Jeremy Hunt, secretary of state for health, has just escaped a head on clash with the junior doctors – and walked into one with student nurses! Within days of the government announcing the replacement of nursing bursaries with student loans, a petition opposing the move collected more than 100,000 signatures: it will now be debated by MPs in January. On the face of it, it does appear a clumsy and unwise move when we have a national nursing shortage.
The rationale behind the removal of the bursary is the optimistic belief that universities will offer more course places funded by the £9,000 annual course fees, and not rely on limited government bursaries. The nursing shortage is proof that the present system has failed: there are five applicants for every one nursing place at university. It is anticipated there will be 10,000 additional training places for nurses, midwives and allied health courses created through this loan scheme – note, this is not 10,000 more nurses! Cynics suggest the places will be taken by overseas applicants eager to get a coveted UK nursing qualification.
Within the profession, there are mixed views on the likely impact of a loans system on nurse recruitment. Many nurses feel this is another blow to a bruised profession and nursing unions say that being saddled with large loans to pay off will deter people from training as a nurse. University deans of nursing welcome the opportunity to increase much needed nursing places. Will it reduce the relatively high drop-out rate on bursary-funded nursing courses?
Nursing networks indicate the difficulty of funding nurse training even with the existing bursary and numerous nurses indicate they would not have undertaken training without the bursary covering their fees.
Now student nurses are set to receive over 25% more money up front with the new loans system, although qualified graduate nurses will accumulate debts of around £50,000. Healthcare commentators suggest employers could recruit and retain nurses by offering to pay off some of their student debt instead of making staggeringly high payments to agencies.
Mr Hunt indicated the new arrangement will bring nursing students into line with all other university students. But nursing is not like other courses leading to a professional qualification – it requires 50% on clinical placements in addition to reading, research and attendance at university. This prevents nursing students taking on additional jobs to boost their student loans as academic, term time courses permit. In addition, the average age of a student nurse on entry to the programme is 28.5 years and they often have a first degree; the government has also announced nursing students will be eligible for a second student loan. Older students are especially valuable bringing maturity and life experience that results in lower dropout rates and higher take up of posts on qualification, especially in the community setting.
I’m genuinely uncertain about the implications on the profession of moving to a loans system. There is no doubt any move to improve uptake and retention of student nurses is welcome. I am not confident this is the right move at this time.