Asked by: Ruth Cadbury (Labour - Brentford and Isleworth)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential impact of changes to the allocation of NHS training places included in the Medical Training (Prioritisation) Bill on UK medical students studying at foreign campuses of UK universities.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Medical Training (Prioritisation) Bill was introduced to Parliament on 13 January 2026. The bill delivers the Government’s commitment in the 10-Year Health Plan for England, published in July 2025, to prioritise United Kingdom medical graduates for foundation training, and to prioritise UK medical graduates and other doctors who have worked in the National Health Service for a significant period for specialty training.
Under the bill, British citizens who have graduated from medical schools outside of the UK will not be prioritised for foundation training places, and a graduate from a medical school in the UK or Ireland will not be prioritised if they spent the majority of their time studying outside the British Islands.
For specialty training places starting in 2026, NHS experience is being represented by immigration status as people with a settled immigration status are more likely to have worked in the NHS for longer. The effect of this is that British citizens and those with certain other immigration status will be prioritised. For specialty training posts starting from 2027 onwards, this provision will not apply automatically. Instead, it will be possible to make regulations to specify additional groups who will be prioritised, where they are likely to have significant experience working as a doctor either in the NHS in England, Scotland, or Wales or in health and social care in Northern Ireland, or by reference to their immigration status.
Asked by: Shivani Raja (Conservative - Leicester East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps his Department is taking following the closure of NHS Commissioning Support Units to (a) support staff affected, and (b) ensure that functions previously delivered by those units continue to be provided safely and effectively.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
As integrated care boards (ICBs) develop their strategic commissioning role and skills, commissioning support functions will be rationalised. This will result in commissioning support units (CSUs) being closed.
Given wider changes in the system, including the larger geographical area of ICBs and the move to a more simplified operating model, for the National Health Service a whole, it is logical to integrate the work undertaken by CSUs into the other organisations that will make up the more streamlined, efficient NHS in future. The closure of CSUs will simplify the landscape and create efficiencies, and will strengthen the strategic commissioning skills in ICBs by giving them the freedom to develop these.
A plan has been developed to ensure all services provided by CSUs and all CSU staff are mapped and destinations clarified, where function will continue, and workshops have been held with NHS England Regions to understand ICB intentions and timelines for the transfer of functions and staff and with the Department and NHS England on functions that may form part of the new Department. Governance arrangements are in place across NHS England and the CSUs to oversee the transition of functions and the safe closure of CSUs.
Staff are being supported through this transition. The CSU Leadership Team hold regular all staff briefings where information on the abolition is cascaded. The CSUs are actively involving the trade unions. A voluntary redundancy scheme has been launched within the CSUs that mirrors that within NHS England. Staff are being actively informed about the scheme through the all-staff briefings.
Asked by: Pippa Heylings (Liberal Democrat - South Cambridgeshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what recent assessment he has made of the effectiveness of the points-based immigration system in the recruitment and retention of UK-trained newly qualified doctors.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
No recent specific assessment has been made of the effectiveness of the points-based immigration system in the recruitment and retention of United Kingdom-trained newly qualified doctors.
However, the number of applications to foundation and speciality training has increased over recent years, both from people graduating from UK medical schools, UK medical graduates, and from graduates of international medical schools, international medical graduates.
For specialty training, the number of international medical graduates applying for places has significantly increased since 2020. Data from the General Medical Council (GMC) shows that the number of non-UK trained doctors applying for Core Training Year One and Specialty Training Year One places has increased from 5,326 in 2019 to 18,857 in 2024, a 254% increase. Over the same period, the number of UK trained applicants increased from 8,836 to 11,319, a 28% increase.
Internationally trained doctors may also be seeking employment outside of medical specialty training posts and GMC data shows that the proportion of doctors taking up or returning to a GMC licence to practice who were trained outside of the UK was 57% in 2019, which has increased to 66% in 2024.
Asked by: Joe Robertson (Conservative - Isle of Wight East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many NICE appraisals were terminated in the five-year period from 2019 to 2024, and how this compares with the preceding five-year period.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The following table shows the number of National Institute for Health and Care Excellence (NICE) appraisals that were terminated between 2019 and 2024, and between 2014 and 2019:
Period | Number of terminated appraisals | Terminated appraisals as a percentage of total appraisals |
2019 to 2024 | 82 | 19% |
2014 to 2019 | 26 | 7% |
Source: NICE.
NICE data shows that terminated appraisals increased in 2019/20 and stabilised with no increasing trend thereafter. This followed NICE’s 2019 commitment to review all new active substances and significant indications. This required industry to submit topics which might otherwise not have been in NICE's work programme. NICE’s data shows that the proportion of terminations has been stable over the last five years, and that terminations reflect that not all products/indications will likely be clinically and cost effective. NICE will continue to monitor terminations with a view to best continuing to support access to clinically and cost-effective medicines for patients in England.
Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will take steps to support educators, supervisors, mentors and trainers in the 10 Year Workforce Plan and work with employers to increase capacity for medical education and training.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
On 8 December, the Government put an offer in writing to the British Medical Association Resident Doctors Committee (BMA RDC) which was rejected. The offer would have increased the number of specialty training posts over the next three years from the 1,000 announced in the 10-Year Health Plan to 4,000, bringing forward 1,000 of these specialty training posts to start in 2026. The BMA have rejected the Government's offer, so that is not going ahead. Our door remains open, and this Government is determined to put an end to these damaging cycles of disruption. On 8 January 2026, my Rt. Hon. Friend, the Secretary of State for Health and Social Care, met with the BMA RDC to kick off a series of talks to resolve the dispute.
The 10 Year Workforce Plan will ensure that the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it. It will include modelling of the potential size and shape of the future workforce and implications for major professions.
We are engaging with partners throughout this process, including universities and higher education institutes. A number of organisations with expertise in higher education were invited to and attended a ministerially led partner event on 5 November. As we continue the open and wide-ranging conversations we’ve been having with staff, patients and organisations across the country, we will ensure that the engagement is robust and representative of different stakeholder groups.
Asked by: Helen Morgan (Liberal Democrat - North Shropshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if the 10 Year Workforce Plan will expand the number of medical specialty training places to meet population demand, beyond the 1,000 proposed in the 10 Year Health Plan.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
On 8 December, the Government put an offer in writing to the British Medical Association Resident Doctors Committee (BMA RDC) which was rejected. The offer would have increased the number of specialty training posts over the next three years from the 1,000 announced in the 10-Year Health Plan to 4,000, bringing forward 1,000 of these specialty training posts to start in 2026. The BMA have rejected the Government's offer, so that is not going ahead. Our door remains open, and this Government is determined to put an end to these damaging cycles of disruption. On 8 January 2026, my Rt. Hon. Friend, the Secretary of State for Health and Social Care, met with the BMA RDC to kick off a series of talks to resolve the dispute.
The 10 Year Workforce Plan will ensure that the National Health Service has the right people in the right places, with the right skills to care for patients, when they need it. It will include modelling of the potential size and shape of the future workforce and implications for major professions.
We are engaging with partners throughout this process, including universities and higher education institutes. A number of organisations with expertise in higher education were invited to and attended a ministerially led partner event on 5 November. As we continue the open and wide-ranging conversations we’ve been having with staff, patients and organisations across the country, we will ensure that the engagement is robust and representative of different stakeholder groups.
Asked by: Sarah Hall (Labour (Co-op) - Warrington South)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will consider an expansion of Paediatric and Perinatal Pathology training posts up to 37 (31.1 WTE) by 2030 to help fill consultant vacancies and help ensure succession planning.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
In the 10-Year Health Plan for England, published in July 2025, we set out that over the next three years we will create 1,000 new specialty training posts with a focus on specialties where there is greatest need. We will set out next steps in due course.
Asked by: Richard Holden (Conservative - Basildon and Billericay)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what guidance NHS England has issued to maternity services on when and how pregnant patients are informed of their BMI, including requirements on explaining associated clinical risks and available support.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The National Institute for Health and Care Excellence provides detailed guidelines for maternity service staff in relation to body mass index (BMI) and managing weight during pregnancy.
This includes the Antenatal Care Guidance which specifies that women should be offered measurement of height and weight, including a calculation of BMI, at their antenatal booking appointment. This should also include an explanation of BMI’s relevance to pregnancy, as well as associated risks and available support. This guidance is available at the following link:
https://www.nice.org.uk/guidance/ng201
In addition, the Overweight and Obesity Management Guidance specifies that for women with a BMI of 40 kilogram per meter squared of height or above, this discussion should include the option of referral to a specialist obesity service or specialist practitioner for tailored advice and support during pregnancy. This guidance is available at the following link:
https://www.nice.org.uk/guidance/ng247
Asked by: Anneliese Dodds (Labour (Co-op) - Oxford East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the adequacy of the National Institute for Health and Care Excellence (NICE)'s current Highly Specialised Technologies Guidance, specifically where it does not recommend a treatment for a rare disease where treatment would have a substantial effect of a medicine on quality and length of life, but is not recommended due to cost-effectiveness estimates being higher than what NICE usually considers an acceptable use of NHS resources for Highly Specialised Technologies.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The National Institute for Health and Care Excellence (NICE) operates a separate Highly Specialised Technologies (HST) programme to evaluate a very small number of medicines and treatments developed for ultra‑rare, severe and life‑limiting conditions. It uses specific methods and a much higher cost‑effectiveness threshold than standard technology appraisals, enabling NICE to recommend treatments at prices that reflect the complexities of ultra‑rare diseases. The HST programme has secured access for National Health Service patients with very rare diseases to effective treatments that NICE would not have been able to recommend through its standard technology appraisal process, with 33 out of the 35 medicines that it has evaluated through the HST programme recommended for NHS use.
There will unfortunately always be occasions when NICE is unable to recommend a treatment through the HST programme despite the use of a much higher cost-effectiveness threshold. These are very difficult decisions to make, and it is right that they are taken independently and on the basis of a thorough assessment of the available evidence.
Asked by: Fabian Hamilton (Labour - Leeds North East)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the report published by Breast Cancer Now, entitled Setting the Bar too High, what assessment his Department has made of the impact of the opportunity cost‑neutrality requirement within NICE’s severity modifier on access to treatments for secondary breast cancer.
Answered by Zubir Ahmed - Parliamentary Under-Secretary (Department of Health and Social Care)
The severity modifier was introduced by the National Institute for Health and Care Excellence (NICE) in January 2022 as part of a number of changes intended to make its methods fairer, faster, and more consistent. The severity modifier was designed on the principle of opportunity cost neutrality to ensure that introducing additional weighting for severe conditions did not increase overall National Health Service spending or displace more care than the previous end-of-life modifier.
NICE has been monitoring how the severity modifier is being applied and found that it has resulted in a greater proportion of medicines recommended than under NICE’s previous methods. The latest figures indicate 87.0% of decisions taken since the severity modifier was implemented have recommended use of the treatment, compared with 82.5% when the end-of-life modifier was being used. For advanced cancer treatments specifically, 84.8% of decisions have been positive since the introduction of the severity modifier, compared to 69.1% under NICE’s previous methods.