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Student loans will damage primary care

The comprehensive spending review this autumn included a welcome increase in NHS funding, but there were spending cuts for nurse education that had been anticipated for some time.

The government’s comprehensive spending review this autumn included a welcome increase in NHS funding, but there were spending cuts for nurse education that had been anticipated for some time.

Student nurses have, until now, undertaken their training without responsibility for paying university tuition. The fees are levied as part of a contract, by the local education commissioner, with ultimate responsibility for the fees resting with Health Education England and the equivalent bodies in the other three countries of the UK.

This change in England leaves student nurses facing a tuition fee of £9000 each year and there is no clarity yet on whether students will be able to apply for a loan for their fees if they already hold a first degree for which they have previously accessed a student loan.

This is important because the average age of a student nurse on entry to the programme is 28.5 years. There are many applicants who have already achieved a first degree in another subject – perhaps in psychology or human sciences – who decide on a change of career that provides an opportunity for the professional application of their original degree.

This is the same for other professional health programmes – medicine has a large number of applicants who hold a first degree, normally in a science-based subject. These students are not permitted to access a second fee loan for the five year medical programme, but are completely exempt from tuition fees if they undertake the coveted four year ‘postgraduate’ programme, for which there are a very limited number of places each year.

If implemented in a similar way in nursing, the route to nursing after a first degree will be accessible only to students with independent wealth or family members who will support the payment of their tuition fees. It could deter excellent potential applicants and lead to fewer mature students accessing the programmes.

The nursing profession – and in particular the community nursing service – will be disadvantaged. Community and primary care services tend to attract more mature nurses after qualification – the autonomy of nursing roles in these environments requires a maturity and self-confidence which is often, although not exclusively, seen in those who have had some previous life and career experience.

The QNI will contribute to the anticipated consultation on this issue and I urge you to inform the discussions with your experience too. The future might depend on it.