Double ‘take’ threatens the future of nursing

Most chancellors of the exchequer give with one hand and take with the other, but George Osborne hit nursing with a double whammy last week. First he announced that nursing students starting courses from 2017 will have to pay tuition fees, then added to the woe by revealing that they would not receive a bursary either. So the next generation of newly qualified nurses will start their careers on not much more than £21,000 and have debts that will take years to clear.

Mr Osborne’s decision follows lobbying from the Council of Deans of Health and Universities UK, who issued a joint policy paper earlier this year making the case for the changes. The two organisations, which represent leading nurse academics among others, argued that a steadier stream of nursing graduates would result. There are already many more applicants than there are places, and universities would have the funding required to lay on additional courses.

Importantly their joint paper also suggested that the government should repay nursing students’ loans after a given period of service, or offer a retention bonus that nurses could use to help pay off their debts. These ideas appear to have been ignored by the Treasury, seduced by early evidence from pilot sites in north west England that suggests would-be nurses are prepared to pay to train.

From a purely policy perspective there may well be benefits to Mr Osborne’s plans. In effect, workforce planning would pass to universities and the free market, which must be worth a go given the failures of all attempts to manage demand and supply. Nursing schools and faculties will be more stable.

However, these potential upsides must be set against the personal consequences for those who qualify from 2020 onwards, drowning in debt having been largely unable to earn while studying and completing placements, and then working in jobs that pay pitiful salaries at the outset and not much more after years of service. Mr Osborne is gambling with the future of nursing, but like most politicians is unlikely to be in office when the consequences of his decision come to fruition.