Is it really bursary or bust? Simon Stevens stirs the pot

In England, the bursary for student nurses was removed in 2017 when they also became liable to pay tuition fees.1 The aim was to reduce the cap on student nurse numbers. While the cynics among us may think the real reason was to reduce the £1 billion spent on non-medical pre-registration education each year, the Council of Deans of Health (CoDH) supported the move. They argued that in addition to removing the cap on numbers the change in financing nurse education would leave student nurses better off financially during their pre-registration nursing course.2 The CoDH later acknowledged that the subsequent reduction in applicants was more than expected.3 The bursary was means-tested with a student living away from home, outside of London with no dependents entitled to £39664 per annum. Most pre-registration nursing courses run over 42 weeks per year (rather than the standard 30 weeks) meaning that students incur additional expenses as well as not having a long vacation over the summer to earn money. This results in many student nurses taking on additional debt. The take home message is that student nurses in England were struggling financially even before the bursary was removed.4–7 Indeed, since then hardship payments to student nurses have risen8 and financial hardship has been identified as one of the key reasons for student attrition from pre-registration courses.9 Under the new system, the maximum (means-tested) maintenance loan available for a student outside London is £8700 per year (£725 per month) plus the payment of tuition fees directly from the student loan company (SLC) to the relevant Higher Education Institute. It is indisputable that student loans provide greater income during the programme of study than the old system. However, there is a need for student loans to be repaid following …