The case for replacing bursaries with loans for nursing students

Nursing bursaries. If we always do what we’ve always done, we’ll always get what we’ve always got.

Nursing bursaries. If we always do what we’ve always done, we’ll always get what we’ve always got.

We have to face facts. We have never trained enough nurses. We have depended on overseas recruitment for as long as I can remember.

We have always had a boom and bust approach to planning training numbers, and for too long we have also had high attrition rates among nursing students. Too often, the reason for student drop-out has been financial – especially for mature students with families.

So it might be the right time to rethink how nursing students are funded, however unpopular this may seem at first glance.

The NHS is one of the few employers that funds its own university training places through bursaries, and in doing so, plans and funds student numbers centrally. Sadly, these plans have often failed to meet the nation’s need for nurses. Yet universities tell us that nursing courses are comparatively popular: they are currently turning away qualified, motivated applicants.

Other professions, such as engineers, architects, lawyers and biomedical scientists do not depend on such centrally planned education provision.

There are parallels with nursing – many of these students have to undertake significant workplace training or sandwich programmes as part of their study commitments. Universities provide places based on popularity of the course and available facilities, for example lab space. So freeing up universities to provide more places for nurses seems to make huge sense.

I have been very taken by the experience of our Romanian and Portuguese colleagues, many of whom were expected to pay for training in their own countries. They tell me that because they had to invest in themselves by funding their training, they are more motivated – both in the important choice of career and in continuing training and not dropping out. Their view was that if nursing is seen as a professional career with reasonable salaries and prospects, the investment is worthwhile over a lifetime career.

True, no one likes debt. But the concept of student loans, despite the original controversy, is now well tested and reasonably well accepted. We have to concede that the current bursary is too small and inflexible, especially for many mature students. The loan will actually increase students’ disposable income during their studies.

Yes, there are risks, and they will need to be assessed and mitiga ted. There may still be a workforce supply mismatch – whether under or over-supply – leading either to not enough nurses being trained or to nurses qualifying with no jobs available.

I have yet to meet a nurse who cannot find employment in the long term, though it may mean working in an area that was not your first choice while building a CV.

And maybe a bit of competition is not a bad thing. I can see many matrons welcoming having five people apply for each job. It is too often the case that many candidates do not even turn up for the interview.

It is important that as many nurses as possible contribute to the consultation in a balanced and thoughtful way. A good place to start your research is to read the recent House of Commons debate in Hansard online, which presents the arguments for and against in a balanced way.

I do regret the link between this debate and the nursing associate role in the consultation document. These are entirely different issues, which should not be confused. But that’s an argument for another day.

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