Apprenticeships are not a new way to learn your trade; they can be traced back to the Middle Ages, when the first national system of apprenticeship was introduced in 1563.
By the 1960s, a third of school-leaving boys became apprentices, but there was a decline in numbers from the 1960s to the 1990s, with a clear political shift to university education. Who remembers the famous 1999 policy aim that 50% of young people should go to university?
Many degrees do not hugely increase graduates’ earning power, and with the advent of tuition fees and increasing costs of living, the debt incurred by students can be large. It is no wonder that earning while you learn has become more popular in recent years; until the COVID-19 pandemic, numbers had been growing year on year.
Can every career be accessed via the apprenticeship route, or are there some – such as a career in healthcare – for which university is essential?
If apprenticeships don’t work for everything, then it would make sense that healthcare careers might be one area in which a university degree is still needed. There are a lot of facts to learn – a lack of understanding of which could be dangerous – and set regulations about the exams that must be passed.
The direction of travel for nursing has been away from the apprenticeship model, with the 2009 change to an all-degree profession, and the recent announcement of a possible apprenticeship route to medicine was not greeted with widespread enthusiasm.
So what about an apprenticeship route to being a pharmacist? It was first proposed in April 2019, but work on it was paused a month later, restarted in October that year and paused again in December. We all know what happened next – the pandemic hit, life as we know it was turned upside down and the apprenticeship scheme for pharmacists is still in limbo.
I can see both sides of the argument for this proposal. Going to university is a big financial commitment, which can feel like a massive hurdle, particularly for those from low income backgrounds. If we want to say that we encourage social mobility in the UK, then surely something needs to be done about access to higher education.
Earning while you learn seems an obvious answer to that, but it isn’t the only one. Means tested bursaries are one way forward, although those currently available seem unlikely to touch the sides of the cost of living; anyone who has a child will laugh at the idea of a £2,000 annual allowance for childcare while studying, as in many areas that would barely cover two months of full-time nursery. More innovative ideas might include subsidising housing for students, or even reducing or waiving fees for courses that produce the healthcare professionals this country so badly needs.
The argument against pharmacist apprenticeships comes down to quality and reliability. Will such schemes produce pharmacists who are of equal quality to their university educated colleagues? Could they instead reduce the esteem in which the profession is held? Comments on a recent online article would suggest not, with apprenticeships being compared to a “McJob”, apprentice pharmacists being described as a “laughing stock” and the idea being called a “dumbing down” of the profession. My colleagues in medicine have similar concerns about the apprenticeship route to being a doctor.
It remains to be seen whether this scheme will practically get off the ground. The recovery from COVID-19 is going to take such a long time that maybe no-one will have the headspace for such a massive change to training programmes. If the proposal does go forward, then surely the changes will need to bring the existing workforce along with them to ensure confidence in apprenticed healthcare professionals. At the moment, that would seem like a big hill to be climbed.
Toni Hazell is a GP based in a practice in London