Removing bursary ‘catastrophic decision’ that left NHS with far fewer staff, says ex-chief nurse
The removal the bursary for student nurses in England was a “catastrophic decision” and led to hospitals being depleted of thousands staff when the Covid-19 pandemic hit, the pandemic probe has heard.
England’s former chief nurse, Dame Ruth May, broke down as she described working on wards during the height of the crisis and how nursing ratios on intensive care units were “stretched”.
The Royal College of Nursing (RCN) has said previously that the removal of the nursing training bursary in 2017 led to a fall in the number of people choosing to study nursing as would-be nurses face tuition fee loans of more than £9,000 each year.
Asked about the nursing and midwifery workforce at the start of the pandemic, Dame Ruth (pictured) said: “There were very nearly 40,000 vacancies in England.
“In 2015, George Osborne (the then Chancellor) announced that they would get rid of the student bursary, which (was) the student fees were paid for and a maintenance grant.
“This meant that there was a significant drop, indeed a 23% drop, in nursing and midwifery applications as a result of that.
“Nurses and midwife students at that period were not receiving that, so they ended up in a lot of debt.
“That meant that we were 5,000 fewer nurses in March 2020 because of that decision, and 700 fewer midwives.”
She added: “5,000 fewer nurses at the beginning of the pandemic because of the bursary decision.”
Dame Ruth estimated that there would be about 40 additional nurses in each hospital, had the number not dropped.
“I reckon it would be around 40 extra nurses in each hospital,” she told the inquiry.
“That I think would have made a difference – maybe we needn’t have made some of the decisions around critical care ratios.
“Of course, if we had more nurses, there would be less burnout, there would be less psychological impact.
“Removing the bursary, for me, was a catastrophic decision.”
She added: “We went into the pandemic with nearly 40,000 vacancies, we could have had 5,000 less.”
The inquiry heard that in critical care, highly skilled nurses usually care for patients on a one-to-one basis, but during the crisis a decision was made to increase the number of patients cared for by each nurse as patient numbers swelled.
“There was always a one to four – but there were occasions when there were one nurse to six patients,” Dame Ruth said.
Asked if the diluted staff ratios affected the care that patients received, she replied: “Yes.”
When asked about her own work on the frontline during the crisis, Dame Ruth broken down in tears as she replied: “It was an utter privilege.”
She added: “I also worked on an ITU (intensive care unit) on a Sunday morning under the radar. There was death. There weren’t any visitors. Nursing ratios were stretched … nurses were at the brunt of this.”
Dame Ruth was also asked if she could make a recommendation for inquiry chair Baroness Hallett to consider.
She replied: “Ensure we have the workforce supply and everything we can do to either bring back the full educational package or write off the debt.
“But the domestic supply of future nurses and midwives in this country is key to a future pandemic.”
Commenting, RCN general secretary and chief executive, Professor Nicola Ranger, said: “The removal of government funding for nursing places is still being felt today with tens of thousands of vacant posts across the whole of health and care and there remains a collapse in the number of people applying to join the nursing profession.
“As a direct result of this, millions are now on waiting lists and lack of staff leaves patients being treated in corridors and other inappropriate conditions.
“Only last week, the current state of the NHS was laid out in the Darzi report and the Government, starting with the Budget next month, has the opportunity to turn things around.
“The only way to reverse this is through funding for nursing education, such as a loan forgiveness model that attracts and retains more people into the profession and does not leave nurses deep in debt as they begin their career.”
Meanwhile, Dame Ruth was also asked if she thought the “stay at home” message “got the balance wrong”, Dame Ruth replied: “In hindsight I wish it was, ‘stay at home but not if you’re pregnant’… in hindsight, yes.”
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