The Government is committed to abolishing student nurse bursaries. The change was announced in last years’ autumn statement. In order to control the cost of the bursary, the Government has previously put a cap on the numbers of student nurses. However, a move to a loans system will allow them to lift this cap. Nothing wrong with that, you might think. Good Conservative policy! Getting a grip on all these handouts! But you would be wrong. It’s an imbecilic policy.
Nursing, as a profession, tends to trundle along at the lower end of wage acceptability. The scrapping of bursaries will, once more, push it down towards the unacceptable. People will choose not to do it. And then Britain will need to take on large numbers of immigrant nurses (again) to fill the shortfall. If you agree with this policy, then you love mass immigration. Go on, shout it from the rooftops: “I love mass immigration!” There is, however, another solution to all this, one that is simple and cheap, and will not dissuade people from becoming nurses.
Back in 1987, an NHS staff nurse with eight years experience earnt £7,750 per annum, which is about £20,500 in today’s money. This poor level of remuneration led to difficulties recruiting nurses. As MP Willie Hamilton commented at the time, “because of the poor conditions of … nurses, they are voting with their feet and either getting out of the profession or refusing to come into it”. The then Public Affairs Committee, cited by Hamilton, raised concerns over a 20 per cent fall in applications to be nurses.
Being a nurse is stressful. Whereas specialists such as podiatrists, physiotherapists and occupational therapists breeze into the ward, do their thing, and then leave, the nurse has to deal with anything and everything – from getting workmen to attend to building maintenance issues, to performing CPR, to informing next-of-kin of deaths. It’s a job that can be easy to walk away from.
In the eighties an estimated 30,000 nurses were leaving the NHS every year. Foreign nurses were brought in to fill the vacancies. The proportion of nurses from overseas rose four-fold between 1989 and 2001. This equated to about 15,000 overseas nurses a year in the early 2000s. When Gordon Brown increased national insurance contributions in 2002 to help fund the NHS, wages increased steadily. Indeed, the 2007 Wanless report noted that nearly half of all the extra funding made available was eaten up by staff pay. Nurses’ pay increased by over 25 per cent in the early years of the 2000s. By 2011 that 1987 salary of £20,500 for eight years’ service [adjusted for inflation] had increased to £31,000 [adjusted], though this has since fallen back to £28,000 as a result of pay freezes. As pay increased, the numbers of foreign nurses recruited fell. By 2013 just over a thousand were recruited across forty NHS trusts (however, this number is now rising sharply again). Poor nursing pay = immigration.
When not at college, student nurses spend twenty weeks of the year on hospital placements. There is no three-month summer holiday; there is actual real work. When I was a mature student in 2005, I received a bursary of £550 a month. In order to live, I supplemented this with an extra job, where I would work on my days off from nursing placement. This meant that I could be working every single day for eight weeks. The idea of doing that, and then having to pay most of the money back, with interest, is incomprehensible to me. It is inconceivable that this will not massively effect the numbers of people willing to study nursing.
There is, however, a simple solution: return nurse training back to the pre-1990s ‘apprentice system’, whereby young nurses start working in a hospital from day one, attending college on day-release. This is a far cheaper approach. It would also allow trainee nurses, often working-class girls, to avoid getting massively into debt. The enforced professionalisation of nursing is pointless.
Most of what I have learnt about nursing came from practical experience. Working as a nurse is to encounter and overcome an ongoing series of problems for which you have never been properly trained. When I attended nursing college (to study psychiatric nursing), I wanted to be taught facts: what are the side-effects of the antipsychotics, what are the different types of dementia, how does mental health legislation work? I wanted to be told ‘learn this’, and then examined on it. I had none of that.
We had wishy-washy discussion sessions for months on end, considering how we might ‘learn to listen’ to people, and not judge them. I had just one solitary lecture about medication, and even then it didn’t actually explain the meds themselves, but dwelt on nebulous issues like ‘trust’ and ‘power’. The truth is, the nursing degree is not academically rigorous; it is designed to be passed. So what’s the point?
The stupidity of the Government’s policy is that is does not even attempt to get to the nub of the problem. Whereas trainee nurses were first lumbered with having to do a pointless degree for three years, now, on top of that, they have to get into a large amount of debt for the privilege. This isn’t Conservative; it’s just daft.