The Three Year Maintenance Grant Shortfall
Adapted from an article originally written in the Student Nursing Times.
January 2020
In 1968 the Government introduced financial support for students training for a career within the NHS. After forty-seven years, in 2015 the Government announced that it would no longer fund NHS Bursaries for nursing, midwifery and allied health students as part of wider austerity measures. Instead students on these courses from 2017 would need to take out both tuition and maintenance loans to cover the cost of their professional degree, as well as the cost of living. Then last year, following success in the December 2019 General Election, the new Government is expected to follow through on their election pledge to provide students with “a £5,000-£8,000 annual maintenance grant every year during their course to help with their cost of living”. Leaving a three year shortfall between 2017 and 2020.
A student midwife starting in 2016 could expect to have their degree funded at a contemporary value of £27,750, a means-tested maintenance grant of up to £9,573 and a non-means tested grant of £3,000. There was also up to £108 for each week over 30+3 weeks worked in a year as well as support towards childcare costs. If you became pregnant, you were even entitled to paid maternity leave. In comparison, a student starting in 2017 could expect that by graduation in 2020 they would have accrued debt of up to £60,000 following three years of academic study and clinical placement within the NHS. There was no grant, no childcare support and no maternity leave pay. The NHS Bursary system in place between 2011 and 2017 was widely acknowledged as restrictive and underfunded: placing the cost onto the shoulders of students was supposed to increase the number of university applicants as well as the number of clinical placements; instead applications to midwifery degrees have fallen. In 2013, over 12,000 people applied to be a student midwife, in 2017 just 6,700 did. In 2018 this fell by a further 7.6%, although data published for the January 2019 cycle suggests there was a slight rise from 2018 figures.
In both 2015 and 2017 the Royal College of Midwives announced that the NHS was critically short of midwives. Media coverage ensured budding students caught on to this need: we were wanted, we were needed and it was time for us to step up. Fresh faced with blank notebooks and keep-calm-I’m-a-student-midwife mugs ready to go, we arrived for our first day in September 2017. It is now three years down the line and whilst it has taken a long time for both academic staff and clinical supervisors to understand what paying to work actually means, we’ve nearly made it. The finish line is in sight.
In 2017 we had stepped up in a time of need, to serve women. In 2020 this cohort will be the only cohort not to receive any financial support for studying to work, and working within the NHS. We must ask: this fair? Is this sustainable?
Paying to work is hard. It means that when you’re expected to work late and the childminder needs an extra £50 for overtime, you feel it. When you lose your parking ticket some time during a 12.5 hour shift and get charged a £20 fine, you feel it. When your personal tutor asks you to come in for a meeting you have to check your bank account to see if you can afford the public transport – because you can’t go out and earn money when you already have a full time job. In previous years the contribution students made to the NHS through their clinical hours was acknowledged by the funding of their training, and the implications of (not to mention strong academic expectations) that students don’t work outside of their study, was recognised with a maintenance grant. Neither system has served us well, but there is a stark difference between the two. From 2020 midwifery students will continue to depend on tuition loans to cover the cost of training; however the new maintenance grant is an acknowledgement of the real work we actually do day-in-day-out for the NHS. An extra pair of hands is an extra pair of hands, whether they come with a PIN or not.
After a three year experiment, the conclusion is plain to see. It is not sustainable to expect the people willing to fill the gaps in a straining NHS to self-fund, it is not sustainable to expect people to work for free for six months of the year. Whilst some of my cohort sisters will explore independent practice, or private employment, the overwhelming majority will seek to work within the NHS they have grown within. Last week, with post-graduation employability at the forefront of third years’ minds, over half of the cohort have stated they hope to work for the local Trust. With a pay check still 10 months away, and the prospect of starting our new careers in tens of thousands of pounds worth of debt, who will step up to fill that gap?
