Earlier this year, myself and Mack Marshall set about encouraging students’ unions in England to respond to the government’s call for input into its now newly launched Ten Year Plan for the NHS in England.

We took it at face value, and thought that students in particular would have plenty to say, lots of ideas to add, and thoughts on the opportunities presented by the three big shifts – moving more care from hospitals to communities, making better use of technology and focusing on preventing sickness, not just treating it.

Plenty of SUs produced detailed written submissions, a fair number encouraged students to submit experiences and ideas to the consultation portal, and several even ran the Department of Health & Social Care’s “workshop in a box”.

They need not have bothered.

Despite comprising well over two million people living in every part of England, students are not even named in the plan as a distinct health population with specific access patterns, risks, or rights. There’s no mention of university health centres, student-led health programmes, or the crisis in student mental health.

Yet almost every other category of citizen IS mentioned – children and young people, working-age adults in the context of employment, older people / pensioners, carers (including unpaid carers), people in the criminal justice system, looked after children and care leavers – as well as women, ethnic minorities, people with disabilities, people with learning disabilities, autistic people, refugees and asylum seekers, people experiencing homelessness, people living in deprived communities, rural and coastal communities, veterans, and members of the armed forces community.

The plan recognises students solely in terms of some of them training to become NHS staff – even then, it does so without mentioning the fantasy of their “supernumerary” (or equivalent) status while on placement that, in reality, sees them paying fees to prop up delivery.

Maybe a mention of the rapid rise in Gonorrhea (largely believed to be a student issue), or the collapse in disability diagnoses, or the problems with GP registration and care continuity were all wishful thinking. But even student mental health doesn’t appear – with promises on provision for “children and young people” restricted to schools and colleges.

For absolute clarity, this isn’t about special pleading. It’s about a section of the population where only 20 per cent rate their health as “very good” compared to 48 per cent of the general population, a group who sleep in mouldy rooms while landlords tell them to “open a window,” and where one respondent in our survey work earlier this year grimly noted they “almost died from an overdose of caffeine trying to work on an essay.”

Our polling found a raft of systemic failures – 49 per cent dissatisfied with NHS services, only 65 per cent registered with a GP where they study, housing conditions that actively harm health, and worrying findings on poor sleeping, disordered eating and access to a dentist.

The issues are broad and huge. We’re talking STI prevalence, dental access barriers, delayed registrations, prescription affordability, disordered eating, poor nutrition/food insecurity, sleep deprivation, stress/academic pressure, delayed disability/ADHD diagnoses, inadequate mental health crisis support, poor/unsafe housing, long GP/specialist waits, inability to register with two GPs, term-time/holiday healthcare barriers, inconsistent medical records during transfers, travel costs, substance use stigma/lack of harm reduction and insufficient preventative screening and sexual health education.

There’s also menstrual health/period poverty, chronic condition management away from home, poor vaccination uptake, sexual assault/trauma with limited support, gender-affirming care delays, alcohol harm/binge culture, international student NHS barriers, unaddressed substance use (study drugs/vaping), digital exclusion affecting telehealth/NHS apps, OTC medication misuse and financial stress impacting nutrition/warmth/care.

Oh and there’s loneliness/isolation, bereavement/family trauma, precarious work health impacts, pregnancy/reproductive healthcare barriers, academic regulations ignoring health conditions, screen-related issues (back pain/eye strain/sleep), inconsistent mental health treatment across locations, lack of culturally competent care for racialised/LGBTQ+/neurodivergent students, under-recognition of postgraduate/mature student health needs and poor accommodation air quality.

Not to forget digital harassment/online abuse, needle spiking/assault fears affecting safety/wellbeing, climate anxiety/eco-distress, lack of campus rest spaces, NHS dental care barriers, help-seeking stigma (particularly male/international/minority students), eating disorder/body image challenges in campus settings, poor care leaver/estranged student transition support and unaddressed student debt anxiety impacts on long-term health.

The irony is that students’ unions even saw a role for them and their members in helping to solve the crisis – rolling their sleeves up to play a role in prevention, calling for partnerships between SUs, universities and local health providers to ensure that diagnostic tests and treatments are available on campus, and (via proper surveys and digital health screening tools) helping out with peer-led interventions on sexual, physical and mental health, disordered eating, and substance use – all to inform teaching and support strategies that bolster both health and academic outcomes.

There’s a fine line between partnering with universities over the health needs of 2m people, and dumping all of their needs and problems on universities. This feels very much like the latter.

As ever, part of the problem is the departmental silo issue we’ve discussed endlessly here – every time student mental health is discussed in Parliament, it’s a DfE minister that gives the vague, finger-wagging-at-VCs answer rather than ministers in DHSC – an assumption that universities will take responsibility, and that it’s students own tuition fee debt that will address their health rather than them getting a look in on the budget of the country’s biggest public service.

The launch of the plan was supposed to be a highlight for the government in a week when we’ve discovered that it has no idea how many students will be impacted by its Welfare “reforms” – and while flagship bills in the Lords on employment and housing roundly ignore students too.

So we are (still) where we are – stuck watching talented students struggle unnecessarily, their potential diminished by preventable health challenges. So much for the opportunity mission.

Health is a precursor to education – ill students eating so poorly they “can’t afford basic nutrition” or sleeping in accommodation where “mould grew on my campus room’s walls before I even came in” aren’t just experiencing personal discomfort, they’re living the consequences of a policy abscess – and paying for it, in more ways than one.