I’m 10 weeks into my physiotherapy degree at Salford. I could be writing about how the anatomy has started to run away with me a little, now that we’ve progressed down the leg to the complex ankle. I could talk about how short of a break reading week felt, or how the post-Christmas viva and placements are looming on the horizon. I’ll get to all of that, but not today. Today I want to talk about the potential changes to the NHS student bursary that have recently hit the news, how such changes might have affected me (had I not have already started my course) and why I think its important that they stay.
So what exactly is the NHS student bursary?
If you’re not on or interested in a course such as physiotherapy, you might not know what all the fuss is about. Well, the NHS student bursary is a means tested grant assessed on the income (if any) of your parents, spouse, or partner, and is meant to cover the cost of living while you are a student on an undergraduate degree studying in one of the following healthcare professions:
Chiropody/podiatry, dental hygiene/dental therapy, dietetics/nutrition, nursing, midwifery, occupational therapy, operating department practioner, orthoptics, physiotherapy, radiography, radiotherapy, speech and language therapy.
Medical and dental students have also been eligible to apply for the bursary from the 5th year of their study. The NHS also pay the tuition fees for eligible courses directly to the university, regardless of the outcome of means testing.
OK, but what changes are being proposed?
Nothing concrete has been put out yet but you can’t escape the fact that the NHS budget is under huge strain. It’s been reported that NHS trusts will be in a £2.2bn spending deficit by the end of this year and while the current government has promised to protect the NHS budget from the increasingly painful austerity measures all other departments are facing, it is clear that cuts elsewhere together with the increasing demands placed on our health service mean that mere protection is not enough. In order to maintain that it is honouring its pledge to protect the NHS, it appears that the government is narrowing and redefining what constitutes necessary NHS spending, which is tantamount to cutting its budget, according to this report.
Inevitably, it seems, the NHS student bursary has become an outgoing that is seen to be no longer affordable, in present conditions. The Chancellor, George Osbourne, has announced that student nurses will have their bursaries replaced by student loans. The press has mainly been reporting on this story as if it were only to affect student nurses but as we can see from the list of bursary eligible professions above, it is exactly the same pot of money that the other student healthcare professionals receive support from. The Council of Deans of Health (the representatives of UK university faculties for nursing, midwifery and the allied health professions) released this statement on the matter, leaving no doubt that that it won’t just be nurses who are affected by the proposed change. They said:
From 2017/18, new students on nursing, midwifery and AHP [Allied Health Professions] pre-registration courses (which lead on to qualification with one of the health professional regulators) in England will take out maintenance and tuition loans like other students rather than getting an NHS grant.
Other students pay tuition fees and take out loans for their study. Why should the healthcare professions be different and why should we care?
Well, these professions attract large numbers of mature students, many of whom have already done a first degree for which they have taken out an initial student loan. That is true in my case. I received a loan for my English degree which I am still in the process of repaying. Whilst I enjoyed my course and gained many skills from it, I came to realise it wasn’t where I could make the greatest contribution to society. I wanted to help people, and I was drawn to physiotherapy through my personal experiences and those of my family. I believe my previous education is a massive boon to my training as a physio, and my maturity and experience are also positive attributes that will help to round me out upon qualification. However, under the new rules, somebody like me would be ineligible to take out another student loan to study. Even if I could, I would not be able to justify racking up more than double the debt I already have. As a mature student with a long-term partner (who already makes a massive contribution financially to help support my current studies), the cost of tuition fees, the lack of a maintenance grant, and the increased debt would have a drastic impact on our present and our future situation. It would have been impossible for me to pursue training as a physio.
It isn’t just the years at university that have an impact financially for potential healthcare students. In order to gain the qualifications necessary to even apply to university, I had to go back to college to study an Access to Science course. The tuition fees for this were £3000, for which I was able to get a loan through the Student Loan Company. I also had to quit my full-time job to go part-time in order to keep on top of the work. This year of financial hardship was only possible because I knew that if I was successful in gaining a place at university on a physiotherapy degree, I would receive the NHS student bursary. Future students are unlikely to be able to take that financial hit as well as the added financial pressure of an unfunded university place. I personally know two people that have applied to study Access courses with the intention of studying an NHS funded healthcare degree. Their futures are very uncertain right now despite work put in and sacrifice made on their parts.
There are many mature students on my course, and it seems that mature students are attracted to the healthcare professions in general. The cynical might believe that this is due to the funding opportunities until now provided by the NHS. However, I firmly believe that it is first and foremost the call to the healthcare and public service coupled with the suitability and capability of mature students from diverse backgrounds in these professions that leads us to consider such a career move. I conducted a small poll of my classmates. Of 15 respondents, 10 stated that the proposed removal of the NHS student bursary would have prevented them from applying to study physiotherapy. 6 of the 10 had already received a student loan in the past, 4 had not. So in total, there are at least 10 people who might not have been on my course, including myself. 10! My classmates, regardless of age or background, are some of the most passionate and brilliant people I have ever met. They will all make amazing physiotherapists. That at least 10 of them would have been denied that chance under the proposed new system is a real tragedy, not just for them but for the NHS and the people they would have gone on to help of the course of their careers.
The findings of my small poll is born out by the findings of a Unison survey of 2000 nurses, which reports that 9 out of 10 would not have applied to train in the absence of the NHS student bursary. With a shortage of nurses already, this is a worrying report. There are no hard figures yet for other healthcare professionals but it is likely that we will see too a detrimental impact in applications elsewhere. Even if the applicants fall only amongst mature students, the lost potential is, for me, unacceptable.
Unfortunately, this squeeze on the NHS is not the first and won’t be the last. The removal of the bursary seems to have the air of inevitability about it. I hope that it isn’t. The government have promised a period of consultation. Let’s hope they listen. Let’s hope they move towards future investment in people and services, rather than short-term budget balancing. And if hope fails, lets fight it.