New health minister Stephen Hammond has pledged to consider proposals to reintroduce bursaries or a new system of grants for student nurses, after hearing about the struggles faced by those currently studying.
In his first debate in the role on Wednesday, Mr Hammond said the government would consult on plans put forward by the Royal College of Nursing to reinvest £1bn a year into higher education for nurses as part of the extra cash promised for the NHS.
The college has produced costed blueprint detailing possible future structures, which include bringing back a bursary system or introducing “forgivable loans” that will be paid back by the government in return for service.
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Campaigners made clear that if bursaries were reinstated they would need to provide increased support for students because the former offer was not good enough.
The government controversially scrapped bursaries for student nurses in 2016 and replaced them with a system of loans and tuition fees.
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Speaking in Westminster Hall, Mr Hammond said: “The government and certainly I, as the new minster, recognise there is much more that we need to do to continue to encourage people to apply for nursing courses particularly the more mature students.
“We will be consulting on the detailed proposals that the RCN has put forward today on future finding for high education – we regard those as serious proposals and we will write to the royal college to engage on those proposals and we will be starting that work straight away,” he said.
“We don’t expect to be rich but to be able to live and to be able to pay bill would be great”
Mr Hammond said he expected the upcoming NHS 10-year plan, due to be published next month, would include a strategy on ensuring a “sustainable supply of nurses” in the future.
Ahead of the debate, Mr Hammond and other MPs met with a group of student nurses to hear about the challenges they were facing.
Among those who shared their story was Grace Paige, who is the final year of a mental health nursing degree at the University of Worcester. The 31-year-old is “happily married” to husband, Russell, and the couple have a four-year-old son, Dylan.
She started studying before the bursary was removed but Ms Paige said she received just £349 a month, which doesn’t even cover her son’s nursery fees.
As a result, Ms Paige and her husband have had to move in with their respective parents while she studies. Dylan is living with Ms Paige and the family are reunited at the weekends, which means little time with her husband.
Ms Paige told Nursing Times: “It’s tough – it took a long time to find our new normal and it’s hard because it’s tiring [being] solo parents and on weekends you feel like you have to cram normal life into two days and if you are on placements some weekends I only have one day with them.
“It’s been hard but our relationship was already really strong and he is very understanding and he says he can see how happy I am doing what I am doing,” she added.
“We will write to the royal college to engage on those proposals and we will be starting that work straight away”
Ms Paige, whose mother is a general nurse, said she wanted to see the bursary returned but also reformed to provide increased support to students.
She added that, at the very least, students nurses should receive a minimum wage while they were on placement. Currently Ms Paige receives the equivalent of £2.37 an hour for the work she was doing.
“We do this because we are passionate about it – no-one goes into [nursing] for the money but passion doesn’t pay the bills,” Ms Paige told Nursing Times. “We don’t expect to be rich but to be able to live and to be able to pay bill would be great.”
Second year post-graduate adult nursing student Megan Fletcher, from the University of Southampton, told Nursing Times that on top of 40 hours of placement work each week, she was also doing between 13 to 25 hours as a bank healthcare assistant in order to make ends meet.
The 24-year-old said nursing students were lost in a “grey area” between academic study and work-placed learning and that funding needed to reflect that.
She added: “I did an undergraduate degree in something else and compared to that this is a different world. The amount of time you are expected to be somewhere that isn’t paying the bills is just absurd.
“I feel like there should be a conversation about how we fund nursing and that conversation needs to take into account the fact we are expected to work 37.5 hours a week, which in any other sphere of work would be paid for or having certain rights around sickness or how you are treated,” she said.
“It’s this void in the system, where you are thrown out into the workplace under the banner of supernumerary which applies in various ways, and it needs to be recognised that [nursing] is different and it can’t be whitewashed with everything else,” said Ms Fletcher.
“The diversity and background of nursing students has radically changed”
Labour MP and former nurse of 40 years, Eleanor Smith, led the debate in parliament today. She highlighted that in every year since the education funding reform, applications to nursing courses had fallen.
She stated: “The diversity and background of nursing students has radically changed, excluding many who would have previously been able to change their personal and economic circumstances through a rewarding career.”
At the same time, the number of vacant nurse posts in the NHS in England has risen to almost 42,000. Without policy and funding intervention, this could grow to almost 48,000 by 2023, Ms Smith warned.
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She said services were so short-staffed that student nurses on placements were being “unsafely used to plug the gaps”. She highlighted that the demands of the nursing course with the academic and clinical expectations meant students didn’t have time to take on a part-time job for extra cash to get by.
“The personal cost of becoming a nurse is turning people away right when health and care services most need growth,” Ms Smith said. “This is frankly disgraceful and irresponsibly short sighted.”
The introduction of new routes into nursing including through apprenticeships and nursing associates equated to “workforce panicking, not workforce planning”, she said.
Ms Smith called for a “new student support offer” for higher education, including a return of bursaries along with an extension of the hardship fund for those who needed more assistance.
She said ambitions set out in the NHS long-term plan, due to be published next month, needed to be matched by a “credible growth in registered nurses”.
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Shadow health minister Justin Madders said the reintroduction of bursaries was essential if the government wanted to address the nursing “crisis”.
“There has not been a single jot of evidence since it was removed that would dissuade us from our initial view that the abolition of the bursary was a short-sighted, damaging and ultimately self-defeating policy,” he said.
Having met with student nurses ahead of the debate, Mr Madders said many were working “unsafe hours” to make ends meet.
He said the NHS could no longer rely on nurses from the European Union to prop up services because uncertainly around Brexit was driving them away.
“Our NHS staff cannot keep giving more at the same time that we are giving them less,” he said. “The government needs to fund our future and invest in nursing higher education – it simply cannot afford not to do so.”
“Student nurses brought the argument to Westminster today, meeting MPs and ministers”
Mr Madders said the government had committed to carrying out a review of the removal of the bursary and questioned Mr Hammond on when that would be published.
In response, Mr Hammond said: “That is currently being worked on both with education and health organisations and stakeholders and we will look at the most appropriate way of making sure that following the recipient of the proposals by the RCN and in context of the long term plan and the chapter on workforce planning, that the higher education funding review takes place… and we will set out that position in due course.”
Mr Hammond said the government recognised concerns about the drop in mature student nurses and was working to see what could be done to address this including whether specific funding through the “learning support fund” could be targeted more effectively to those students.
Speaking after the debate, Dame Donna Kinnair, acting chief executive and general secretary of the RCN, welcomed Mr Hammond’s commitment to consider the college’s funding plan.
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“Student nurses brought the argument to Westminster today, meeting MPs and ministers to share the experiences of hardship and hard work that make them unique,” she said.
“The government has heard the call – today in the house new health minister Stephen Hammond committed to ensure funding support for the future supply of nurses as part of the ten-year plan for the NHS,” said Ms Kinnair.
“Mr Hammond also committed to consider the funding proposals set out by the RCN, and work with the college to address the fall in student numbers and the 42,000 nurse vacancies that are crippling our health care system,” she added.