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For the last 18 months I have had the privilege of leading the BMA’s medical student finance committee. In a few months I will be starting as an F1 in the Isle of Wight. One of my few regrets is that it will be time for me to move on from the medical students committee.
I’d like to take this opportunity to give my thoughts on the state of student finance, what it means for the profession and what we should be doing to improve financial access to medicine as a career.
So first a quick recap. Despite going against the Liberal Democrat manifesto the coalition government trebled tuition fees in England to £9000 per year. In 2015, the newly elected conservative government abolished means tested maintenance grants and broke an explicit promise to raise the student loans repayment threshold in line with inflation.
Finally the government despite all evidence to the contrary has decided to push through the abolition of the NHS Bursary for nursing, midwifery and AHP students. These changes mean that many medical students can now expect to repay >£100k and future nurses will graduate with >£50k of debt. All of this from a government that said we were all in this together.
Those are the headlines. But they are not just headlines. They have consequences. They affect aspiration and if left unchecked it will mean that access to the profession either as a nurse or doctor will be more and more determined by ability to pay, not ability.
The government may be the first government in history to argue that cutting corporation taxes stimulate activity, but raising the price of education doesn’t depress it.
The government likes to pretend that these changes haven’t affected participation to higher education. Well take a look at the UCAS application figures, which show that since 2012 there has been an 11 % drop of the number of students from England applying to study medicine. Research shows, unsurprisingly, those who are economically worst off are much less likely to apply to medicine.
But allow me to get beyond the statistics and tell you that in the last 18 months I have seen countless cases of students unable to finance their students. Sometimes students so dedicated to studying medicine that they spend, and borrow whatever they have to pursue their dream of serving in the NHS only to have to drop out, purely for financial reasons. And not just there, I am contacted by prospective students who are unable even to apply to medicine for lack of financial support. Just recently I was contacted by a student nurse who was thinking about studying medicine as a second degree. AS a medical student, I am in awe of student nurses ad it would benefit patients and doctors alike to have a dual qualified doctor working in the NHS but student finance rules will not allow for this. We have a system which allows 16 year olds one short at deciding the right path for their career. If you want to change your path or want to dual qualify, whatever the benefit to the NHS but for a small number of accelerated courses, you are on your own.
So what can we do? In the first year of my role I sought to persuade government that their policies were wrong. Like it or not this is a government that sought to resale from its promises over child tax credits and even tried to reduce funding for the disabled. I wish I could say that fair funding was a government priority, but it isn’t. But there is hope. There are things that we can do to fight for fairer access to education.
Many universities are interested in seeing what they can do to help applicants. I would like to give particular praise to the University of Bristol Medical School after it introduced a placement policy for medical students, specifically seeking to help medical students in financial difficulty.
There are also some wonderful charities seeking to help students. Not least BMA Charities, which helps doctors and medical students in financial distress. For more charitable sources see the BMA Student Funding Guides.
Martin Luther King famously said that the arc of the moral universe is long, but it bends towards justice. I believe that the student finance policies of the last ten years have been regressive but when I meet with BMA members I believe we will keep fighting until ability and not ability to pay determines who looks after patients.
Tom Rock is deputy chair and finance lead for the BMA medical students committee