Newly qualified doctors and nurses in England could have their student loans written off under plans being examined by Labour to tackle the NHS’s staffing crisis.
Wes Streeting, the shadow health secretary, is considering introducing what health experts call “student loans forgiveness” to help the NHS recruit and retain more clinical staff.
Streeting said at a meeting of the Hornsey and Wood Green Labour party in London last week that he was looking into financial incentives to encourage staff to keep working in the NHS.
He was responding to a question about whether medical and nursing graduates should be forced to stay in the NHS for a set period or given financial rewards for doing so.
Streeting ruled out compelling new clinical recruits to spend minimum periods in the NHS. However, he left open the possibility that a Labour government could use rewards, which health experts and NHS unions believe could reduce the high number of staff who quit soon after joining. There is acute concern in the NHS and government about staff leaving for other jobs or to work abroad.
Streeting said: “On golden handcuffs and those sorts of incentives, we are thinking about it. We want to make sure we pitch it right, though. I don’t want people, especially staff who are coming out on strike for the first time … to think that we think that the answer is some new penalties [on staff]. That’s the worst thing we could do.”
He added: “But I think we should look at those incentives.”
Unions representing doctors and nurses welcomed Streeting’s remarks. Prof Philip Banfield, the leader of the British Medical Association, said: “Student debt write-off could be an incentive to stay and, done properly, assist retention now. This is well worth exploring.”
Prof Nicola Ranger, the Royal College of Nursing’s director of nursing, said: “Proposals from Labour in this area are constructive. Loans written off in exchange for service or the full removal of fees [for nursing degree courses] are options that must be on the table as part of making nursing attractive.”
The NHS in Wales already compels nurses, midwives and allied health professionals to work in the service for two years after graduating as a condition of having their tuition fees paid and receiving a bursary. In 2016, when he was health secretary, Jeremy Hunt announced plans to force new medical graduates to spend four years in the NHS, but that was never implemented. In Malaysia, five-year medical school scholarships are conditional on working in the country for 10 years.
The Nuffield Trust health thinktank has hailed student loans forgiveness as an example of the “bold policymaking” needed to address the NHS’s workforce difficulties. It said the policy would reduce early career dropout, improve staff wellbeing and yield more applications for clinical courses.
In research it published in September, it estimated that write-offs would cost £230m a year for nurses, midwives and allied health professionals in England and another £170m a year for doctors. But, it added, such costs “look highly affordable” when compared with other policies or costs that the NHS’s lack of staff leads to, such as the £7bn annual bill for temporary personnel.
Dr William Palmer, an NHS workforce expert at the thinktank, said “carrots before sticks” – loan write-offs rather than mandatory periods spent in the NHS – was the best approach to helping the health service accomplish its long-term workforce plan, which envisages a big expansion of staff over the next 15 years.
A Labour spokesperson said: “Given the shortages of doctors and nurses, we are always looking at ways to keep doctors and nurses in the NHS. However, ‘golden handcuffs’ are not Labour’s policy.”
