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Replace doctor trainee bursaries with loans, think-tank recommends

The Government should make medical students pay for their training via student loans, repayable on the condition that they work in the NHS, a think-tank has recommended.

Civitas said that the ‘severe shortage’ of doctors in England – and especially GPs – means that it is time the Government lifted a cap restricting medical school places at just over 6,000 per year.

It said that to finance this, Health Education England (HEE) should stop paying bursaries, fifth year tuition fees and clinical placement fees, and instead medical students ‘should be required to take out a loan from the Student Loans Company to cover the total cost of their training’.

Civitas suggested that by transferring the ‘upfront cost’ of training doctors to the Department for Business, Innovation and Skills’ balance sheet, the Department of Health could afford to lift the cap on medical school places.

The report said: ‘The eradication of upfront payments by the NHS would mean the current cap on the number of doctors training each year could be lifted and the UK could finally train the number of doctors it needs.

’Importantly, such a training loan would be repaid on behalf of each medic by the NHS through HEE on condition that doctors work for the NHS after graduating. If graduates leave the country to work abroad or transfer from the NHS into the private sector they would become liable for the repayment of these loans.’

Civitas argued that, as it stands, ‘either of these career moves by a newly trained doctor leaves the taxpayers’ huge investment in such medics’ training wasted’, but that its proposal ‘would finally safeguard such an investment’.

It added: ‘This proposal offers a means of training far more of our NHS doctors here in the UK, and thus ending a long-standing reliance on both overseas medics and agency staff to fill vacancies.’

But Dr Krishna Kasaraneni, chair of the GPC’s education, training and workforce subcommittee, said that to ‘financially penalise’ trainees at a time when applications to medical schools have fallen was unwise, and suggested that the Government cannot pressure doctors to work in the NHS.

He said: ‘Last time I checked we were not in a totalitarian state, so I think “utter nonsense” would probably be my position on this.’

The proposal comes as the Government’s plans to lift the cap on nurse training places while removing bursaries has been widely criticised, including by the BMA, which argues that there is ‘a clear link’ between cuts to the NHS Bursary Scheme and reduced applications for medical training.