“Training a doctor costs over £200,000. So in return we will ask all new doctors to work for the NHS for four years, just as army recruits are asked to after their training.”
Jeremy Hunt, 4 October 2016
“It costs £230,000 to train a doctor in England and proposals set out in a consultation launched today (14 March 2017) include plans to obtain a return on this investment.”
Department of Health, 14 March 2017
“It costs the taxpayer £230,000 to train a doctor, over and above fees paid by individuals.”
The Telegraph, 14 March 2017 and YouGov, 18 March 2017
That £230,000 estimate includes repayable student loans, as well as grants to cover tuition fees, living costs and the cost of clinical placements.
It’s not the cost to "the taxpayer". Students have to repay the loans anyway, regardless of whether they work for the NHS.
The estimate comes from the Department of Health. It’s consulting on whether new doctors should have to spend a fixed term working in the NHS. Under the proposals, doctors who don’t might have to pay “a sum of money in addition to their loan repayments” to reflect the cost of training them.
Some outlets have reported the £230,000 figure as the taxpayer’s investment in each doctor. That’s misleading in this context, but it’s easy to see why the mistake may have happened.
Here’s how the figure was quoted in the Department of Health’s press release, which you can read for yourself here:
Jeremy Hunt, the Secretary of State for Health, used a similar figure in a similar context when he outlined the proposal at the Conservative party conference back in October:
You can watch the speech as it was delivered here. We’ve asked the government if Jeremy Hunt was referring to the same estimates.
The government should make it explicit that these costs are not all borne by the taxpayer and that students are already obliged to “pay back” the part that comes in student loans, whether or not they go on to work for the NHS.
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The government ultimately pays less than £230,000 to put a doctor through medical school
The £230,000 estimate can be broken down into approximately:
- £163,000 paid in grants that the government won’t get back. These either go directly to students, to healthcare providers to support clinical placements, or to universities to reflect the higher costs of delivering medical education.
- Another £64,300 comes in student loans. These are similar to loans for other kinds of university courses, covering tuition and living costs.
Graduates have to repay their loans once they earn a certain amount, currently £21,000 for new students. That applies to all university graduates, whether or not they work for the NHS.
The government expects to get back at least 75-80% of tuition fee and maintenance loans across all subjects, as a pessimistic estimate.
Given that, we expect the final cost to “the taxpayer” is closer to £163,000 than £230,000.
Including private funding, the total cost of training a doctor will be higher than £230,000
The Department of Health’s estimate doesn’t include any private funding that supports students through their degree, so it won’t tell you the full cost of training a doctor to both individuals and the government.
Training costs after medical school
Before the government published its estimates in March, the other set we could find came from the the Personal Social Services Research Unit.
Its estimates for the annual cost of training doctors after medical school are published on page 202 of “Unit Costs of Health and Social Care 2016”.