Clinical placement costs cap nursing student numbers


Nursing schools were not all impressed when Victoria announced new scholarships (CMM September 2). This is why

Nursing schools were not all impressed when Victoria announced new scholarships (CMM September 2). This is why

Public and private hospital providers have increasingly introduced fee-paying for undergraduate nursing placements over the last 10 years, initially restricted to private providers but more recently and more widely introduced by state public hospital systems, to cover clinical supervision costs.

The problem is Commonwealth activity-based funding for hospitals through Health Agreements with states is meant to include funding for clinical teaching, training and research in hospitals. And that public funding is meant to cover clinical teaching across all health disciplines – medicine, nursing, allied health. Except that, many hospital placement providers are using ABF income to cover the costs of fee-free clinical training for medical students. This means there’s no public funding left over to cover the supervision costs of nursing and allied health students, which means hospitals have to pass the costs on to universities.

Under the Rudd and Gillard governments, which set up Health Workforce Australia, there was a dedicated Commonwealth funding programme specifically for clinical training for nursing and allied health disciplines, the HWA Clinical Training Funding Programme. It was paid to directly to universities, calculated on their EFTSL enrolments, to use as they determined to fund or subsidise the costs of clinical training.

The Abbott government abolished the HWA, and along with it the CTF, in 2015. Since then, universities have had to cover the entire cost of clinical training for nursing and allied health students, in an environment of increasing fee-setting by providers.
More recently, as a result of the Jobs Ready Graduate (JRG) Package introduced by the Morrison Government, nursing and midwifery and allied health courses saw a reduction in the student contribution to fees without a requisite and commensurate increase in government funding for the CSG portion.

In real terms, this has meant a $1700 reduction per nursing student per year. For a nursing school with 2000 students, that’s almost $3.5m lost.
For universities offering nursing courses, many of them have to artificially limit their nursing intake, dependent on the availability and affordability of clinical training places. Many universities are, or were (before the pandemic nursing workforce crisis), oversubscribed in nursing applications. There’s plenty of demand from qualified, quality prospective students – there just isn’t enough money in nursing and allied health undergraduate education to pay for the clinical placements.

So putting more funding into additional places isn’t going to do much, if there’s not an accompanying investment in public and private hospitals to cover the costs of clinical training.

Danielle Brown is Project Coordinator in Edith Cowan U’s School of Medical and Health Sciences