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Healthcare Students: Tuition Fees

Volume 804: debated on Thursday 23 July 2020


Asked by

To ask Her Majesty’s Government what plans they have (1) to reimburse tuition fees, or (2) to forgive any current study-related debt, for any current nursing, midwifery and allied healthcare students who are employed by the National Health Service.

My Lords, the Government are extremely grateful to all students who chose to opt in to a paid clinical placement in the National Health Service during this extremely difficult time. We have ensured that all students who do so are rewarded fairly for their hard work. The students will continue to be required to pay tuition fees and there are no plans for a specific scheme to reimburse tuition fees or to forgive any current debt for them.

My Lords, at the height of the pandemic, Ministers joined the rest of us in applauding nurses and healthcare workers as heroes for their bravery and dedication. Sadly, now at the first opportunity to show their gratitude, they have let down the nurses by refusing them a pay increase and warning them that next year’s may not happen either. By their own action, the Government have shattered morale in the health service and made the recruitment and retention of nurses much more difficult.

My Lords, like many, many others, I joined in the applause for nurses and all those working in the NHS, particularly at this difficult time, not least my aunt, who is a nurse and midwife of 25 years’ standing. As I say, we are extremely grateful to all those have chosen to opt in. They are paid and are entitled to an NHS pension contribution during this period. On nurses’ pay generally, I simply make the point that the starting salary for nurses has increased by over 12% since 2017, so we certainly value those who are working in this rewarding career.

My Lords, are the Government concerned that, in a recent survey by the Royal College of Nurses, 74% of nurses said that they felt valued by the general public but only 18% felt valued by the Government? Surely paying them better, in training and afterwards, is the obvious way to value nurses if the Government are serious in their intention. Will the Minister guarantee to include in any review of pay and conditions those nurses who work in care homes and in the community, as they are so important in ensuring better integration of health and social care, which the pandemic has shown to be vital, though lacking in many places?

My Lords, we certainly value those who work in the nursing profession, which is why, as I say, the starting salary has increased by over 12% since 2017. The money with which those working in nursing are rewarded is just one way in which the appreciation of the country is expressed, particularly at this time.

My Lords, the removal of the nursing bursary had a devastating impact on student nurse numbers, with a 31% reduction in university applications for nursing courses since 2016. Student nurses have become an invaluable part of the workforce at a time when the country needs them most. These brave young students have lost tuition and university life, as have other students, but they responded to the country’s need. Surely the Minister can see how inappropriate it is to charge them tuition fees.

My Lords, the hours of those who have joined the workforce early to help with the crisis count towards the 4,600 hours that they have to complete as part of their training. While they have been working, they have remained under the care of their higher education provider. This is still part of their training, as well as being a valuable contribution to the NHS at this time. From September this year, the new maintenance grant of £5,000, which is not repayable, comes in for all nursing students, to make it easier for people to study and then join the profession.

My Lords, given the immense and appropriate praise that the Prime Minister and the Government have given our nurses during the Covid crisis, why are nurses not receiving a pay increase along with doctors and dentists, as has just been announced? I know that there is a current pay agreement, but I am sure that, as my noble friend will know, the British public would be overwhelmingly in favour of an increase and would back it totally.

My Lords, while nurses were not included in the announcement made this week, I can only repeat that the starting salary for nurses has gone up by 12% since 2017.

My Lords, given the National Audit Office report into the NHS nursing workforce of March this year and this week’s Public Accounts Committee session concerning the report, can the Minister confirm that the question asked by the noble Lord, Lord Forsyth of Drumlean, in this House on 30 January regarding the potential cost-effectiveness to the taxpayer of writing off educational loans for nurses after five or 10 years’ service has been discussed with the Treasury and the Department of Health and Social Care? If so, can further urgent consideration be given to this matter before the expected Autumn Budget?

My Lords, I do not know whether the specific question raised by the noble Baroness has been discussed, but I will find out and certainly write to let her know.

My Lords, applauding healthcare staff is one thing, but the Minister should take note of the Royal College of Nursing’s report this week, which stated, as others have said, that for the nursing profession to feel valued and to address the current workforce shortage, the Government must provide better financial support for nursing students, including the reimbursement of tuition fees, and forgo all current debts for nursing, midwifery and allied healthcare students impacted by the removal of the bursary. Can the Minister please confirm when this will happen?

My Lords, I have answered the question about reimbursement, which was the one that began this session. On nursing numbers, I would make the point that the number of nurses in our National Health Service is now at a record high and has gone up by 12,000 in the last year alone.

My Lords, many student nurses have to travel considerable distances from where they train to complete different aspects of their course, such as on mental health or learning disability. What support is given to students with their travel and accommodation expenses in these circumstances?

The noble Baroness makes an important point. Part of the new maintenance grant, which comes in in September this year, is in addition to a further £3,000 that is available to help with childcare, other dependant costs and living costs of that sort.

How responsive will the Government be to specific proposals to localise the future training of nurses, so that nurses are more able to live at home when they go through training, rather than having to rent accommodation?

My Lords, that is a good and important point, which I will of course discuss with the department. Some people need to study near to home for childcare and family reasons; others like having the opportunity to travel to another part of the UK and study there, for the benefits that that brings them.

My Lords, I am grateful for the question from the noble Baroness, Lady Jolly, which was the one that I was due to ask. I also welcome the announcement from the Government of an additional £5,000 for student nurses from September of this year. However, can my noble friend confirm that the Government will consider whether student loans might not have to be paid back by those nurses who spend more than five years in the NHS? That could assist with the retention of nurses.

My noble friend’s back-up question is just as good. The repayment of tuition fees begins only once people exceed a repayment threshold, which is currently £26,575, but I will certainly discuss the point that she makes more broadly with the department.

My Lords, the dedication of nurses and allied healthcare staff has shone like a bright light in the gloom of the Covid pandemic. Does the Minister agree that the least we can do to encourage those entering the profession is to reimburse tuition fees and write off any student-related debt? The Government should seriously reconsider their position.

The noble Lord is absolutely right: nurses have brought a great deal of comfort not just to those who have received their support directly but to their families and the general public, who have been watching on. However, as I said, those who have chosen to join the NHS early during their studies have been paid for their service and are receiving pension contributions. We are extremely grateful to them for doing so.