In the last month, student nurses, midwives, junior doctors and other healthcare disciplines have been organising and liaising with each other in response to the cuts to the NHS bursary in the Autumn spending review by George Osborne. At the adjournment debate regarding the cuts to the NHS bursary, Wes Streeting MP gallantly defended and spoke with great clarity of how cuts would affect the NHS workforce. From this, we found out that there are plans for a two pronged route into nursing; degree and apprenticeship. Suddenly, the plan has been exposed – associate nurses as a cheaper alternative to degree level registered nurses. For me, I am proud to have been given the opportunity to study at degree level to be a children’s nurse. It is a really tough course with 50% of my studies in university and the other half in clinical settings and I have often had to work weekends, nights, bank holidays and regularly miss social events. If I happen to be sick, I have to make those hours up or I will fail to progress onto the next year of study. This means for three years, it is very difficult to plan anything at all as there is the very real possibility of failure. Healthcare students live, eat and breathe what they are studying as there is just no time to do, or think, of anything else. We are fully immersed into the NHS and we have a prime seat in observing what is actually happening in hospitals, communities and other settings and how this directly affects those using healthcare services.
Nursing has advanced over the years where entry level newly qualified nurses need to have a very good underpinning of theory to practice safely and initial studies from RN4Cast have shown that patient mortality has decreased since graduate nurses have been introduced in Europe. Nurses who have been trained before the degree education route are integral to the NHS as they have progressed, evolved and seen the changes that have occurred in hospitals and the community. Experience and the ability to embrace change is what makes a truly remarkable practitioner. I am well aware that there is an argument about us degree educated nurses being “too posh to wash” but this is not an argument that needs to be had and is entirely unsubstantiated; there are no short cuts in nursing. Having factions within nursing is exactly what the government wants in order to divide and conquer.
Many healthcare students are in full support of the campaign to stop the NHS funded bursary becoming a repayable loan from student finance. From the way in which this government has decimated social care, health care, emergency services and education, I admit that when I first heard the news about the bursary being cut I was cynical. Loan repayments have been estimated to be over £50,000 with a freeze on student loan thresholds meaning that while healthcare professionals enter the rigid Agenda for Change banding (which has been frozen at a 1% pay rise cap until 2020) and the cost of living rises with inflation, they will still have to pay off their student loans at the same threshold creating a fiscal drag situation. Yes, sneaky George has put in the small print in the review that this will now happen rather than the promise of repayment thresholds rising with cost of living. It is starting to become apparent that healthcare professions are becoming privatised and are not valued for the work that they do – this also applies to the current junior doctor contracts dispute.
When healthcare courses can be up to 50% in clinical settings, theory needing to be condensed and completed in 18 months rather than three years, there is little time to work to subsidise living costs alongside such a demanding course. For example, student nurses are expected to complete 2300 hours over three years in order to become a registered nurse in line with the Nursing and Midwifery Council. Currently, the bursary, although a small amount of funding, is a lifeline for many and travel to clinical placements can be refunded if the placement is further than the journey to university. The loan system could mean that travel reimbursements are stopped. Other degree courses do not have the intensity of work as those that are in healthcare and social work. As student nurses on placement, we are expected to be responsible and safely look after the patients we are allocated. In our final year of study, we are expected to take our own caseload of patients under observation from a registered nurse mentor. If loans were then to replace bursaries, we would essentially be paying to work. Adjacent to this, nurses and other healthcare professionals have the wider issues of safe staffing ratios, threats to unsociable hours pay, threats to close down invaluable services such as A&E and maternity, lack of service provision and/or funding and the constant diatribe from certain media outlets and governmental organisations. For people who simply want to go to work and care for patients in the best way they can, these issues are ever present as a precursor for privatisation and dilution of our professions.
In September this year, it was proposed that junior doctor contracts would be changed which meant that their pay was slashed and their hours of work would be unsafe. The response from junior doctors to this was, and is, incredible with a strong sense of unity especially as other healthcare professionals and the public rallied behind them. I certainly feel with the relentless onslaught of short sighted cuts, revisions and demonization in the press of “greedy” doctors and nurses who “think they are special” that actually the relationship between healthcare professionals has been strengthened as we face manipulated statistics and generalising statements together. I, and the rest of us who believe that the NHS is being privatised piece by piece, are still yet to be proved wrong after a category of questionable choices instigated by the government.
Join the Twitter storm and discuss the bursaries on 4th Jan here.
On the Saturday 9th January, we will be assembling at St Thomas’ Hospital at midday and marching to Downing Street to defend our NHS and save our NHS bursaries. If you care about the future of the NHS, you must care about the NHS bursaries. Please march with us.