Until 2017, students studying nursing in England received a bursary and paid no fees. The bursary was paid by the NHS and was a remnant of the days when nursing students were employed by the hospitals where they trained. By the end of the 1990s, all nursing education moved to universities, but the bursaries remained.

The UK government’s decision to stop bursaries in England was met with protests, especially by the Royal College of Nursing. Proponents of the bursaries argued that it would exacerbate current nursing shortages. We need to attract more candidates, not drive them away, they argued, especially older women from lower socio-economic groups.

Only the bursary system did not solve nursing shortages and it was not flexible enough to respond to changing demands. When we needed more nursing students, the NHS did not necessarily have the funding to provide bursaries. Contracts between universities and the NHS had a cap on the numbers of nursing students funded.

I propose four reasons why bursaries for nursing students aren’t needed.

1. We can’t afford it and they don’t need them

The NHS can no longer afford the scheme, especially with the proposed expansions in the numbers of nursing students. Nursing students, along with other university students, have access to student loans that cover their tuition fees and provide them with a living allowance.

Nurses, almost uniquely, are virtually guaranteed a job on graduation and if they earn £24,000 annually – the middle of the lowest pay band for a staff nurse – they only need to repay £11 a week.

2. Nursing students are not employees

It is often thought that nursing students are working as employees of the NHS while they are in hospital. They are not. They are “supernumerary”, which means they are not included in the workforce. This recognises that they are students and that they are there to learn. They may have less opportunity than other students to work and earn money to support themselves, but this is surely offset by almost guaranteed employment on graduation?

3. Nursing is not a vehicle for social engineering

Some worry that older women from lower socio-economic groups, those who have had families or are seeking a late or second career, will find it hard to study nursing. But are these concerns justified? The initial introduction of student loans did not reduce the numbers of applicants from lower socio-economic groups to university. Why should it affect nursing?

We need a nursing workforce that is diverse in gender, ethnicity and age. But someone entering nursing late may only work for a short time in the NHS. This is not good value for money if that money is being spent by the NHS.

Nursing and the NHS do not exist as vehicles for social engineering where everyone who ever wanted to be a nurse can become a nurse. Both nursing and the NHS exist to provide a service: patient care.

4. We’ll get the most motivated students

While bursaries were available, both nursing students and nursing lecturers reported that some students were only studying nursing for the bursary. They had no intention of entering nursing on graduation and, in fact, many nursing students never enter nursing.

With an end to bursaries and an end to the cap on numbers, we have a much more flexible system that can respond to the need for nurses. The issue remains the availability of places for nursing students in the NHS. But universities can now negotiate with any part of the NHS they wish – not just their local hospitals – and can pay the NHS for training places. This should provide the flexibility needed and an incentive to the NHS to provide, and even compete to provide, the best training places.

This article was originally published on The Conversation. Read the original article.

It's fair to say trade unions are something many people know about and use, but very rarely understand.

As a young NHS worker, I vividly remember the words of considered importance my mother gave me on the first day I started work (a long, long time ago) “Join a union,” She said, “Doesn’t matter which one, they will protect you.” Essentially, this is the general expectation of what a union does - stick up for the workers during tough times - but is that a role they are fulfilling? Do the nuances of UK employment law; the difficulties of the negotiation negate they apparent lack of observable progress?

“In any industrial negotiation the work starts months, even years, before reaching the negotiating table.” Josie Irwin, Associate Director of Employment Relations at the RCN, believes a lot of the good work that happens behind the scenes goes largely unnoticed by the general public. “In 2015, we took a strategic decision to work together with all fourteen trade unions represented in the NHS to get our members out of austerity. To achieve this, trade unions employ a wide range of techniques to influence government policy, from direct lobbying to securing media coverage. But what unites all these elements is they rely on members getting involved – it is members’ voices that carry the most impact, whether meeting MPs or [being] quoted in the national media.”

It wasn’t until the mid-1800s that trade unions had any real power.

In 1820, a sixty thousand-strong mob went on general strike for a week - later referred to as the Radical War or Scottish Insurrection. They downed tools in defiance of the high unemployment, unfair working conditions and unresponsive Government, at a time of national civil and economic unrest in the aftermath of the Napoleonic Wars.

Much of the Nineteenth Century is littered with instances of fractious industrial tensions; of trade unions becoming more organised, well funded and powerful. For men. Women, on the other hand, were largely excluded from the unions, both in membership, formation and in fact its hierarchies until late in the Twentieth century. There is evidence of challenges to the male-dominated world, largely due to the tenacity groups of reformers like the Women's Protective and Provident League (WPPL), but it wasn’t until the 1875 West Yorkshire weavers’ strike that women played a central role in unionism. Symbiotic to the development of unionism is the way in which the Labour Party and in part, Socialisms’ ontogenesis, unfolded in the UK.

Very much a grassroots party, Labour came into being through the political ambitions of trade unionists understanding their ability to affect real change came from within the walls of power. Political manoeuvring became a prominent tool of protest during the first half of the Twentieth century, with trade unions offering strong support to the war effort by cutting back on restrictive practices during the Great War, for the good of the nation. Even so, the introduction of the Munitions of War Act 1915 saw strike action and lock-outs forbidden with swift interventions to quell any trouble. In spite of this increasing Government macro management, union membership increased from 4.1 million to 8.3 million by 1920 and the TUC (Trades Union Congress) saw numbers swell with 77% associated to the Congress.

Looking back, it feels like nothing has ever really changed and if you look a little deeper, it really hasn’t.

Margaret Thatcher’s iron grip on unionism lead to mass unrest, strikes up and down the country - most famously the year-long Miners strike of 1984/5 - and mass unemployment. Thatchers’ capitalist ideology saw unions as a barrier to economic growth and so imposed laws to further restrict their powers; powers which she felt had blighted both the Wilson and Callaghan (Labour) government that had preceded her.

The Miners strike became very much a war of attrition, each side fighting for what they felt was right. For Miners’ Union leader Arthur Scargill and the miners that was financial stability - coal pit closures were rife in the 70s and 80s as the seams dried up and work was hard to come by. While the Tory-led Government wanted to bring the country out of a paralysing economic downturn.

The narrative of the unions continues to be that of protecting the proletariat from the tyranny of their capitalist overlords. A tad histrionic maybe, but when you consider the Government implemented the Trade Union Act in 2016 leading to a TUC-led investigation on it’s effects to members in terms of work/life balance, it's clear even today, that trade unions and Government are at loggerheads over pay and conditions. You only have to look at the recent junior doctors pay dispute and the response by Jeremy Hunt or even the nurses pay rise to see that the role of the unions is perilous and fraught with frustration. But due to this perceived lack of results or underachievement, is it any wonder then that the average person on the street views trade unions as somewhat feckless, lazy organisations doing only the bare minimum for its membership.

Writing in the Guardian, an anonymous trade union employee blows the whistle on the inner workings of their organisation telling a disturbing (and somewhat one-sided) story of alleged membership fee wastage, underwork - they point out the article was written at their desk  - and a lack of fresh ideas. With all the signs of an employee burnt out but reluctant to leave the obvious benefits of being paid ‘money for old rope’ their words are alarming: “When potential members ask me why they should join, I give them the usual spiel but what I’m really thinking is: “Join our rivals, they are cheaper and care more about you than we do.”” Interestingly, this was borne out in part when contacting four of the main healthcare unions for their right to reply. Only two, the RCN and Unison initially responded, asking what was needed. Only one, the RCN, managed to email a comment after a week of waiting for management sign-off.

One of the main obstacles preventing unions is the rise in individual-rights based employment law.

An article written in the Industrial Law Journal by O’Sullivan et al (2015) finds this somewhat hampers the union's ability to negotiate using tried and tested collective bargaining methods. However, they go on to highlight the unions concede that the new laws can be used positively to support and protect vulnerable groups of workers. Added to this, at some point down the years, unionism became a commodity. On forums all over the internet, union members discuss the value of their membership in terms of money - A is cheaper than B and you get XYZ as well - but does that miss the point of having representation? Many articles exist for student nurses and qualified staff alike comparing the value of each union against each other: Unionism boiled down to determine its price per pound of flesh - fairly ironic.

What price do you put on even remaining in the country to do the job you’ve worked so hard to get?

Unions appear, by and large, to be the only ones doing more than voicing concern for the ever-dwindling NHS workforce. RCN general secretary, Janet Davies is quoted as saying European expat staff play an integral part in the skill mix of hospital wards all over the UK. “With 40,000 nursing vacancies in England alone after years of poor workforce planning,” She said, “We cannot afford to lose EU nurses too.” Over a fifth of EU nationals have left the country as a direct result of Brexit and the uncertainty they face over the longevity of their stay in the UK. Equally, as more and more young workers bounce between a cafe job here and a zero hour contract there, never has there been a time for trade unions to have the powers to level the playing field.

And yet they are continually viewed in a negative light, the victims of a well-orchestrated narrative. Or are they?

There is always more they could do to improve their standing. Millennials, for all their perceived faults, are in fact a different breed to the hairy-armed activists we remember from university, full of bluster about saving the planet, tofu and recycling. The kids of today can see the troubles ahead of them but rather than band together like the old days and ‘march in solidarity’ which they see just doesn’t work anymore, they instead choose different careers, travel more and look to overcome their issues in spite of authority. Trade unions need to be smart, rebrand their messages and allow new members to consider the benefits of working with a union behind them, supporting their ambition and providing opportunities for betterment.

So, do unions have a place in today’s workforce?

Absolutely, but with that comes new challenges which require new thinking and new energy. This new generation is at peace with the real world application of robots taking their jobs. They are already fostering new avenues of wealth creation and more cohesively working towards a better future. Two-way communication is key to unions surviving this latest workforce re-enablement, but if current experience serves as their narrative, unions will make themselves extinct long before Government legislate them out of existence.

A union is only as powerful as its members.

Students should be included in the vote on the proposed NHS pay deal - because it directly affects their future.

In March the Government, alongside healthcare unions, announced 'modernisation' of the Agenda for Change pay structure and revealed a radical overhaul of both the structure and terms and conditions of the pay system.

However, many have highlighted issues with the proposed pay deal.

The official recommendation from all unions, except the GMB, is that the deal should be accepted and unions are set to ballot their members later this month. But, only current NHS employees who are under an Agenda for Change contract will be included in the vote - this excludes the majority of healthcare students.

Student nurses alongside student radiographers, physiotherapists student and other allied healthcare professionals are the healthcare professionals of tomorrow and the proposed NHS pay deal will have a direct impact on their future.

As qualified professionals it is important we have our students on our side, students are united, numerous, have immense voting power and the ability to change the outcome of any vote.

Image: © Monkey Business

The Royal College of Nursing has admitted it is 'frustrating' for those wanting to vote on their future, as currently, the only way for students to get involved is to ensure eligible members exercise their right to vote.

Katharine Youngs, Student RCN Trade Union Committee Member, said; "I know that not being able to vote in the consultation is very frustrating – especially if you know that you want to work in the NHS when you qualify.
 
"But the deal proposes changes to current NHS contracts of employment, and not future contracts, so we cannot vote on something that doesn’t apply to us right now, in the same way that RCN members in the independent sector won’t be able to vote.
 
"As student members, we can still get involved in the consultation by spreading the word about the deal in our universities, and help both fellow students and NHS staff in our placements to understand the benefits we will experience in the future.
 
"You can encourage those RCN members working in your NHS placements to take part in the online consultation when it opens on 23 April. You can also attend the pay events around the country to hear more about the deal and ask any questions as well as visiting the RCN website for full details of the deal.

But, Richard Betley, a Student Nurse and RCN Member, disagreed with the official stance and feels that students need to be actively involved; "As paying members of the RCN, students should be included in any votes which directly affect their future. The pay deal is structured over a 3 year period so any student currently studying nursing will qualify during this period.