Since we launched our call with UUK for fundamental reform of education funding in England last week we’ve had some great discussions with students, professional bodies and others. Here are some key questions we’ve been asked.
Why not just campaign for increased grants?
We’d probably all prefer that this was feasible but in the current political environment there aren’t any signs that this is a realistic option. There might come a time when we can make those arguments but it’s unlikely to be in the lifetime of this Parliament and trying to let the current system limp on for another five years is enormously risky.
Would change damage widening participation?
This is fundamentally important. Nursing, midwifery and some of the AHPs do much of the heavy lifting in terms of opening up access to higher education. It’s in nobody’s interest to damage this. But what’s interesting about the data in England is that the move to student loans hasn’t reduced the numbers of students applying from lower socio-economic groups. In fact, numbers have increased, with UCAS data showing that young people from lower socio-economic groups are more than 60% more likely to enter higher education in 2014 than 2006. Widening participation stats are now better in England than in Scotland. This doesn’t mean there aren’t risks but it’s wrong to automatically assume that a system change will put new students off.
What about mature students and those who want to become a health professional after they’ve already done a degree?
This is where we think the greatest risk probably lies. The Independent Commission on Fee’s 2014 report found an 8.0% decrease in the 21-24 age bracket and a 10.5% decrease in the 25+ age bracket since the shift to student loans. We don’t want to lose these students, so we need to quantify the risk and put in place financial incentives to encourage these students to keep applying.
There’s also an issue about those students who do post-graduate pre-registration courses. They’re some of our best students and are highly valued by employers, so we would need to make sure that there aren’t disincentives. Part of this is an argument for an Equivalent or Lower Qualification (ELQ) exemption, so that students could still access loans.
Won’t students be worse off for daily living expenses?
Student support is a huge concern, particularly as so many health students currently struggle with daily living expenses. We think a clear ‘red line’ in any reform should be that health students end up with more money to spend, since the courses are longer (42 weeks compared to 30) and workloads are high. We need a full point-by-point comparison to make sure that students wouldn’t lose out (e.g. on the allowances for childcare/dependents) but the figures we’ve seen suggest that most health students might be better off under the existing loan system. With the budget announcements today (conversion of Student Finance England grants to loans and an increase in the maximum loan amount to £8200 plus additional allowances) we need to look at the detail of the proposals and make some costed comparisons to work out how these changes would affect a new system.
Having a fundamental look at this also gives us an opportunity to look at parts of the system that disadvantage health students now, such as the duration of the maintenance loan in a student’s final year.
How would this help the workforce crisis?
An education funding system based on NHS grants means little flexibility when NHS workforce predictions are wrong, or don’t adequately take into account the needs of other sectors. The NHS has a fully legitimate interest in the numbers of health professionals being educated but experience suggests it shouldn’t be the only decisive voice in decisions on numbers.
This is evident at both micro and macro level. The top-ranked physiotherapy course in England had its places cut by a third for this autumn based on predictions from the sub-region where it happens to be based, even though it recruits students from across the country. So fewer young people get to study on the best course, at a time when we know that AHPs will be vital to delivering the new services that patients need – these sort of decisions serve no-one: employers, students or universities.
This is also what we’ve seen on a macro scale with nursing. It’s not like there weren’t warnings when the NHS predicted it would need fewer nurses and slashed the numbers of education places in 2010/11 to 2012/13. But they weren’t listened to and there was no counterweight to prevent the cuts. The predictions were wrong and in 2015 we’re facing the lowest number of nursing students graduating in the past 15 years.
As the NHS focuses back in again on balancing the budgets and cancels NICE’s work on safe nurse staffing, it’s unrealistic to expect this cycle not to repeat itself unless the system is reformed.
How quickly could this happen?
No change like this could happen overnight. It wouldn’t be fair to change the deal for existing students, so this shouldn’t affect anyone already on a course. Given the UCAS cycle and the care that would need to be taken on implementation, we think the earliest significant change could be introduced is the 2017/18 academic year.