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“If we need more nurses, we need to fund university places”

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As a child I was far too trusting. My father, who didn’t live with me, took me on a day trip to Ramsgate once.

It wasn’t as glamorous as it sounds, given that I lived about two miles away in Margate, but he had bought a pork pie which made it a picnic. He liked to tell me stories about his heroic youth and, in one of them, he pointed at a cliff top and told me had been standing there when William The Conqueror came overhead in his plane and shook his fist at my dad.

“What did you do?” I asked, eyeing the pork pie.

“I drove to London and told Winston Churchill,” he said.

“What did he do?” I asked.

My dad shrugged. “That’s how the war started.”

The thing is, nonsense seeps in through the same pores as truth and I never doubted that William the Conqueror had a plane. Not right up to getting my mark for O-level history.

These days I am less trusting. Indeed, when institutions gather together to tell me something is unquestionably for the best I find my liver begins to itch. Instinctively I doubt them.

Have you noticed in recent months the recurrent story warning us of a change to how nurses fund their education? A story on in June proclaimed, ‘Academics call for urgent overhaul of student nurse funding’. This ‘call’ turned into a ‘row’ in July and had become a ‘risk’ by September, and something akin to a proposal in waiting last week.

The thinking is that if we get rid of student bursaries we free up universities to recruit larger numbers of students because they will not be dependent on commissions. It would also save the Treasury money and we know how important that is.

It is a policy born of a particular and transcendent logic. The logic of the internal market. If all exchanges, from beds and services to the very education of clinicians, exists in a market place then we can measure it, value it in a certain way, exchange it and - when we need to - revalue it.

And for the record, no matter how deeply entrenched that premise is now it is still wrong. The truth is that, if we need more nurses, we need to fund the commissioning of university places - not only because we need to attract nurses from a wide range of backgrounds, and not limit access to the profession on grounds of income or propensity to manage debt - but because we need to reassert the value of public service as something that requires public rather than just personal investment.

Two narratives emerge when proposals like this are made. The first is a narrative of economics. The logic of the marketplace is constructed by a negotiation between universities and government and is premised on the fact that universities need more money and are not going to get it from a government that doesn’t understand public service. It is a narrative born of pragmatism.

The second narrative is more insidious. It changes assumptions and expectations about what is ‘the sensible course to take’. It creates a new normal. A normal where paying to be a nurse is an opportunity and not a burden. That narrative shifts our assumptions. It is at heart ideological.

I don’t trust either of those narratives. I think the first punishes students - and we have a responsibility to protect them. But I think the second punishes us all and I think to sleepwalk further into that is professionally masochistic.

Mark Radcliffe is a lecturer, and author of Stranger than Kindness. Follow him on twitter @markacradcliffe

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