Posts Tagged ‘Tuition fees’

You’ve never had it so good (cos you’re rich)

By Katherine Teale - 20th November 2010 5:28 pm

So Lord Young thinks we’ve never had it so good - surely the most crass demonstration of ignorance since Marie-Antoinette (and we all know happened to her).

The truth is that for many, like his lordship, life is great. Provided you can keep your job, have private health insurance, send your kids to private school, never go on a bus, and live in a gated community in Surrey, it’s perfectly possible that you’re rubbing your hands with glee at the thought of more cuts. They only affect ‘other people’. In fact, I think the 18 millionaires on the cabinet should describe to the rest of us how exactly they will be personally affected.

Meanwhile, back in the ‘bloated’ public-sector (funny how those words seem to go naturally together these days) the proportion of millionaires is a little smaller. In fact, out here in the world of ordinary people who don’t have trust funds, there seems to a large number of people who claim the cuts will affect them quite badly.  These individuals are unfortunate (or irresponsible) enough to fall into one of the following categories - they are old, young, ill or  poor.

My own  hospital, which serves some of the most deprived populations in the UK, now has to save around 5% of it’s budget year-on-year. We have already shed over 200 staff. This makes government claims to be ‘ring-fencing’ the NHS budget just a little hard to swallow, because at the same time we know that ministers are sneakily adding many social care responsibilities on to our patch without additional funding.

As theatre director, I look at this with despair - we are already aiming for nearly 90% theatre ‘utilisation’, which means that many theatre lists overrun (human physiology being a little unpredictable) and our staff repeatedly have to stay way past their shift times. Yet we are having to look at ways of increasing efficiency and saving money. We also have a minority of colleagues who seem to be blind to how serious the situation is - perhaps they live in that gated community in Surrey and never watch the news.

I was a little cheered by one of our medical students who told me last week that she had gone to ‘the march’. A group of her friends had gone on a coach together, which, as it involved getting up at 5.30am, showed impressive commitment for a teenager (one university lecturer on the march  remarked that kicking in the window of Millbank Tower was the hardest work his students had done all year, which I thought was a little harsh). My medical student saw no violence, and said that the crowd was full of 15 and 16 year olds worried about cuts affecting higher education in general (removal of grants for over 16s staying on at school, for instance) as well as university fees.

I just hope that I can persuade Chloe to take up anaesthesia as a career - she’s just the sort of colleague we need…

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Medical students join angry tuition fee protests

Healthcare Republic - 11th November 2010 4:29 pm

Hundreds of medical students from across the UK have joined protests against university fees in central London.

The National Union of Students estimates that at least 50,000 students took part in protests in central London on Wednesday over plans to abolish the cap on tuition fees that universities can charge.

Karin Purshouse, chairman of the BMA medical students committee, said there was a large turnout of students from medical schools all around the country, some dressed in scrubs.

“Medicine already has a low intake of people from low-income families and this will only get worse. Medicine should be about peoples’ ability not their ability to pay,” she said.

Read more at Healthcare Republic.

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Juniors face massive debts if tuition fees rise

By Mike Broad - 15th October 2010 1:45 pm

Ministers have been warned that medical students could face debts of potentially £100,000 if tuition fees rise - a financial burden that would discourage many applicants from lower income families.

Proposals to allow universities to charge fees of up to £12,000 are contained in Lord Browne’s report, Securing a Sustainable Future for Higher Education. It also recommends that students should pay higher rates of interest on their student loans and an increase in the income level at which these loans are repaid, from £15,000 to £21,000.

While Vince Cable, business secretary, welcomed the report, he is also trying to contain a Lib Dem revolt on the issue - the Lib Dems made a manifesto commitment to scrap tuition fees.

Cable said: “We are looking at his proposals carefully and considering a contribution level of £7,000.”

The BMA estimates that any further increases in tuition fees could result in a prohibitive level of debt for the next generation of medical students.

Graduates are currently leaving medical school with an estimated £37,000 worth of debt under the present £3,290 annual fee. They also have to rely on around £16,000 worth of support from their families over the course of their degree.

Raising fees would increase debt significantly. If fees are levied at around £10,000 for example, this could leave students studying in the UK living with debt of around £70,000, the BMA predicts. However, these are conservative average levels of debt, based solely on student loan debt and exclude credit card, professional loans and other debts.

There is the potential that some students could incur debts up to and beyond £100,000 if fees are set at £10,000 or above by medical schools.

While Dr Hamish Meldrum, chairman of BMA council, welcomed the proposal to raise the income level at which loans are paid back, he was “deeply disappointed” by proposals that “will lead to crippling levels of debt for future medical students”.

He said: “The five-year medical degree is already an expensive undertaking because of its length, costly course materials and an intensive programme of study that leaves students with little room for taking on part-time work to supplement their fees.

“If tuition fees are increased further then students are looking at incredibly high levels of debt that could reach as much as £100,000. At this level many potential students from low-income families would be discouraged from applying to become the doctors of the future. Already just one in seven successful applicants currently comes from the lowest-income backgrounds.”

The BMA is writing to the business secretary in order to ask him to abandon the most damaging recommendations.

Karin Purshouse, chair of the BMA’s medical students committee, said: “We strongly urge the government to look again at the BMA’s proposal for a forgivable loan system for medical students that would allow student loan debt to be reduced for each year a doctor is employed by the NHS. This would truly open up medicine to people from all backgrounds, as well as increase the likelihood that UK educated students would remain in the UK.”

Read more on the forgivable loan system.

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New plan to improve access to the profession

By Mike Broad - 18th January 2010 4:08 pm

Labour claims a new plan to promote social mobility will, for the first time, open up the medical profession to people from less privileged backgrounds.

In a comprehensive response to Unleashing Aspiration, the final report from the Panel on Fair Access to the Professions, the government has agreed to implement the vast majority of its 88 recommendations.

The government has promised additional support to 130,000 of the “brightest” young people from poorer backgrounds to help them secure a place at college or university.

One of the key proposals is to re-launch a forum which promotes access to the professions. The forum, chaired by minister of higher education David Lammy, will implement recommendations and ask professional organisations to report on progress.

Many of the recommendations involve improving and extending careers advice, professional placements and work experience for school children and students.

Nick Deakin, co-chair of the BMA’s medical student committee, said: “There is a great deal in this announcement which is positive, but ministers have sadly ignored the elephant in the room - tuition fees and student debt.

“A guarantee to look at how to help students from low income families at secondary school level is extremely encouraging. Research has shown that poor career advice and an absence of encouragement in the classroom are key barriers to professions like medicine. Many children in less well off areas discount medicine as a career because they regard it as a goal they can not reach. We will await the detail of these proposals with interest.”

The influential report of former health minister Alan Milburn said that careers such as medicine and law were dominated by people from affluent backgrounds.

A new Social Mobility Commission will provide expert evidence on trends and policy in social mobility and produce an annual report on progress. Professor Sir John Hills, director of the Centre for Analysis of Social Exclusion at the London School of Economics will be the chair.

In a 55-page document on social mobility, the government only mentions tuition fees once. It says it will review ‘the impact of variable tuition fees to consider a radical reshaping of the student support system’.

Deakin commented: “All the good sentiments in this announcement could be washed away if politicians decide to lift the cap on tuition fees. Just one in seven of those at medical school are from the lowest income groups, partly because of the huge debt they incur and the pressure it places on their families. Estimated debt stands at £37,000, while parents have to find £3,000 per year to support their children.

“If we are truly to get talented children enthused about medicine, we must stop pretending that financial barriers don’t exist.”

The Conservatives questioned why Labour has not done more to improve social mobility after 12 years in power.

Read a blog on the issue.

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Encouragement will widen professional access

By Liz Denny, medical student in Liverpool and the BMA's lead on accessibility - 18th December 2009 1:34 pm

There will be many of you who will approach yet another report about equality and widening access to medicine in the same way that I approach the Peter Andre and Katie Price circus.

I don’t understand it, I don’t care about it and frankly I wouldn’t be that fussed if a gigantic foot dropped down on top of it.

I sympathise with this reaction as in recent months we have been deluged with reports, pronouncements and initiatives on this topic, not least from Alan Milburn’s summer report on widening access to the professions. Unfortunately much of this has been wrapped in the overbearing language of political correctness which makes you want to pull your hair out.

But, buried beneath this mountain of political spin lies a couple of serious points. It is true, as the BMA’s new report into the make up of medical school demonstrates, that as a profession we have an appalling track record of recruiting students from low income backgrounds.

Just one in seven medical students comes from this group, despite the government pouring £392 million into widening participation schemes in recent years. The glut of spending has resulted in an increase from the lowest groups of just 1.7% since 2003. Not exactly time for the party hats and the cava.

I imagine though that many of you again would have been left unmoved by this last paragraph, possibly because you suspect that what is coming next is a call for positive discrimination. Certainly our report suggests this view is filtering through to students, with a rising rate of applicants refusing to answer questions about their social status, possibly due to a fear they could end up being penalised if they are judged to be too wealthy.

Well, this isn’t what the BMA or I believe in. Positive discrimination is as unfair as it sounds - there is nothing positive about discriminating against anyone.

What instead needs to happen is for us to remove the barriers holding back low income students. Many of these lie at school level, well before application forms are even filled in.

Pupils from low income areas receive worse grades than their counterparts in more affluent districts and, perhaps linked to this fact, many automatically think a career in medicine isn’t for them. Another issue may lie in the career advice students get, as there is evidence of an inconsistency in the quality of these services.

Certainly, in my own experience, I didn’t feel I got much encouragement to go for medicine despite my grades. There of course other barriers, not least the increasing cost of a medical degree which all politicians appear to have genetic pre-disposition to ignore - despite medical students now facing a £37,000 debt bill after graduation.

To tackle these problems we don’t need phony positive discrimination schemes. We need to look at the school system and how it interacts with medical schools, especially in terms of career advice services. We need no more increases in tuition fees and someone in Whitehall to wake up to the debt problem that threatens to bury the ambitions of thousands of students with the brains but not the wallet to get into medical school. And we also need a proactive set of mentoring schemes - an area the BMA is looking to work on - aimed at raising the sights of children so that they believe a career in medicine is within their reach.

Tackling the under representation of low income students is therefore not a flag to be raised in the cause of political correctness. It is about something more real, more practical and more important - making sure we get the best talent into our hospitals and that everyone gets the chance to fulfil their potential.

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Lower tuition fees would open up profession

By Tim Crocker-Buque, chair of the BMA's medical student committee - 23rd July 2009 5:45 pm

It is a great shame that Alan Milburn decided to attack the medical profession for a mythical brand of elitism in his recent report on social inclusion, rather than showing some courage and tackling the corrosive legacy of tuition fees that his government has bequeathed to students and their parents.

Aspiring doctors face a costly route to qualification. An expensive five to six year course charging £3,140 per year in tuition fees includes a host of hidden financial costs, such as an intensive 48-week term that doesn’t allow much time for paid work and expensive materials and travel costs.

Students are now facing an estimated graduation debt of £37,000, and that is only a projected average, with many students graduating with much more.

The BMA estimates that this pressure is resulting in parents having to provide £3,000 a year in financial support to their children - a clear deterrent to those with the ability, but not the bank balance, to complete a medical degree.

If the review on tuition fees expected later this year recommends lifting the current cap medicine will only be open to those affluent individuals who can afford to pay. Figures suggested have ranged from £5,000 to anything up to £10,000. This would have a devastating effect on the future medical workforce.

It is therefore disappointing - to say the very least - that Alan Milburn’s report has left the subject virtually untouched. His one suggestion to waive fees for students living at home is an empty policy as large numbers of students do not live within travelling distance of the UK’s 32 medical schools.

The medical profession is working hard to increase social inclusion and we endorse plans for better career services and mentoring schemes. But if we are really to tackle this problem, politicians like Milburn must put an end to the rhetoric and lift the crippling financial cost of education that threatens to stifle the ambitions of thousands of talented students.

Suggesting that the projected astronomical debt figures are not a deterrent to those students from lower socio economic groups is very short sighted and with only 11% of medical students coming from the lowest three groups, this is unlikely to improve.

The government needs to recognise the financial barriers to medical education, and seriously consider its policy on tuition fees. There has got to be a more appropriate solution to the higher education funding black-hole, which does not result in the financial devastation of generations of students.

Read Jerry Nelson’s view.

Read the BMA’s view.

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Medicine is becoming more socially exclusive

By Mike Broad - 22nd July 2009 11:18 am

Only young people from the most affluent backgrounds can consider joining the medical profession, a government report into social mobility claims.

Former health minister Alan Milburn, chair of a study on widening access to high-status jobs, said professions - like medicine, law and journalism - have become more, not less, socially exclusive over time.

The wide-ranging study, Fair Access to the Professions, by an independent panel of experts, calls for more equal opportunities in education and employment.

It claims that a typical doctor born in 1970 grew up in a family with an income 63% above that of the average family; today, this now equates to growing up in a family that is richer than five in six of all families in the UK.

One of the study’s key proposals is to recruit university students from a wider range of social backgrounds, with tuition fees being waived for students living at home.

The BMA, however, rejected the idea that this would have a substantial impact - with too few students living close enough to medical schools.

Tim Crocker-Buque, chairman of the BMA’s Medical Student Committee, said: “Ministers have no hope of addressing this poor level of participation without examining the crippling and increasing costs of medical education.

“The Panel has been undermined from its inception by the government’s refusal to allow it to examine fully two of the main barriers blocking wider access to medicine - debt and tuition fees.”

The union estimates that just 4% of medical students currently come from the lowest two socio-economic groups and future generations of doctors face an average graduation debt of £37,000.

Other recommendations of Fair Access to the Professions include: higher education being more widely available in further education colleges; universities becoming more involved in schools, such as by having representatives on boards of governors; professions and universities publishing more details on the social background of their intake; and, better careers advice to raise pupils’ aspirations.

Richard Marks, head of policy of Remedy, said: “This is an unashamedly political report, explicitly motivated by the desire to bring about social change.

“Medicine requires individuals who are natural leaders with self-confidence, drive and ambition, prepared to make significant personal sacrifices to further their studies. Our profession can only thrive if we select doctors showing these personal skills. These traits are developed by their school and family upbringing.”

The study suggests that some professions - like law and politics - are becoming less dominated by people from private school, but others like medicine remain the same.

It does acknowledge, however, that diversity has improved, with one in four of all medical school applications and acceptances in 2007 being from ethnic minority backgrounds. Furthermore, women make up 57% of both applications to, and acceptances by, medical school.

The Prime Minister, who commissioned the report, said he will give the findings serious consideration.

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Tuition fee review threatens to exclude majority

By Mike Broad - 12th June 2009 1:22 pm

Doctors are going to be recruited from increasingly privileged backgrounds in future if the government lifts the current tuition fee cap in its anticipated review on fees and funding later this year.

Student leaders this week called for a thorough review of medical school funding. Many medical students, paying the maximum annual tuition fee of £3,140, already face financial hardship over the five to six year course.

They warned that large parts of society will be excluded from studying medicine because of the cost, with many only being able to do so with significant parental support.

The National Union of Students (NUS) published a new document Funding Our Future: a blueprint for an alternative higher education funding system, which proposes a graduation contribution scheme to replace the current tuition fee system.

Last month, the government announced that an independent review of funding and fees would be launched following the release of a Higher Education Framework in June or July.

Tom Foley, BMA lead on student finance, commented: “The BMA agrees with the NUS that the introduction of tuition fees has been a total disaster for students that will be exacerbated further if the government lifts the current fee cap. 

“Tuition fees have done nothing to solve the chronic problem of higher education underfunding and, worse still, they have saddled many medical students with a mountain of debt.

“Graduation debt from a medical degree is expected to reach £36,000 in the coming years. Just 4% of clinical students come from the lowest two socio-economic groups and all students are now relying on £3,000 of yearly handouts from their parents – a terrible burden on working families at a time of recession.

“We will be consulting our members on the way forward as it is important in these testing economic times that we have a serious debate about how we guarantee that our university system is based on the principles of fair access.”

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