing the number of places on nursing courses by removing a so-called ‘cap’ (it should be pointed out that the ‘cap’ is only there because there wasn’t enough money committed to funding extra nursing course places in the first place), but is this even possible with dwindling NHS budgets? Will there even be enough staff to provide these students with a quality education and train them? Combatting the problem with the very same thing that’s causing the problem is just ludicrous – but we’re stuck in a viscous cycle that can only be broken by a serious intervention from the government that does more to help retain qualified nurses.
George Osbourne says we need to train more nurses to combat the close-to-crisis point shortage of nurses in NHS. And he’s right. For too long we have relied on recruiting nurses from abroad. I’m in no way dismissing the hard work, commitment and dedication of foreign nurses and I’m not advocating for closing the doors either, but it’s simply not sustainable to rely on nurses coming to the UK from abroad nor it is ethical to be poaching the talented and skilled workforces of global health systems – at a time (think Ebola in West Africa) when we should be helping to strengthen them.
But what caused this problem in the first place? A disillusioned nursing workforce is partly to blame. But how can we blame them? Nurses are only human too! Nurses work long hours, commit so much physically and mentally to their patients and many are desperately overstretched whilst being paid a wage capped at well below the rising rate of inflation. With austerity and a rising cost of living, the real-terms pay cut is a disaster for the profession and for our NHS.
As a student nurse myself, it would be laughable to say I wanted to go into the career for the money. And actually, I think I can speak for practically every one of my fellow students here, by saying it was a passion and desire to want to make a positive difference to the lives of our patients and their families which is what brought us to where we’re at today.
But now George Osbourne has managed to make going into a career in nursing even more unattractive – and maybe even impossible for some people. We have a longer academic year and fewer holidays than typical university courses and spend half of the year working unpaid for the NHS. We struggle to find part time work because of the flexibility required by our employers to be able to fit it in around our studies.
Currently we receive a bursary, a means tested grant and a smaller loan to be paid back. But now future students will face an even bigger loan for their maintenance allowance which will bring them more in line with the government’s new plans of funding for students on other courses. The changes may also require nursing students to pay their own tuition fees too (see note at the bottom of the page), which would result in even more debt. A loan which we’re not even sure everyone will qualify to apply for. The average age of an applicant to a nursing course is 29, and many of these already have a previous degree. The government haven’t specifically specified whether these applicants would be exempt from existing rules where student finance is only available for one degree.
All of this to combat the deficit of nurses in the UK and train more nurses? With 10,000 more places on nursing courses but with all this change, can George Osbourne even be sure whether more people will now apply for nursing courses? Nursing as a profession, the backbone of the NHS, is looking less and less appealing by the day. But maybe, that’s just what he wants.
We’re not going down without a fight.
Note: It is unclear how George Osbourne plans to create 10,000 new places on nursing courses at this point. He may either:
a) take away grants and students will have to take out a loan for their maintenance allowance, and therefore freeing up money to fund more university places
b) take away the funding that essentially pays the tuition fees for students and make students pay their own tuition fees, therefore making universities free to recruit as many as students as they like (as on other courses)