Education (Student Support) Madam Deputy Speaker (Dame Rosie
Winterton) I must inform the House that the Speaker has
certified the instrument as relating exclusively to England and
being within devolved legislative competence. The motion is
therefore subject to double majority voting of the whole House and
those representing constituencies in England. 7.00
pm ...Request free trial
Education (Student Support)
7.00 pm
-
(Ashton-under-Lyne)
(Lab)
I beg to move,
That an humble Address be presented to Her Majesty, praying
that the Education (Student Support) (Amendment) (No. 2)
Regulations 2018 (S.I., 2018, No. 443), dated 28 March
2018, a copy of which was laid before this House on 28
March, be annulled.
I thank the Leader of the House for scheduling this debate,
which marks an important moment. In this Parliament,
Members have had to assert our right to decide the law of
the land—a right that some Ministers have tried to avoid by
denying us votes on statutory instruments. In this case,
the Government let the 40-day period lapse without
providing time. They have now agreed to the step, which I
think may be unprecedented, of revoking their own
regulations and relaying them to allow us a binding vote.
Whatever the decision tonight, I hope that we have
established the right of the Opposition to secure votes on
the Floor of the House. The Government cannot simply
legislate by the back door.
On the regulations, the Government’s actions once again
seem to defy basic sense. Just last week, they rejected our
motion to implement their own guarantee and manifesto
commitment on school funding. Now, they are ploughing ahead
with their plan to scrap bursaries for yet more nursing
students, despite knowing full well the disastrous
consequences that will follow.
Two years ago, the Government ignored the Opposition and
those who work in the health sector when they scrapped the
undergraduate bursary. The results were predictable. In
2016, before the abolition, there were more than 47,000
nursing applicants in England. In 2018, the figure fell to
about 31,000—a fall of over 15,000. It is clear that this
is the reason why we have seen the sharpest ever decline in
nursing applications. I know what the Minister will say. He
will say that the number of applications is less important
than the number of acceptances; he will say that the
Government have committed to create more trainee places for
nurses. They promised an increase of 5,000 nursing places
and said that the nursing bursary had to be scrapped to
make that possible, but what have they delivered? Seven
hundred fewer students training to be nurses.
-
Dr (Sleaford and North
Hykeham) (Con)
Does the hon. Lady agree that what is important is that we
train more nurses and that there are more applicants than
the number we need to train, so that there is good
competition that ensures we get the best candidates? It is
not necessary to have masses more than we need; we just
need enough.
-
I agree with the hon. Lady that we need to ensure that we
have not only more applicants, but more people in training.
However, 700 fewer students have been training to be nurses
since 2017.
-
Mr (Coventry South)
(Lab)
Once again it is women who are being hurt, particularly
adult women who have brought up a family and want to take
up a new career in nursing. They are being denied that
opportunity or being forced into debt.
-
Forced debt for students and nurses of whatever gender is a
really important issue, which I will come on to. My hon.
Friend is absolutely right to highlight that we need to
encourage both genders to see nursing as a legitimate
career.
I mentioned that there are 700 fewer students training to
be nurses. That is the first fall in close to a decade.
-
(Lincoln) (Lab)
Does my hon. Friend agree that the bottom line is that
without applications we cannot train nurses? That is just
all there is to it.
-
My hon. Friend is absolutely right and I congratulate her
on her outstanding dedication to nursing.
The Government said that they can fill the gap with nursing
apprentices. They promised 1,000 of them, yet it has now
been revealed that just 30 apprentice nurses have started
the course. To miss a target may be unfortunate, but to
miss it by 97% and carry on regardless just seems reckless.
The shortfall is not the only problem with relying entirely
on apprenticeships. A nursing apprentice will take four
years to become a registered nurse. Even if there is a
miraculous surge in apprentices starting this summer, we
would not see any new qualified nurses on our wards until
2022.
-
(Lewes) (Con)
I am not sure the hon. Lady understands what life is like
on a bursary as a student nurse. There is just £400 a month
to live on. Apprentice nurses are paid. They are a member
of a team and they have a guaranteed job at the end of it.
That is a very different system, which is a step forward in
progress towards getting more nurses into the profession.
-
I respect the hon. Lady and I pay tribute to her for her
work in the NHS as a nurse, but the figures show that not
only is this change making it difficult for trainee nurses,
who do an excellent job on our wards, it is contrary to
what we need. Applications fell by 33%, with a 42% drop in
mature students. In contrast, an undergraduate nursing
course can take three years and postgraduate courses,
referred to in the regulations, can take two years, making
them some of the quickest ways to tackle the shortfall in
numbers.
The same is true with the nursing associates suggested by
the Government as another solution. The Government’s policy
is not only unfair, it is failing completely on their own
terms. They have pushed ahead with a policy that has
reduced the number of people training to work in our NHS
and now they are trying to do it again. I should add that
trainee nurses in any of these routes have to do the day
job as well. I pay tribute to our nurses for the fantastic
job they do every single day in our NHS. Trainee nurses do
not get paid the going rate. Those affected by the
regulations actually have to borrow money for the
privilege.
I hope the Government are clear that simply having more
trainees on wards is not a solution to staff shortages.
They are there to learn their job, not to do someone
else’s. There is clear evidence that using support workers
or trainees as replacements for qualified nurses has
potentially disastrous consequences for care. I hope the
Minister will confirm that that is not the Government’s
intention.
This measure does not make any financial sense. Tuition and
a bursary for a postgraduate or diploma student could cost
less than the average premium the NHS pays for an agency
nurse for a single year. Providers have suggested that they
could expand their courses by up to 50% if funding was
available. This comes at a time when there are 40,000
nursing vacancies in the NHS. The Government’s failure to
fill vacancies is so severe that the Migration Advisory
Committee has placed nursing on the shortage occupation
list, even as potential recruits in our constituencies are
denied the support that they need to serve in the NHS.
-
(Oxford West and
Abingdon) (LD)
Does the hon. Lady agree that in the end, the only people
we must care about are the patients? In Oxfordshire, in the
John Radcliffe Hospital, 170 beds were closed primarily
because there was a staff nursing shortage. These measures
are not going to fix the immediate problem. Why are the
Government continuing to do something that is not
evidence-based and will not work?
-
I absolutely agree with the hon. Lady. She is absolutely
right to point out that all our focus has to be on making
sure that the jewel in Britain’s crown—the national health
service—has the qualified staff to do the job and keep our
patients and loved ones safe.
I have talked about the failure to fill the vacancies in
the NHS at the moment, and that is even before we consider
the impact of Brexit on the 21,000 brilliant nurses who
have come from EU countries to serve in our national health
service. Only two months ago, the Health Secretary said
that the winter crisis in our NHS was “probably…the worst
ever”, but if he carries on like this, there will be worse
to come.
It is one thing for Ministers to push ahead with policies
against the warning of the Opposition. It is quite another
for them to ignore their Departments’ impact assessments,
yet that is precisely what Ministers have done. The
Department for Education’s assessment of the changes to the
bursary said that it would disproportionately affect women
and ethnic minority students, yet Ministers have wilfully
pressed ahead. Then the Department of Health and Social
Care found that the change could make women, older students
and students with lower incomes less likely to participate
in postgraduate nursing courses. Again, Ministers pressed
ahead, and we have seen the consequences not just in the
number of applications, but in who has applied. Just as
they were warned, the profile of our future nurses has
become less representative. In particular, there has been a
42% fall in applications from mature students.
This is not simply a matter of fairness or even just about
the benefit of a diverse workforce providing frontline care
to a diverse population. Older nursing graduates are more
likely to stay longer in the NHS and are more likely to
choose areas such as mental health or learning disability
nursing, which are facing severe staff shortages. Just
yesterday, campaigners warned of the impact that the
abolition of the bursary has had on those areas.
-
(Chelmsford) (Con)
The hon. Lady is making a very powerful point, but we need
to be very focused with our intervention. I represent an
area that has a nursing school. Although applications have
dropped, we still have five applicants for every place and
30% more qualified applicants for every place, so if we are
to take measures, we need to make sure that they are very
targeted in the areas in which we intervene.
-
I absolutely agree that we have to make sure that we target
interventions and make sure that they work, but part of the
reason I have brought the motion before the House today is
that the interventions are simply not working. Since 2017,
we have 700 fewer students training to be nurses, so the
impact is absolutely clear, and I hope that Government
Members will support our motion.
Some universities are even looking at closing down
specialist courses entirely. If today’s regulations pass,
there is every reason to believe that this will get worse.
Nearly two thirds of postgraduate nursing students are over
25, more than a quarter are from ethnic minorities and 80%
are women, so the impact of today’s regulations will surely
be even worse than the previous cuts. Even if the
Government are determined to make the change, there are
good reasons not to make it now. This policy would move
postgraduate nursing students over to the main student
finance system, which means dealing with the Student Loans
Company.
There is every reason to believe that the Student Loans
Company is not yet ready. In recent weeks, the Government
have been dealing with an error by the company that has led
to 793 nurses being hit with unexpected demands to repay
accidental overpayments they were unaware of. The
Government’s response was a hardship fund of up to £1,000
per student, yet the Minister for Universities, Science,
Research and Innovation, the hon. Member for East Surrey
(Mr Gyimah), admitted in a written answer to my hon. Friend
the Member for Blackpool South (Gordon Marsden) that the
majority of students were overpaid by more than £1,000 and
will be left short. Perhaps when he responds, the Minister
will tell us how he can possibly expect nursing students
affected by this policy to have any faith in the system
they will be stuck in.
With the Government finally embarking on their flagship
review of higher education, they could have allowed this
issue to be considered as part of the review before going
ahead with this change today. Ministers have insisted that
this change is necessary now to make how we fund training
sustainable, yet there is little reason to believe that it
will achieve this. The average NHS nurse earns just over
£31,000 a year and the average graduate now leaves
university with £50,000 of debt. A new nurse with a
postgraduate qualification will take 86 years to repay
their undergraduate debt on the average NHS salary—that is
before we add interest—which is nearly triple the current
repayment period before debt is written off, meaning they
will not even begin to repay the debt. How many
postgraduate students affected by this policy will repay
any of, let alone all, their additional loan, and how much
of that debt will simply be written off by the taxpayer in
decades to come?
-
(Redditch) (Con)
Does the hon. Lady not agree it is completely wrong to talk
about debt in the way she is—in this place—as though it is
some sort of credit card debt? It completely misrepresents
the situation for young people from disadvantaged
backgrounds thinking about going to university. Her words
will be putting them off.
-
I am not sure it is my words that are putting people off; I
would say the thought of having £50,000 of debt hanging
over them for a very long time is putting people off going
into education.
-
I started my nurse training in 2000 as a single mum. When I
finished, I had £15,000 of debt—and that was with a
bursary. It took me five years to pay it off. People say we
should not talk about debt, but we have to talk about
it—debt is debt. Students come out with debate. I came out
with debt. I sit here listening to people who know nothing
about this talking as if they do. It simply is not true.
-
The passion from my hon. Friend reflects how people feel up
and down the country. It is funny because we all know what
happened at the general election—and the verdict was clear
on the Government’s position on education and student debt
and tuition. [Hon. Members: “You lost!”] And of course the
Government lost their majority at the same time, and the
weak and wobbly Prime Minister has done nothing to make
anyone in the country feel more confident about her
future—but I digress.
How many postgraduate students affected by this policy
repay any of, let alone all, their additional loan? Will
the Minister explain how this is sustainable? How much will
really be saved in the long run? Or is this another example
of what the Treasury Select Committee have called the
fiscal illusion—in this case, of a student finance system
that allows the Government to pretend they have made a
saving when they are simply passing the bill down to the
next generation? It is no wonder that all the devolved
nations have maintained their own NHS bursaries.
-
Dr
The hon. Lady talked about the general election and
promises on education and education funding. Will the
Labour party be keeping its education promises to repay the
debts of students who have already incurred them?
-
I should have thought that Conservative Members would have
read what was a great manifesto. They have hidden theirs
now—I cannot see it, because it is hard to find—but ours
was absolutely clear, and we continue to be clear about the
fact that we would abolish tuition fees. The debt that our
students face at the moment is the result of a tripling of
student debt on the Conservatives’ watch.
I hope that Conservative Members will support our motion,
not least given the financial consequences of Government
cuts for their own budgets, but also because I believe that
we should welcome nursing students from all over the United
Kingdom. If we do so, the whole country will benefit. If
the House votes for the motion, that vote will be a clear
call for the Government to rethink the cuts, restore the
bursary, and respect the will of the House.
A few months ago, the Health Secretary said that the NHS
was “nothing without its nurses”. I support that sentiment
tonight, but the sentiment without substance is not enough.
I am sure that there is not a single Member in the Chamber
who would not acknowledge the urgent need for us to recruit
more nurses, so I ask all Members to put their votes where
their voices are. I commend the motion to the House.
7.21 pm
-
The Minister for Health (Stephen Barclay)
I join the hon. Member for Ashton-under-Lyne (Angela
Rayner) in welcoming the opportunity to discuss the
increase in the number of postgraduate places that will be
unlocked as a consequence of the statutory instrument. She
ended her speech by saying that there was an “urgent need”
to recruit more. The central premise of her opposition to a
change that will remove the arbitrary cap imposed by the
bursary, and hence unlock additional places for
postgraduate students, seems a strange one on which to base
her speech, given that we are ensuring that we can continue
to increase the number of nurses that the Government have
delivered through the postgraduate route, as we have
through the undergraduate route.
At present, about 2,500 students gain access to nursing,
midwifery and allied healthcare professions through the
postgraduate route, a number that is constrained by the
cap. The policy that we are discussing has already been
applied to the much larger population of about 28,000
undergraduates studying the same subject. The statutory
instrument will ensure consistency in the approach to both
populations, while enabling both to increase their number
by 25%.
This is part of a much wider package of Government
measures. We are, for instance, increasing the number of
apprenticeships. I know that my right hon. Friend the
Member for Harlow (Robert Halfon), as Chair of the
Education Committee, has repeatedly championed their
importance as a route into nursing for those who do not
want to go to university. Similarly, my hon. Friend the
Member for Chelmsford (Vicky Ford) has campaigned
repeatedly in respect of medical school places. There are
five new medical schools and 1,500 new medical places,
again as part of the increase in the number of nurses. We
have made a commitment through “Agenda for Change”, working
with the trade unions, to deliver pay increases and we have
programmes such as the return to work programme, which has
seen more than 4,000 former nursing staff applying to
return to the profession.
-
(Harlow) (Con)
I will be supporting my hon. Friend this evening. I welcome
what he said about apprentices. I think this squares the
circle. We need to rocket-boost apprenticeship programmes
in the NHS. I intend to say more about that in my speech,
but may I ask whether he is committed to that today?
-
I was just taking inspiration. Let me explain the route
into nursing through apprenticeships. A four-year package
will enable people who do not want to go to university—this
is a point that my right hon. Friend has repeatedly made in
the Education Committee—to progress to nursing roles by
means of what he has often referred to as a ladder.
Healthcare assistants tend to feel trapped in roles that do
not give them an opportunity to progress. This is at the
heart of what the Government stand for: giving people an
opportunity to progress at different stages in their lives
through the apprenticeship route.
-
Sir (New Forest West)
(Con)
Will my hon. Friend address the allegation that there are
700 fewer nurses in training?
-
My right hon. Friend will not be surprised to learn that
that is a selective picking of the facts because it does
not include direct entrants, to cite just one example that
was not included. I could go on, but I know the—[Hon.
Members: “Go on”.] It does not take account of direct
entrants; that is one population that was not included. It
also—
-
rose—
-
Would the hon. Lady like me to go on or to give way?
-
Would the Minister confirm the number?
-
I am happy to confirm that. We now have 13,100 more nurses
on wards since 2010 and we have a commitment to expand the
numbers—[Interruption.] It is a new programme and we are
expanding the number of apprenticeships. We have committed
to 5,000 this year, expanding to 7,500.
It is interesting, is it not? Having routes that give
people opportunities to progress—having different choices
for people and empowering individuals, not all of whom want
to go to university—so that people from different
backgrounds can go into the profession is the very essence
of what our party stands for. It is shame—
-
Dr (Central Ayrshire)
(SNP)
Does the Minister therefore challenge the figure of only 30
apprentices and does he recognise that with a four-year
course they will not be ready until 2022, and there is a
need for nurses now?
-
I absolutely recognise that the apprenticeship route will
take four years, but the Government have given a clear
commitment to that and that is backed up by
significant—[Interruption.] The UCAS figures are embargoed,
so I do not have the latest figure. The point is that it is
a four-year programme and it will take time to roll out,
but it is backed by significant funding: the NHS is
contributing £200 million to the apprenticeship levy. That
is a signal of this Government’s commitment. The Minister
for Apprenticeships and Skills is here, championing the
apprenticeship route, as are other Members through the
Select Committees. It is a shame that some Opposition
Members are not reflecting on the benefits offered by
apprenticeships as an alternative route into the nursing
profession that will deliver more nurses. That should be
welcomed.
-
(Henley) (Con)
I think my hon. Friend the Minister has forgotten that the
Minister for Education, my right hon. Friend the Member for
Bognor Regis and Littlehampton (Nick Gibb), is also here,
which reinforces the point that the starting point for
promoting nursing is at school. Does my hon. Friend agree?
-
I do agree with my hon. Friend. Indeed we have three
Ministers from the Department for Education here, which
again shows the Government’s joined-up approach. The NHS,
as the employer of 1.5 million people, is a standard setter
that can provide leadership in the apprenticeships market
and looks at doing so not just for nursing apprenticeships,
but across a range of apprenticeship routes. The Minister
for Apprenticeships and Skills, who is a former Minister in
the Department of Health, understands that issue extremely
well.
-
Does the Minister really think that this needs to be an
either/or? Could we not do the very good work that is going
on with apprenticeships and also maintain this important
bursary? Does he have something to say to the chief
executive of the Royal College of Nursing, who says these
changes are short-sighted? Has the RCN’s position changed?
-
I agree with the hon. Lady that we can do both: we can have
the apprenticeship route, but we can also increase the
number who do postgraduate training as an entry point into
the profession. It is also why we are looking to expand the
number of undergraduates. This is also empowering for
students because it means that, while they are undertaking
their course, they will receive more funding than they
would under the existing system. Under the move to the loan
system, depending on the circumstances of the course,
health students will typically receive up to 25% more in
the financial resources available to them for living costs
during the time they are at university. For example, a
student without dependants living away from home could
access £9,256 under the loans system, compared with £6,975
under the NHS bursary system.
-
(Leicester South)
(Lab/Co-op)
The Minister is being typically gracious in giving way. He
said in his opening remarks that he wanted to unlock
additional places but, according to the RCN, far from
unlocking additional places, the removal of the bursary has
led to a fall of 700 places on nursing degrees and a 3%
decline in the number of people starting nursing courses
since 2016. Is it his view that the RCN is lying?
-
The hon. Gentleman is quoting selectively. He is right to
point to 2016, because the number of nurses in training was
at a record high—an achievement by this Government for
which little credit was given by the Opposition. The new
system will take time to bed in, but it is important to
ensure that more places are available and that there are
more applicants, and that is our approach.
-
Opposition Members seem to be portraying the bursary system
as a panacea, but it was not a well-functioning system.
There were more applicants than available places, and it
was a real struggle for students from poorer backgrounds,
such as myself, to live on £400 a month with no alternative
income. The system also only catered for students with an
academic background. The new apprenticeship system allows
degree-entry nursing, but not necessarily through the
academic route.
-
As a nurse, my hon. Friend speaks with great authority and
she is right. This is about empowering those who want to be
a nurse, not all of whom want to go to university. She is
also right to remind the House that many people’s ambitions
are choked off by the existing system. Under the bursary
system, over 30,000 people who applied to be a nurse were
rejected. Too many people were being rejected, and we need
more nurses, so we have a package of measures to increase
the number of nursing places. Nothing has been said about
those who were thwarted in that ambition. Universities,
too, have consistently argued that healthcare postgraduate
courses were an area prime for growth if we offered
suitable loan products.
-
(South West
Wiltshire) (Con)
The Minister is right to highlight the university sector
but has he, like me, recently visited his local further
education college? If he has, I am sure that staff will
have expressed the same view that I heard in Trowbridge
recently: the new apprenticeship route into nursing is good
for FE colleges that want to offer nurse training. Some
colleges currently feel constrained because they are frozen
out by universities but, in setting up such courses,
colleges will be able to offer nursing to a much greater
range of people than is currently the case.
-
As a medic, my hon. Friend alights on an important point
that I am happy to pick up. A number of the professions are
degree entry, which precludes the further education college
sector, so I will be happy to discuss that with him.
It is worth drawing to the House’s attention that it is not
just universities that have been pushing for a change.
Professor Dame Jessica Corner, the chair of the Council of
Deans of Health, said:
“Our members report receiving a high number of good quality
applications for most courses and they will continue to
recruit through to the summer. Where courses have
historically had a large number of applicants, fewer
applicants might well not affect eventual student numbers”.
The key issue is not just how many people apply; it is
ensuring that there are sufficient applicants for the
places and then increasing the number of places on offer.
-
(Sheffield Central)
(Lab)
Will the Minister give way?
-
I have given way quite a lot, so I will make a little
progress.
In addressing the Opposition’s points, we have moved
slightly outside the scope of the SI before the House,
which concerns postgraduates, into a discussion about
undergraduates, and the Chair of the Health Committee, my
hon. Friend the Member for Totnes (Dr Wollaston), made the
point that the postgraduate market has certain features
that are distinct from the undergraduate market. In certain
disciplines, such as mental health and learning and
disability, some older applicants may be more risk averse
about taking on a student loan, depending on when they did
their first degree. If it was before 1998, they probably
will not have a student loan, but let us not forget that
the Labour party introduced tuition fees, so many who
studied after 1998 will have a loan.
Working in conjunction with colleagues in the Department
for Education, and taking some of the lessons about
targeted support that have been learned in teaching, we
intend to offer £10,000 golden hellos to postgraduate
students in specific hard-to-recruit disciplines—mental
health, learning and disability, and district nursing—to
reflect the fact that those disciplines often have
particular recruitment difficulties. That £9.1 million
package will be supplemented by a further £900,000 to
mitigate a particular challenge with recruiting in any
geographical areas. For example, if an area such as
Cornwall suddenly found itself having difficulty in
recruiting speech and language therapy recruits, a targeted
measure—perhaps at a different quantum from £10,000—could
be implemented in order to reflect those geographical
issues.
-
(Totnes) (Con)
I thank the Minister for meeting me to discuss the concerns
raised by the Health Committee in our nursing workforce
inquiry. As he has stated, applicants for learning
disability and mental health nursing tend to be older, and
those applicants are more likely to stay. They are
particularly affected, so I am grateful to the Minister for
listening to our concerns. Putting the needs of patients
first by allowing for these targeted extra packages is very
welcome.
-
I am grateful for that support from the Chair of the Health
Committee. Having spent four years on the Committee myself,
I know the value that members of Select Committees bring to
the House. The Health Committee, particularly under her
chairmanship, is hugely valued in the Department. The
mitigation package that has been put before the House
tonight reflects the constructive engagement that we have
had with the Committee. We realise the importance of having
consistency between undergraduates and postgraduates, and
of expanding the supply of places, but it is also important
to recognise that there might be specific areas in which
there are recruitment challenges, and that targeted action
to mitigate those challenges is appropriate.
-
I thank the Minister for the announcement that he has just
made. At the nursing college in Chelmsford, and also at
Cambridge and Peterborough, we have 30% more qualified
applicants, but there have been fewer applicants for mental
health nursing. This targeted intervention will really help
to address that need. Will he confirm that this will be
locally based where necessary—that is, in the areas where
we need the help most?
-
I am happy to confirm to my hon. Friend that there will be
a local element to the targeting of the package. She has
been a powerful advocate in helping to secure the new
medical school at Chelmsford, which will be a huge boost to
the local health economy.
The statutory instrument before the House tonight is part
of package being brought forward by this Government,
alongside the “Agenda for Change” increase in pay and
alongside our ambitions to increase the number of
apprenticeships and to encourage people to return to the
profession. We have already made this change for the much
bigger population of 28,000 undergraduates, and it is right
that we should now apply that consistently to the 2,500
postgraduates. We have a targeted measure of support to
address any hard-to-recruit areas, and I therefore commend
this statutory instrument to the House.
7.37 pm
-
Dr (Central Ayrshire)
(SNP)
As the Minister says, we are here to discuss removing the
bursary from postgraduate nursing students, but it would be
crazy not to learn from the experience of the past two
years following the removal of the undergraduate bursary in
2016. Scotland maintained that bursary, as indeed did
Northern Ireland and Wales. We provide £6,500 as a bursary
and up to £2,500 carers allowance for those with caring
commitments, and obviously there are no tuition fees, so
that saves another £9,000 a year. Our students are
therefore £18,000 a year better off. Only in England has
the undergraduate bursary been removed and tuition fees
introduced. So nurses in England will face coming out with
debts of £50,000 to £60,000.
As has already been said, there has been a 33% fall in
applications. Several Government Members have said that
there are still plenty of applications, but what talent has
been lost in that third? Exactly who are the people who are
not applying for nursing because there is no longer a
bursary? There has been an even bigger fall—42%—in the
number of mature students applying, yet we know that mature
nursing students have a much greater tendency to stay in
the place where they start and to stay in nursing. We are
discussing postgraduate students tonight, and the biggest
advantage of postgraduate students is that they will be
trained more quickly. The Minister mentioned the
fact—although he did not expand on it—that postgraduates
already have student loans. The idea of asking them to take
on second student loan is likely to result not in a 33% or
42% drop but in an even bigger drop.
The Minister talks about the extra money that the NHS is
investing, but why not invest it in attracting people to
study nursing as a degree? It is fine to talk about nursing
apprenticeships, but we hear that only 30 people have taken
those up, and they will not be ready until 2022, so they
are not a quick answer. I have nothing against the idea of
nurse apprentices, but nurses are now leaders in the health
service; we have advanced nurse practitioners and nurses
who are managing and leading services. That requires them
to be educated to degree level and to have the experience
to act as leaders.
What we hear from the Royal College of Nursing is not that
there are now 700 fewer nurses in total, but that 700 fewer
nurses have started training through the degree course, yet
all this change was meant to be about expanding that
number. It has not expanded; it reduced last year. The
danger is that that pattern will continue and be even more
marked for postgraduate students.
In Scotland, obviously, we have maintained the bursary.
Instead of a 3% fall in the number of people starting
studying, we have seen an 8% rise. Indeed, we have already
seen a 10% increase in the number of people signing up for
nursing places this year. We all need nurses, because all
four national health services are struggling with the
workforce, but NHS Improvement reports that there are
36,000 vacancies in NHS England. That is catastrophic.
Literally, one in 10 nursing jobs in England are empty.
That is more than twice the vacancy rate we face in
Scotland. This is safety issue. The Secretary of State
talked about safety. This is part of what led to the junior
doctors’ strike, because we are talking about avoidable
deaths. Research shows that the only measure that reduces
avoidable deaths in hospital is the ratio of registered
nurses to patients—not healthcare assistants, auxiliaries,
doctors or anyone else. This is about registered nurses
actually looking after patients.
The extra places that we were told would be funded by
removing the undergraduate bursary will start only this
autumn, so they will not be ready until 2021. The
apprentices will not be ready until 2022. Postgraduate
students starting this autumn will at least be ready in
2020. This is urgent. The NHS in England is struggling for
the lack of nurses. They are the people who make the
difference to safety. The Government should be investing in
whatever will produce high-quality nurse leaders as quickly
as possible, and that is postgraduates.
7.42 pm
-
(Harlow) (Con)
To achieve social justice and deal with the skills deficit,
we need a skills revolution. In many sectors, we have a
real skills shortage, particularly at level 4 and above.
Young people are pushed towards traditional degrees, but
only 52% are getting jobs after graduation that require a
degree, according to the Chartered Institute of Personnel
and Development. On the flipside, degree apprenticeships
are just not growing fast enough, and we need to invest
more in further education and skills provision.
I welcome what the Minister has said today, and I thank him
for meeting me to discuss this issue. We must go further on
nursing apprenticeships, which I believe are the answer to
this whole problem. We can square the circle and support
nurses by rapidly expanding the apprenticeship programme.
Hon. Members will know that I am a passionate advocate of
apprenticeships, and I therefore support the introduction
of new routes into nursing, through degree apprenticeships
and the creation of the nursing associate role.
Nursing degree apprentices will not have to pay anything
themselves, as my hon. Friend the Member for Lewes (Maria
Caulfield), a brilliant former nurse, explained. They will
be able to become degree-registered nurses in four years.
Similarly, the new nursing associate role will provide
extra capacity in the workforce, and many of those who
train as nursing associates may decide to continue to
degree-level nursing.
The twin themes of the Education Committee in this
Parliament are social justice and productivity. Nursing
degree apprenticeships are key to both. They offer an
attractive route both for mature students and for those
with children, ensuring that all those who wish to train as
nurses have the opportunity to do so. I am not suggesting
that people should not have the choice of a three-year
undergraduate course, but we must maximise the
opportunities provided by degree apprenticeships. Doing so
would mean that we have a sufficient nursing workforce and
that aspiring nurses have options for training.
I have real worries about the fact only 30 people began
training as a nurse through the nursing apprenticeship
schemes this year, and we need to rapidly improve the
number of people doing degree apprenticeships. There needs
to be a taskforce involving the Minister for
Apprenticeships and Skills, the Minister for Universities,
Science, Research and Innovation, Health Ministers, the
Institute for Apprenticeships and others to drive this
forward and to encourage people with a proper advertising
campaign, using the £200 million levy. Thirty is just not
enough; we need many thousands of people. If people in my
constituency and across the country knew about the schemes,
they would want to take them up.
-
Dr Murrison
Does my right hon. Friend agree that part of the way we
might expand the numbers taking the apprenticeship route is
to unleash the power of the further education sector? The
sector now has degree-awarding powers and would be very
attractive to a large number of people not just in the big
urban centres but in the smaller regions, too.
-
Like me, my hon. Friend is a big champion of further
education and understands it completely. This could be an
incredible moment for our further education colleges
because, along with some very good private providers, they
could be leading the way in providing degree
apprenticeships.
-
(Solihull) (Con)
My wife was a renal nurse for 15 years, and she says that
one of the key changes that happened in her time as a nurse
was the university-fication of the nursing profession. Does
my right hon. Friend agree that having this diverse route
is a much better way to do things and brings in people from
all backgrounds?
-
My hon. Friend is right. My hope is that, rather than 50%
of all students just going to university, one day 50% of
all students will be doing degree apprenticeships in all
subjects, but especially in the subjects we need,
particularly in coding, healthcare, science, engineering
and nursing.
-
Dr Wollaston
I welcome my right hon. Friend’s work as Chair of the
Select Committee on Education. Does he agree that we are
losing too many healthcare assistants because in the past
there have not been the opportunities for them to progress?
These regulations are an important way to retain such a
valued part of our workforce.
-
As so often, my hon. Friend is a mind reader. I will
address her point, but of course she is right.
These jobs should not be limited to degree level; we should
ensure there are apprenticeships in healthcare professions
from level 3. We must have sufficient progression for those
already working in the sector. The nursing associate role
is a positive step that will provide opportunities for
healthcare assistants to progress within the sector. From
there, they could train to become registered nurses, if
they wish.
-
(Enfield,
Southgate) (Lab)
Will the right hon. Gentleman give way?
-
This is the last intervention because I am conscious that
other people want to speak.
-
In the light of the poor recruitment to the apprenticeship
schemes, does the right hon. Gentleman agree it is best to
keep both routes open—the bursaries and the apprenticeship
schemes—to maximise the number of people coming into the
system?
-
I thought that initially, but I have listened to my hon.
Friend the Minister’s arguments. There was previously a
cap, and not everybody was able to get into the system. If
we can encourage people down the apprenticeship route, they
earn while they learn, there is no debt and they get a lot
more than they would get if they had a bursary.
-
(Chippenham)
(Con)
Will my right hon. Friend give way?
-
This is genuinely the last time I give way. It is
impossible to say no to my fellow member of the Education
Committee.
-
Further the intervention made by my hon. Friend the Member
for South West Wiltshire (Dr Murrison), my constituency
neighbour, I, too, met Wiltshire College last week, and it
is eager to take on nursing apprenticeships. The college
shows we can get past the few roadblocks, because it is
already affiliated with universities in offering degrees.
That is one way in which we can look positively at
increasing the number of apprenticeships, rather than
looking at it negatively, as we hear from the Opposition.
-
My hon. Friend is a remarkable member of our Committee and
she is right in what she says. It is good that the Minister
for Health, the Minister for School Standards, the Minister
for Universities, Science, Research and Innovation and the
Minister for Apprenticeships and Skills are here, because
we need to unblock the road blocks and bureaucracy and
really make these things happen, so that thousands of
people are doing this, not just 30.
We need to ensure that we are making the progression as
smooth as possible. Our Committee is concluding its
inquiries on value for money in higher education and the
quality of apprenticeships and skills training. Nursing
bursaries are relevant to both, so we decided last week to
hold a one-off evidence session on the subject in the next
few weeks. I hope that the Minister for Health will accept
our invitation to discuss the matter in greater detail
then. I urge him to carry on championing nursing
apprenticeships for other healthcare professionals and to
set out in detail, at a later date, what the Government
will do on apprenticeships. Let us make that culture
change, so that apprenticeships are not seen as the
inferior option to traditional courses. The change must
start in Whitehall, and only when it happens will we see
nursing apprenticeships used to their full potential,
contributing effectively to tackling the skills deficit and
helping the most disadvantage to do the careers that they
and our country need.
7.51 pm
-
(Lincoln) (Lab)
As Members probably know, I was a nurse until last June. I
did 12 years in cardiology and almost three in out-patient
gynaecology clinics. As an ex-nurse, I could not be any
more in opposition to this amendment to nursing bursaries,
as I am concerned that it will fail to address the problems
with nursing recruitment and will intensify the fall in
applications to nursing courses. Overall, applications have
fallen by 33% since March 2016, when bursaries were
withdrawn. At that time, the Royal College of Nursing, a
much respected and non-political body, said the changes
were unfair and risky, and the Royal College of Midwives
argued that the move threatened the future of maternity
services in England.
I hope that all of us in this Chamber acknowledge that
there is a workforce crisis across the whole NHS. As the
RCN has said,
“plans by the government to remove the NHS bursary for
pre-registration students in England must be stopped
immediately”.
It goes on to say that,
“nurses need bespoke financial support if the government is
to meet its commitment to grow the nursing workforce and
meet the future population demand for health and care
services”.
The National Audit Office has reported that the impact of
the EU referendum appears to be driving EU nurses away, and
both the Care Quality Commission and the NAO have raised
safety concerns relating to nursing shortages—it is not
just Opposition Members who are saying that.
-
(Leeds North West)
(Lab/Co-op)
My hon. Friend gave many years’ service as a nurse and I am
sure she worked with many nurses who came here from abroad.
The Migration Advisory Committee has placed nursing back on
the shortage occupation list. In the light of that, is not
this statutory instrument wrongheaded, as we need nurses to
come through all routes if we have a nursing shortage?
-
I completely agree with that.
There are 40,000 nursing vacancies across the NHS and, for
the second year in a row, more nurses are leaving the
profession than joining, with one in three expected to
retire in the next 10 years. The Government have made much
of the nursing associate role and apprenticeships for
nurses. Nursing associates provide a support role for
nurses, and the RCN feels that diluting and substituting
registered nurses with associate nurses has potentially
life-threatening consequences for patients. That is the RCN
saying that, not me.
This Government also speak in glowing terms about the
apprentice nurse role. I do take the points made by the
right hon. Member for Harlow (Robert Halfon)—he means
well—but it takes four years to train as an apprentice
nurse and our health service is, as the RCN says, in crisis
right now. Furthermore, this route is not currently
providing the 1,000 new nurses per year that the Government
planned for, with RCN figures suggesting that there are
just 30 apprentice nurses at present—I will give that
answer.
I was a mature student. I was 41 when I started my
training, and a single parent. We have heard a lot tonight
about how we will encourage people who do not want to go
down the university route. I worked in Tesco on a checkout.
I had been to grammar school and it had failed me, so I had
to go to night school to get my A-levels to become a nurse.
That took me a year, three nights a week, on top of
working. I then worked for three years as a nursing student
to become a nurse. I could not have completed my training
without a bursary. I also borrowed £5,000 a year from the
Royal Bank of Scotland, so I came out hugely in debt, even
though I had a bursary, and it took me five years to clear
that debt.
-
(South Suffolk)
(Con)
You shouldn’t have.
-
That is what I had to do to become a nurse. I think I got
around £500 of bursary at that time, and I had myself and
my 10-year-old daughter to keep.
My friend Ali was a wife and a mum, and she needed her
bursary, and my friends Clare, Haley, Adele and Lisa were
younger and single, but they still needed their bursaries,
because everybody has bills to pay. None of us could have
trained without our bursaries and none of those friends
would have gone on to be the nurses they are today without
them. Please, will no one on the Government Benches talk
about encouraging disadvantaged people to train as nurses?
When we had bursaries, we did—I did.
The bottom line is that more nurses equals better
healthcare provision. We cannot go on with an NHS in the
state it is currently in. The Government continue to ignore
completely the wise words of those who are experts in their
field—like the Royal College of Nursing—when it comes to
the support available for future healthcare professionals.
They seem to think that they know best, but the reality
does not bear out that fantasy. The regulations must be
scrapped and the Government should reinstate nursing
bursaries immediately.
I stand in this Chamber time and again defending our NHS,
and I hear people who have no idea what it is like on the
ground. Sometimes they sit looking at their phones when
people like me are talking. I despair. If the Government
will not listen to me, I hope they will heed the wise words
of the RCN, because it is right on this. Please listen to
the RCN and please reinstate nursing bursaries.
7.56 pm
-
(Lewes) (Con)
May I start by declaring that I still work as a nurse on
the bank shift, mainly at the Royal Marsden Hospital in
London? It is a pleasure to do so.
I have previously been very outspoken against the removal
of bursaries and the move to a tuition fee-based system,
for practical reasons: student nurses are different from
most students. The course requires them to do a set number
of practical hours, and the fact that those are often
unsocial and irregular means that it is almost impossible
for student nurses to get other part-time work to
supplement their time on their courses. We have heard today
that student nurses are often mature students who have come
from other professions and so already have financial
commitments, such as mortgages and loans, that they have to
bear in mind when they start a nursing course.
Postgraduates who have existing debt are often reluctant to
take on more to become a student nurse.
However, since the changes were introduced a couple of
years ago, the background has changed. We have seen the
rise of the apprenticeship route for nursing and of the
associate nurse. My difference with Opposition Members is
that I have actually worked with some associate nurses who
are in training, and with apprenticeship nurses in
training, and the difference is phenomenal. They are
enjoying their courses a huge amount more because they are
working in a practical setting. It is not just about what
they are learning on their nursing course; they are back to
being part of the team. They are not students who just come
to their placement from university; they are learning about
being part of a hospital team and a clinical community.
Associate nurses and apprentice nurses are more than just
students; they bring experience with them. Many have
backgrounds as healthcare assistants. The experience that
they bring from a variety of settings is phenomenal. I know
about the support that they have given me on shifts as a
bank nurse, and that would not have been available with
student nurses previously. We are underestimating their
power.
I echo some of the comments in the debate: we do need to
ramp up the apprentice and associate routes, because that
is the way forward. The bursary system was far from ideal.
I lived on a bursary of £400 a month for the three years
that it took me to train as a nurse, with little or no
additional income. As the hon. Member for Lincoln (Karen
Lee) said, student nurses rack up significant debt during
those three years. That shows that the bursary system was
far from ideal. The statutory instrument took some of those
points into account, establishing a hardship fund for
struggling students and grants for childcare, travel and
accommodation—none of which were available under the
bursary system. They are there to support students who have
financial pressures.
The bursary system has failed to achieve the number of
students that we need. There was a cap on the number of
places. Each and every year there were more applicants, but
there were not more students coming through the system,
because the cap did not allow those applying to secure the
places. We need to embrace change, and use this as an
opportunity to increase the number of nurses. We should
also make student nurses feel valued, and give them a
variety of routes into nursing. They have the associate
nurse role, which means that they are healthcare assistants
who want to do their associate training. They can then top
up their training in the future to become registered
nurses, or they can go down the apprenticeship route to
qualify.
I see Opposition Members laughing. They seem to find it
difficult to understand how a Conservative Member of
Parliament can be a nurse—I am talking about someone who
came from a deprived background and who took the route into
nursing because she could not get into university. I will
not apologise. I am not afraid to speak out for student
nurses and for nurses. I worked with the RCN in the “Scrap
the cap” campaign. I spoke out when there was a move away
from the bursary system, but, with my hand on my heart, I
can say that the associate and apprenticeship routes into
nursing are the way forward. It is misleading to pretend
that the bursary system was a panacea, that student nurses
were happy and that we were fulfilling the numbers that we
needed.
I am a member of the RCN and I fully respect everything
that it does to support nurses, but its briefing has been
slightly misleading. It lists only two routes into nursing:
the two-year postgraduate route, and the three-year route
into nursing. It does not even mention the associate route
or the apprenticeship route, which we need to take into
account. It also highlights the fact that applications into
nursing have fallen, but it has not mentioned that 2017 saw
the second-highest number of students ever accepted on to
nursing courses—26,620 students—and that was despite an
overall fall in the total number of applications.
-
I have the briefing here, and it does mention it.
-
I thank the hon. Lady for her intervention. As a member of
the RCN, I, too, have had the briefing, and it does not
mention the associate and apprenticeship routes into
nursing.
The bursary system was not the panacea that Opposition
Members claim it to be. I am happy to stand up to fight for
nurses when I think that Labour Members may have a point,
but I think they are now moving into the realm of scoring
political points, which is their usual tactic. There is a
better way to get nurses into training, and I urge
Ministers to continue both the associate route and the
apprenticeship route, to give student nurses alternative
routes into nursing, to boost nursing numbers and to
develop nursing into a degree-entry healthcare profession.
8.02 pm
-
(Gedling) (Lab)
May I just say to the hon. Member for Lewes (Maria
Caulfield) that this is not about scoring political points?
It is about debating in this House of Commons something
that is of immense importance to our country. I agree with
her that no one has a monopoly on these things, but it is
only right and proper that we have an open and frank debate
about the matter. That means that there will be a clash of
views and a clash of opinions, but out of that will come
better policy, and I hope that the Government, as they move
forward, will listen to some of the concerns that have been
raised, even if they do not change their policy. There is
nothing wrong with that. That is not political point
scoring; that is holding the Government to account for the
policies they are pursuing.
Let me also say this: the only reason why the Government
are being held to account is that my hon. Friends on the
Opposition Front Bench have obtained this debate. They
deserve a great deal of credit for that, because the
Government were not going to debate these regulations.
Indeed, the House of Lords Committee, which scrutinises
these secondary legislation reports, said that it was
unprecedented for the Government to be forced to hold a
debate in this place when revoking one set of regulations
and replacing them with another. So, it is quite right that
we are actually saying this to the Government. We would not
be able to get the Government to put forward their views as
to why removing bursaries is a good thing, and we would not
be able to explain why we are holding them to account, were
it not for the fact that we raised this matter in the way
that we have.
The hon. Member for Lewes criticised the Royal College of
Nursing’s figures, but the RCN—a highly respected body in
this country—has laid out the statistics, including for
many of the routes that she says it has not, regarding the
fall in the number of applications since NHS bursaries were
got rid of two years ago. There has been a 33% fall in the
number of applications for nursing degrees. It may be that
that does not matter, but the Government still need to
address and defend it and explain why the RCN is wrong to
highlight that as a figure that should cause us concern.
-
That is the point: despite the fall in the number of
applications, the number of placements has actually
increased to its second-highest level ever. If the bursary
system was so great, why were the nursing student numbers
not coming through it, and how come we had such a high
drop-out rate of student nurses?
-
Let us see where this goes. The hon. Lady’s point is that
it does not matter that there has been a 33% fall in
applications, because other things will happen, but that is
not the view of the Royal College of Nursing. Applications
from mature students have been disproportionately affected
by the funding reform; the number of applicants aged over
25 has fallen by 42%. I do not know whether the Minister
intends to respond—it would be a shame if he did not—but
perhaps he can explain why that figure does not matter.
That point needs to be addressed in debate. The hon. Lady
disagrees, but I say that it does matter, and that it will
cause problems for future nursing recruitment.
-
Dr Whitford
The hon. Member for Lewes (Maria Caulfield) asks why not
enough nurses were coming through. Is that not simply
because there was a cap on places? The Government keep
linking the bursary with the cap. The issue was not the
bursary; it was the cap. If the Government want to invest
in nurses, they should lift the cap but not remove the
bursary, because that will shrink the number of
applications.
-
I thank the hon. Lady for her intervention. I say to the
Minister that there is hard evidence from the Government’s
own equality analysis that the reforms will,
“increase the amount of student loan borrowing for
postgraduate students and could lead to a fall in student
numbers. The government has acknowledged that, due to the
student intake, the impact will fall largely on women,
older students and, to a lesser extent, students from
ethnic minorities.”
Where is the Government’s defence of that, and what are
they doing to mitigate it? I have no doubt that the
Government would say, “We have done x, y and z.” Indeed,
that is what the hon. Member for Lewes has said, but where
is the Minister’s explanation?
It is not just the Government equality analysis that says
we should be concerned about the changes. A House of Lords
Secondary Legislation Scrutiny Committee report, published
just a few days ago, also raised concerns. First it
criticised the process and then it said:
“Our second, no less strongly felt concern is with the
wider impact on recruitment to post-graduate nursing
courses which may result from the switch from bursary to
loan support”.
That is why this debate is so important. There is evidence
from highly respected Select Committees of this House, and
from the Government’s own equality analysis, and were it
not for the actions of my Front-Bench colleagues, we would
not even be debating the issue and the House of Commons
would not even be reflecting on a major change to the way
in which we fund the postgraduate training of our nurses.
We all agree that the nurses of this country deserve our
respect, and that they do a wonderful job, but the point of
this debate is to ask whether we are going to address the
shortage of nurses following the removal of nursing
bursaries. As my hon. Friend the Member for
Ashton-under-Lyne (Angela Rayner) said, we have serious
concerns and doubts about that, and it is quite right that
those are debated.
Let us see whether the hon. Member for Lewes is right, or
whether the Royal College of Nursing is right that the huge
fall in applications we have seen at undergraduate level
will be reflected at postgraduate level, and that down the
track the Government will regret ignoring the professional
bodies and their own equality analysis. The Government need
to reflect on that and see what more can be done. Rhetoric
about our nurses being brilliant is fine, and we all share
that admiration, but at the end of the day, what this
country needs is hard-nosed policy that works.
8.10 pm
-
(Redditch) (Con)
I will keep my remarks brief. It is a great pleasure to
follow the hon. Member for Gedling (Vernon Coaker). I agree
with him that we need a new long-term system that works and
removes the cap from people who wish to study as nurses.
The vice chancellor of Oxford Brookes University, Alistair
Fitt, has said that nursing bursaries “had to end” and were
not a sustainable system. The cap on places was
discouraging people who wished to enter the nursing
profession, which is so important for all our
constituencies.
In Worcestershire, we need more nurses, not fewer. I
welcome the work that has been going on in a partnership
between my NHS trust and the University of Worcester. I
backed their calls for a medical school, and the work being
done on the ground is already reducing nursing vacancy
rates. They are down from 8.4% to 7.5%, and nursing
turnover rates are down from 14% to 10% in the last year.
That is a tribute to local professionals working hard to
tackle the real problems in my area for the benefit of my
constituents. I want to see more of that.
Under the new system under the regulations, postgraduate
healthcare students will be 25% better off as they take
part in their studies. These are new measures, and we need
to back the Government. We should not vote for the Labour
party’s motion to annul these Government regulations, which
will to help more people to enter the nursing profession at
senior levels. We are talking about the senior leadership
roles that we need in all our hospitals to deal with the
needs of our population and their healthcare.
Finally—I said I would be brief, and I will be—we
definitely need to stop the rhetoric about student debt,
because it puts people off going to university. I refer
Labour Members to the comments of , a respected
financial expert, who just last week said that it was
completely wrong—[Interruption.]
-
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. The hon. Lady is making a serious speech. There
should not be so much chuntering going on.
-
Thank you, Madam Deputy Speaker.
’s comments were,
it is true, aimed at politicians on both sides of the
House, but we have all heard the Labour party’s recent
claims about student debt. The idea that that is the same
thing as a debt has, in reality, put people from different
backgrounds off studying at university. Student debt is not
the same thing as a credit card debt. It is a graduate tax
that people pay only when their income reaches a certain
level of income, and that is the same for nursing students.
We have to go forward with a sustainable solution.
-
Dr Whitford
Will the hon. Lady give way?
-
I will not, because time is short.
Conservative Members will work to fight against the
weaponisation for political ends of students and people who
want to be students. We will open up more opportunities for
everyone in this country to make a career in the NHS, if
that is what they choose to do, and we will run the economy
in a balanced way to support our precious NHS during this
Parliament and in the years to come. I will not be voting
for Labour’s motion tonight.
Question put.
The House proceeded to a Division.
-
Madam Deputy Speaker (Mrs Eleanor Laing)
I remind the House that the motion is subject to
double-majority voting of the House, and of Members
representing constituencies in England.
Division 156
9 May 2018 8.14 pm
divided:
Ayes: 234 Noes: 295 Ayes: 234 Noes: 295 Votes cast by Members for
constituencies in England: Ayes: 199 Noes: 273 Ayes: 199 Noes:
273
Question accordingly negatived.
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