Midwife recruitment in Wales hit by student finance pressures

Financial pressures are forcing student midwives out of their chosen career, with increasing numbers leaving their courses before completion because they simply can’t afford to continue according to a report published today.

These are the stark findings of The State of UK Midwifery Student Finance, a new report published today (16 September) by the Royal College of Midwives (RCM).

With clinical placements and longer term times, student midwives, like other healthcare students, are often unable to take on additional work to supplement their finances, while those that do find themselves working 70 hours a week.

The RCM has warned that this largely unreported crisis needs to be resolved if we are to meet the goals of all four UK governments to improve maternity care.

Commitment

Fiona Gibb, Director of Professional Midwifery at the RCM, said: “Those choosing to study midwifery are incredibly committed, yet so many of them feel forced out of their dream career before they’ve even begun because of financial worries.

“Our report found that the many women – and they are mainly women – who are studying midwifery as a second career or after they’ve had children are being penalised for doing so. Access to childcare benefits and Universal Credit, among others, is either reduced or taken away from them.

“Their options are to take on paid work on top of their heavy study and placement schedule, to take on more debt, including borrowing from family and friends, or to drop out and leave their dreams of becoming a midwife behind them.

“The system has to be smarter than this, so that we don’t lose these future midwives from an NHS that desperately needs them.”

The RCM has made four recommendations for governments in Wales, England, Scotland and Northern Ireland.

Their first aim is for maintenance loans for student midwives that would be forgiven after three years of service in the NHS, specific to the country in which they studied.

Secondly, they have asked for financial support that increases by inflation.

The other recommendations are preserved benefit entitlements, so that the vocational burden is not borne by the whole family and prompt reimbursement for the cost of student placements, which can involve high travel costs.

Debt

Fiona continued: “Every midwifery student is feeling the pinch, no matter where they are based. Nearly three-quarters of students in Scotland have taken on additional debt, while the threshold for grants and allowances for those studying in Northern Ireland are low, meaning those with partners in work may not be able to access them at all.

“In England, though, we see the highest burden, as it is the only one of the four UK nations where midwifery students must pay tuition fees. Starting your career, which you’re extremely likely to spend entirely in the NHS, with a nearly-£30,000 debt is an incredible burden to bear, particularly when there are so many other financial hurdles these students have to overcome.

“That’s why we’re calling on the Westminster Government to level the playing field with the other nations and scrap tuition fees for midwifery students in England.”

The RCM’s State of UK Midwifery Student Finance report is the first of its kind, and represents the views and experiences of undergraduate students across the country. Some of the stories those students have shared with the RCM highlight the personal impact of these issues. One second year student in Scotland told the RCM:

“Sometimes I don’t attend days on campus because I cannot afford to pay for public transport. I use my local food bank and last winter, I avoided turning the heating on and used blankets instead”

Many students take on bank shifts as healthcare assistants, often in the same hospitals where they are undertaking their clinical placements. This is tiring work, but necessary for many, like this second year student in England who said: “I do full-time placement hours plus additional shifts which on occasion means I work 70 hours a week.

This was echoed by a final year student in Northern Ireland: “I often find my working hours totalling upwards of 60 hours per week in order to stay afloat with bills”

The RCM will be discussing its findings and recommendations with the health and education departments in each of the four nations over the coming weeks and months.

A Welsh Government spokesperson said: “We are once again extending the NHS Bursary for eligible healthcare students studying in the 2024-25 academic year, alongside removing the Reduced Rate of Maintenance Loan for new and existing eligible, full-time, Welsh-domiciled NHS Wales Bursary students. This will enable eligible students to access the full amount of maintenance support should they wish to.

 “We will also hold a future consultation as we recognise that we need to consider if the current financial package remains attractive. This will help us to establish the best and most appropriate way of continuing to support those who choose to study healthcare related programmes in Wales.

 “Despite pressures on our budget, we have maintained investment in education and training for the NHS workforce at £281m this year, and since 2017 midwifery training places have increased by 41.8%.”