I remember it as if it were yesterday, a report of 2008 stating that ‘More than 25% of student nurses in the UK do not finish the course, at a cost of more than £98m a year’. Some 26.3% due to finish in 2006 left early, according to figures obtained under the Freedom of Information Act for Nursing Standard magazine. Of 25,101 students who started either degrees or diplomas, 6,603 did not finish their programmes’ (1).

My concern about this subject increased after reading a report of 12 March, 2015, by Nicola Merrifield: ‘An “urgent” assessment of the reasons student nurses leave their undergraduate degrees is required to stop NHS education funding from being wasted, according to the chair of a major review of nurse training’. This was referring to the Shape of Caring Review, chaired by lord Willis, which found: ‘the average drop out rate for student nurses at universities in England was more than 20%, but warned some places in fact had up to 50% attrition’ (2). The review suggested that health care assistants should have a portfolio of competencies recorded on a computer data base. (If HCA Maureen can do it, no need for Nurse Maureen).

But, praise the Lord, things are not all what they seem! Responding to a report by chief executive of Healthcare Management Solutions, Tony Stein, that 40% of nursing students drop out in the first year, Lizzie Jelfs points out that: ‘Higher Education Funding Council for England data for nursing shows a 90% continuation rate from year of entry to the following year’ (3).

This, of course, does not contradict the findings of the Willis review; it is to be assumed that a further 10% on nursing students drop out of their course from the second year onwards. Different time scales, different statistics, and, of course, averages mask some very high rates (40%?,50%?) of attrition in some courses. Or should we accentuate the positive, and say 60% and 50% continuation rates?

An important point might be this: it is not nursing, per se, that students leave, it is the low pay, low staffing levels, long, unsocial hours, and ever-hovering threat of litigation that is left. At least, that is what students inform me.

Another important point is a political one, and, at the mention of politics, many nurses bury their head in a Saharan sand dune. This was always the case, with the RCN being seen as almost radical in ‘sitting at the table’ with government to influence their policy. This was the strategy once taken by Tony Benn, who thought that governments could be influenced by campaigns, debates, and petitions, quoting the Suffragette Movement as an example. This era of politics has died, as I once suggested to Mr. Benn, who, seeing the ever increasing power that corporate dogma had over government, tended to agree.

Therein lies the problem. The neoliberal dogma that government serves dictated that nursing was subject to a radical ‘skills-mix’ review. It was decided that cheaper levels of training to nurse will be implemented, whether expanding the role of Senior HCA’s to be the ‘nurse tecnicians’ of Florida, or having a shorter, and cheaper nurse training programme, comprising of SEN qualification in speciality areas of nursing. Some level of degree nursing will be maintained, of course, but nursing will be carried out by a broader, and cheaper, staffing mix.

This is neocon dogma, and dogmatists do not debate. To think that nursing will be immune from such politics is akin to believing that the EU will abandon its free movement of people principle – i.e. free movement of cheap labour.

This tide is coming in. There is no point in the RCN being Canute. The government despise the RCN (and UNITE and UNISON), and have no place at their table for them, except for being beneath it, like some dog waiting to be thrown a scrap. (Taking this analogy further, if the dog does not get its bone, will it bark like an alsation, or whine like a poodle?).

The real question is this: what do the RCN propose to do in a ‘not negotiable’ world?

They will not engage government in a table tennis game of selected statistics. The government have their own selection, which mostly concentrate on cost reduction, a pre-privatisation strategy.

The game is over.

lenin nightingale 2015

(1), 10 April 2008

(2) Nicola Merrifield,, 12 March 2015

(3) Lizzie Jelfs,, 26 May 2015


  1. I myself going to study nursing have found that so many problems are responsible for the drop out rate. It could be from anything such as lack of financial help, victimisation from attending placements (though this could be due to many factors) and even being refused changing you’re branch after first year or finding you hate the branch you have chosen and not being offered any way out but dropping you’re course and applying elsewhere. People have a heavy few weeks and some shocking placements and decide it isn’t for them but more options to switch would encourage a change of heart. Having to pick a branch straight off the bat is pressuring since not all applicants have experience in all groups of people let alone the kind of care you give to these groupings.

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