The government has confirmed plans to end bursaries for student nurses and midwives from next year, sparking anger across the health sector.
Replacing bursaries with loans would free up about £800m a year to create additional nursing roles by 2020 and help more students enter the profession, according to the Department of Health.
However, the Royal College of Nursing (RCN) said the changes were unfair and risky, while the Royal College of Midwives (RCM) argued that the move threatened the future of maternity services in England.
Student nurses, midwives and allied health professionals, including occupational therapists, speech and language therapists, podiatrists and radiographers, currently do not pay tuition fees. They receive a mixture of a non-means-tested bursary, a means-tested bursary and a reduced-rate student loan to help with their living costs. The government-funded Health Education England decides how many student places are available each year.
However, in a move first outlined by then chancellor George Osborne in November, bursaries will be replaced by loans in England to cover tuition fees and maintenance costs. The government claims this will allow the cap on student numbers to be lifted, creating up to 10,000 extra training places this parliament.
Health minister Philip Dunne said two-thirds of those who applied for a university nursing course were not currently offered a place and that the changes would give those in training about 25% more financial support while they studied.
The RCN general secretary, Janet Davies, said: “While our members are extremely unhappy with this model, it is positive that the government has listened to some of our concerns, including the transitional bursaries for postgraduates and hardship funds. But there is still a worrying lack of clarity on clinical placements.
“Nurses will be dismayed that these plans will go ahead with no testing, despite the overwhelming concerns that they have consistently raised.”
Jon Skewes of the RCM said the midwifery body “unequivocally condemns” the decision. “We have grave concerns for the future of maternity services and the midwifery profession in England as a result,” he added.
“Ministers have made minor concessions on the cost of placements and hardship, but this does not compensate for the large debts that midwifery students will experience and is not sufficient.”
Last month a coalition of more than 20 charities, medical and professional bodies and trade unions, led by the RCN, the British Medical Association, the Royal College of General Practitioners and the Patients Association, wrote an open letter to then prime minister David Cameron arguing that ending bursaries for student nurses and midwives would be an “untested gamble”.
The coalition issued the letter ahead of the public consultation on the changes, which ended on 30 June.
Christina McAnea, head of health at the Unison union, said the consultation had been a sham and ministers had failed to listen to the profession’s concerns. “They seem not to care that in a few years’ time the NHS will be seriously short of nurses and there will be too few new recruits coming through to fill the gaps,” she said.
“That’s because the prospect of graduating with more than £50,000 of debt will discourage many from entering the profession at a time when the NHS is struggling to fill vacancies.”
Nurses spent much of their courses working alongside paid colleagues, McAnea added, and were also unlikely to earn enough to ever repay their student debt. She warned that the change was likely to mean 2,000 fewer graduates a year, which would force the health service to spend more on agency staff.
In January, student nurses and midwives marched through central London in protest against the plans to axe the bursaries.
More than 160,000 people signed an online petition calling on the government to retain bursaries, and the issue was debated in the Commons on 11 January.
Carmel Lloyd, the RCM’s head of education, said at the time that the plans were appalling and would deter many from considering a career in midwifery. “The RCM is extremely disappointed that the government did not seek advice or consult with us prior to making this decision,” she added.
