You wouldn’t work for free. Why should healthcare students?

It’s 5pm and you’ve just finished an extra shift on placement.

You supported a deteriorating patient this morning, helped manage an emergency this afternoon, and you haven’t had a glass of water since 8am.

You’re still in your scrubs. Your rent is due tomorrow, and you can’t pick up a paid shift this week because you’ve got placement again – 37.5 hours of it, unpaid, same as last week and the week before that.

You’re one of the students who’s thought about quitting, but you got into nursing because you want to help people, so you keep going.

Your work today was essential to the running of the health service. But if placements are essential, they should be paid.

That’s the principle behind Pay the Placement, a campaign we’ve launched that is picking up support across the sector – because right now, we’re asking something of healthcare students that we wouldn’t accept anywhere else.

What’s really going on

Spend time with nursing and healthcare students and a pattern quickly emerges. They’re deeply committed to what they do – and under enormous pressure because of how we make them do it.

Their degrees require them to complete over 2,300 hours of placement in real healthcare settings, and these aren’t optional experiences or occasional ride-alongs. They’re long, structured shifts in hospitals, clinics, and communities, often mirroring the responsibilities of paid staff.

These students are contributing to frontline services, supporting patients, and functioning as part of the workforce – juggling all of that alongside full-time study, and often a part-time job on top just to survive. And they’re not paid.

That’s possible because of a broad exemption in the National Minimum Wage Regulations 2015, which says that students undertaking work experience as part of a higher education course don’t qualify for the minimum wage.

The government’s own “Make Work Pay” agenda has pledged to tighten the ban on unpaid internships – but explicitly carved out an exception for placements that are “part of an educational or training course.” The principle that work should pay, it seems, stops at the door of a hospital ward.

Priced out

This isn’t just a question of fairness – it’s a structural problem. Placements dominate students’ time, making part-time work difficult or impossible, while students are still expected to cover the costs of travel, food, uniforms, and equipment, all while paying tuition fees. The result is a system that pushes students into financial strain – and then tells them they should have budgeted for it.

Consider the maths. The maximum maintenance loan for most students living away from home outside London works out at roughly £9.50 an hour when spread across typical placement hours – well below the National Living Wage of £12.21.

Students are effectively being asked to live on less than the legal minimum the government has decided everyone else needs, during placements that prevent them from earning extra money.

We hear the impact every day – students choosing between attending placement or affording rent, cutting back on food, travel, or rest, relying on free tea and toast in staff rooms as their only nutrition for the day, and finding themselves unable to participate in wider university life.

Around 70 per cent of nursing students have considered quitting their course because of financial pressure, compared to 26–41 per cent of undergraduates overall. And at Essex, healthcare students make up 17 per cent of the student body but just 6 per cent of event attendees and 3 per cent of sports members – shut out by time and money. Many question whether they can ever actually just be students.

The supernumerary fiction

In theory, students on healthcare placements hold “supernumerary status” – meaning they’re additional to normal staffing levels and there to learn, not to plug gaps. In practice, cash-strapped NHS trusts routinely rely on students to maintain safe staffing ratios, and recent reviews from the Nursing and Midwifery Council have found that supernumerary status is commonly not upheld.

Students end up functioning as shift workers rather than learners, carrying out the same tasks as paid colleagues but with none of the protections – and every hour missed to illness, bereavement, or crisis is an hour they’ll need to make up.

And it really is none of them. Because students on educational placements aren’t formally classified as workers, they’re not entitled to holiday pay, protection against unfair dismissal, or whistleblowing safeguards. When they get bullied or harassed on placement – and they do – their options are limited. Students exist in a regulatory void with nowhere to turn.

Who pays the price

If students can’t afford to complete their training, the consequences don’t stop with them. The sector will keep losing people it desperately needs, the workforce will become less diverse, and the pressure on an already stretched system will only grow. Apprentices doing comparable on-the-job learning are entitled to a minimum wage – admittedly a lower one, but a wage nonetheless.

Australia has already introduced paid “prac” for nursing, midwifery, teaching, and social work students on placement, recognising that you can’t build a workforce by bankrupting the people training to join it. It’s worth asking why the UK still treats this as too radical to consider.

The problem extends beyond healthcare too. Teaching students face similarly gruelling unpaid placements, and evidence to the House of Commons Education Committee has highlighted a cycle where placement workload contributes directly to the teacher recruitment and retention crisis.

Social work students face the same pressures. Some of society’s most essential future workers – nurses, teachers, social workers – are effectively subsidising their own training through unpaid labour in sectors already struggling to recruit.

Universities, SUs, and sector bodies all have a role here – not just in pushing for national change, but in honestly examining where their own models rely on unpaid labour and asking whether that’s still acceptable.

Pay the work

Pay the Placement is grounded in a simple idea – if the work is essential, it should be paid. The campaign calls for all nursing and healthcare students to be paid for their placement hours, and supports the Royal College of Nursing’s call for a full review of healthcare student funding, because the current system simply doesn’t reflect the realities of placement-based courses.

While national reform takes time, institutions don’t have to wait – they can be transparent about the real costs of healthcare courses and strengthen local support, whether that’s travel funding, hardship provision, or covering the out-of-pocket expenses that students currently absorb alone.

What’s next

The campaign is building towards Pay the Placement Campaign Week, running 11–17 May 2026 – a coordinated national push to drive awareness and petition signatures, with activity across campuses and a spotlight on International Nurses Day on 12 May.

You can sign the petition at Fund pay for student nurses and midwives for placement hours – Petitions, join the campaign as an institution or organisation, or write to your MP using the campaign’s open letter. Because if healthcare students are essential to the system, then supporting them properly should be too.