“It’s a daily struggle”: How nurses grapple with childcare costs

Like many people during the Covid pandemic, Leanne reassessed what kind of job she wanted. She left her career as a solicitor and started retraining as a mental health nurse, driven by her own experience of post-natal depression and her gratitude for the nurse who supported her. 

But Leanne’s resolve has been tested by her bank balance. She and her family have had to live on her husband’s income for three years, as well as paying £10,000 per year in tuition fees. And, on top of that, they’re paying over £1,000 per month on average in childcare costs. 

“It feels like an injustice sometimes,” Leanne, who has two children aged three and six, says of the high childcare costs. The NHS gives an annual £2,000 grant to student nurses who are parents, on top of the standard bursary – but unfortunately £2,000 is a drop in the ocean for childcare costs. And, as a student, Leanne isn’t eligible for some of the childcare subsidies for working parents.

The UK desperately needs to attract and retain nurses. The NHS has been in the headlines all winter, as healthcare workers struggle with overwhelming workloads, staff shortages, and real-terms pay cuts. Thousands of nurses are on strike today and tomorrow in England, after starting walkouts last month for the first time in the Royal College of Nursing’s history.

Leanne, who lives in Warwickshire, knows of mothers in her area who are interested in doing a nursing degree but worry about childcare costs – these costs are an issue for nurses not just during training but after they qualify too. She hears of women who decide to wait until their children are older. 

“Do we want more nurses or not?”

Any issues that affect working women are particularly acute in the NHS – almost 90% of nurses and over 75% of NHS staff overall are women. In recent weeks healthcare workers have pointed out how many of their salaries barely cover the UK’s high childcare costs, sharing tweets such as these:

“The cost and availability of childcare is a really critical issue for staff across the NHS,” says Kate Jarman, co-founder of the FlexNHS campaign, which advocates for flexible working and other work-life balance reforms. “We’ve found that families, [both] single parents and families with dual incomes, all are struggling.”

Jarman says that, within FlexNHS’s network of 20,000 social media followers, women talk about leaving NHS roles because of childcare costs or moving into part-time roles where progression is harder. Childcare issues affect both adults in two-parent families, but it is typically mothers who reduce their working hours or leave altogether as a result.

The NHS has a shortage of over 47,000 nurses, accounting for almost 12% of roles, according to 2022 data. The King’s Fund, a health think-tank, has found that the largest chunks of nurses leaving the profession are aged 25-35 – the age when many people become parents.

“It feels like an injustice sometimes”

Leanne (pictured above) says childcare is a live issue for many of her classmates, most of whom are parents who have come to nursing a bit later in their careers. They all have jobs alongside their full-time course to cover costs. And this will not suddenly ease when they graduate – newly-qualified nurses earn just over £27,000 a year, while experienced nurses have had a 20% pay cut in real terms over the last decade.

“It’s not like I’m going to qualify and suddenly I’m going to be comfortable,” Leanne says. Childcare costs for one child aged under two equate to 70% of a newly-qualified nurse’s weekly wage, according to an analysis last year by Nursing Standard, the Royal College of Nursing’s magazine.

UK families pay some of the highest childcare fees in the world, largely because state funding for the sector is lower than in many developed countries. This stymies working parents in all sectors – 40% of mothers say they work fewer hours than they would like to because of childcare costs, while 43% have considered leaving their job altogether, according to a survey last year by the campaign group Pregnant then Screwed.

This is particularly pressing in a sector that urgently needs staff. “[People say] you have to love nursing to go into it – but there must be other incentives too,” says Isabelle, a student nurse and a mother of three in Greater Manchester. She and her husband, an NHS paramedic, pay around £850 per month just for part-time childcare and patch together the other days with help from relatives.

Calls for childcare reform

Parents, childcare providers, and campaigners have long called on the government to invest more in childcare, in order to lower fees for all families. Jarman says that childcare reform – in terms of fees, flexibility, and the number of places available – is “absolutely vital” in helping to solve the NHS’ staffing crisis. “The NHS is the biggest employer in the country so we’ve got a real interest in trying to make this kind of policy work,” she says.

Both Leanne and Isabelle add that student nurses should be eligible for the same childcare subsidies as working parents, given that their degrees include several work placements in NHS services. Leanne’s placements have involved 11-hour days and taken place during school holidays.

Prime Minister Rishi Sunak has come under fire this month for not announcing any childcare reforms since taking office in October. The opposition Labour party has said it would guarantee childcare for all children aged nine months to 11 years if elected, although its plans are not yet fully costed. 

While politicians scrap in Westminster, parents are left to fend for themselves. Leanne’s car is due for an MOT next month and she’s worried that it will fail – she and her husband have already run down their savings and maxed out their credit cards. Isabelle wants to finish her course and become a nurse, but she wonders if it’s financially possible. “It’s a daily struggle [to make ends meet],” she says. “But I don’t want to quit, I just want to keep going.”

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Work-life balance and flexible working are also a big issue in retaining nurses. We will explore this in an upcoming story.

Photo credits: RCN, Shyamantha Asokan

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