Healthcare students get a cash “boost” – as long as you’re prepared to redefine the word

The government has announced increases to healthcare student placement expenses rates of 50 per cent, and a series of improvements to the NHS bursary scheme – raising the amount a medical student’s parents or partner can earn before their income becomes deductible from their bursary, and raising childcare allowance to align with the rates provided by the Department for Education (DfE) for earlier years of study.

Navina Evans, who’s the Chief Workforce, Training and Education Officer for NHS England, says the changes are a “welcome boost” for healthcare students:

Financial support is key to helping to attract a diverse range of students onto healthcare courses, many of which may be mature students with families they need to financially support while they learn.

And health minister Will Quince says the changes will “help to support the next generation” of NHS staff in their training:

We have therefore listened to students’ concerns and are taking action to ensure they are appropriately reimbursed for any additional costs of travelling for clinical placements, as well as boosting means-tested and childcare support for medical students.

I think “boost” is stretch, to be honest.

The Travel and Dual Accommodation Expenses (TDAE) rates haven’t actually gone up since 2015 – and in much of England over the past couple of years, the only circumstances under which you’d have been finding a bed and some breakfast for £55 would have been if you were prepared to share said bed with bedbugs, and then eat them in the morning.

As such even an increase to £82.50 is pushing it unless they only do placements in the first three weeks of January. It wouldn’t be so bad, but these students are paying fees to staff our hospitals under the gaslight of “supernumerary status”.

Travelling in in their own car rises to 42p a mile – which is still 3p a mile less than HMRC’s approved mileage rates from tax year 2011/2012. No reimbursement for parking where students are charged, obviously, and nothing to address the shocking waits that students often have to endure to get the money back.

Given nursing students accepted onto degree courses this month are down 13 per cent YOY, you can understand the quote from the RCN:

The UK government must remove the burden of student debt and tuition fees from prospective nurses, and better pay those in the profession. These changes must be made if the NHS workforce plan is to deliver the nursing staff needed for the NHS and social care. Far more work needs to be done to make nursing attractive to the next generation. The nurses of tomorrow are still being put off by the prospect of eye-watering student debt, low pay, and intolerable working conditions.

For medical students, the uplift on the threshold for rates of contribution and deductions from the contribution of a parent, spouse, civil partner or partner is especially astonishing. It was raised to £24,279 back in 2009 and has been there ever since – if it had been properly uprated for earnings, that threshold should now be about £32k.

Meanwhile, the bursary rate for medical students – £3,643, of which £2,643 is means tested (outside London, away from home rate, not counting any applicable extra weeks allowance) hasn’t changed since 2012. That is the amount of money we ask the poorest medical students, who haven’t really got time for PT jobs, to live on in Year 5 (or in some cases Year 6) of their course.

A step towards a solution would be to allow medical students to access maintenance loans (DfE’s budget) in Years 5 and 6 – which Welsh Health Minister Eluned Morgan has confirmed will actually happen in Wales in the 2024-25 academic year. NHS Bursary students will have access to the full maintenance loan available from Student Finance Wales, including Medical and Dentistry students in their bursary years.

Student nurses, midwives and allied healthcare professionals who commit to working in Wales for up to two years after qualifying are eligible for the bursary, and medical and dentistry students who usually live in Wales are able to access the full amount of maintenance loan in their bursary years regardless of where they study in the UK.

The Welsh Government is also to hold a consultation on the best way of continuing to support people studying healthcare programmes in Wales to ensure Wales continues to attract and retain the brightest and the best students. In England, Rishi Sunak’s much trumpeted Long Term NHS Workforce Plan neither mentions nor budgets for increases to bursary rates at all.

Oh – and that childcare grant/allowance announcement? That takes the amount medical students can claim from up to £128.78 to up to £183.75 a week for one child, or from up to £191.45 to up to £315.03 a week for two or more children (or up to 85 per cent of their costs, whichever is less).

It’s a decent increase – but the average cost of sending a child under two to a nursery for 25 hours per week (part-time) is now £309.16. You might reasonably ask why students aren’t entitled to the free childcare that the government keeps yapping on about, but as ever for some reason students are treated as somehow impervious to the impacts of the cost of living crisis.