Economists have estimated that demand for healthcare courses will drop by at least 6% following the removal of bursaries next year, leading to thousands fewer nurses being trained in 2017.
They also predicted that universities would lose at least £57m next year, largely due to smaller student intakes, under the new arrangements that will see nursing, midwifery and allied health professional students in England having to take out loans to fund their tuition fees and living costs.
“Fewer nurses qualifying in 2020 will have disastrous consequences for patient safety and exacerbate the current recruitment crisis”
Meanwhile, the report – titled The Impact of the 2015 Comprehensive Spending Review on Higher Education Fees and Funding Arrangements in Subjects Allied to Medicine – estimated the government would fail to make the vast majority of savings it expects from the move because a large proportion of student loans would have to be written off.
According to the analysis, carried out by consultants London Economics for Unison and the National Union of Students, the cost to healthcare students to study at university would increase by 71% under the government reforms.
Current arrangements mean the average cost to a student on a healthcare course is around £21,000 for a three-year degree, based on the assumption that although they receive bursaries, the student is potentially losing out on a full-time salary in that time.
When the reforms are brought in, the economists predicted this cost to students would jump to around £36,000 – taking into consideration loan write-offs – representing an increase of 71%.
“The changes will mean greater volatility and uncertainty for universities’ future funding”
They said trends over the past 20 years had shown increasing the cost of university education to students was linked to a negative effect on the number studying. Applying this effect to nursing would lead to a 6% drop in healthcare students, equal to a loss of 2,100 nurses per cohort from autumn 2017 when the reforms are introduced.
The report also noted trusts could expect to spend an additional £100m a year on agency staff to fill the gaps emerging from the smaller number of graduates.
In their introduction to the report, Unison head of health Christina McAnea and NUS national president Megan Dunn said the drop in student numbers would have “disastrous” consequences for patient safety.
“The increased cost to students will deter people from becoming a nurse, midwife or allied health professional,” they said. “Far from creating 10,000 extra additional training places as claimed by the government, the changes will reduce current participation levels by 2,000 students.”
“Fewer nurses qualifying in 2020 will have disastrous consequences for patient safety and exacerbate the current recruitment crisis in the health and care sector,” they said.
“The government is drinking in the last chance saloons and sleepwalking into this disaster”
Meanwhile, the report authors said they expected universities to see their overall income from healthcare students reduced from £851m in 2015-16 to £795m in 2017-18.
This was based on the expected 6% reduction in student numbers, plus the fact that universities will be subject to rules under the loans system that mean they have to pay back around 15% of tuition fees for improving access.
“Instead of creating a sustainable funding system for universities, as promised by the government, the changes will mean greater volatility and uncertainty for universities’ future funding,” said Ms McAnea and Ms Dunn, who warned that it could lead to some courses being stopped altogether.
Government savings would also in reality be far less than originally expected, added the report.
Care minister Norman Lamb
It said the £534m per student cohort the government planned to save was based on the assumption nurses would earn similar salaries to other graduates.
In reality, the government would only save around £88m because it would have to write off a large proportion of loans, it said.
At the launch of the report, shadow health secretary Heidi Alexander and former health ministers Norman Lamb and Dr Dan Poulter urged the government to reconsider the reforms in light of the findings.
Mr Lamb warned that unless the government found more money for both NHS services and for training the workforce the system would “crash” by 2020.
“They [the government] are drinking in the last chance saloons and are sleepwalking into this disaster,” he said.
“To just take this money from student nurses and allied health professionals in order to seek to prop up the system, which is crumbling before our eyes, is wrong-headed and needs thorough review,” he said.
Ms Alexander said the report reinforced concerns that the government was taking a “huge gamble” on the future NHS workforce and patient safety.
“We can’t afford to train 2,000 fewer student nurses and other allied health professionals in the next year or so, because we’ve got a desperate shortage,” said Ms Alexander.
“This whole policy has been designed to save money but when you look at the extra spend on agency staff, overseas staff, the costs being put off to the future, you’re all but wiping out those supposed savings,” she added.
The Department of Health said it disagreed with the findings and the figures calculated in the report.
It said the report failed to recognise the demand for student nurse training places outstripped demand, with two thirds of applicants turned away.
It also said the analysis did not take account of further money that will be supplied to universities under the loans system from the Higher Education Funding Council for England, which allocates government funding.
A Department of Health spokeswoman said: ”We don’t agree with the findings of this report or recognise the figures quoted. We need more home-grown nurses so the NHS doesn’t have to rely on expensive agency staff or overseas nurses.
“Currently two thirds of people who apply to become a nurse aren’t accepted for training and our plans mean up to 10,000 more training places by the end of this parliament, with student nurses getting around 25% more financial support whilst they study,” she said.