Commons Chamber

Tuesday 27th January 2026

(began 1 month, 2 weeks ago)

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None Portrait Q2. What steps she is taking to provide regional funding. (907481)
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committed to driving growth everywhere. The Budget ensured that Scottish public services are fairly
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None Portrait Q5. What assessment she has made of the potential merits of providing Government-backed loans for SMEs. (907485)
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recently supported over 4000 businesses and over 65,000 jobs right across the country. >> Jo White.
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None Portrait Q7. If she will make an assessment of the potential impact of trends in the level of living standards on the economy. (907487)
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Luke Murphy.
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None Portrait Q8. What steps she is taking to providing funding for rail infrastructure. (907488)
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Dave Robertson.
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None Portrait Q12. What assessment she has made of the potential implications for her Department's policies of the Final Report of the Covid Counter Fraud Commissioner, published on 9 December 2025. (907492)
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Thank you, Mr. Speaker. This government has recouped £400 million
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Matthew Pennycook Portrait Matthew Pennycook MP, Minister of State (Housing, Communities and Local Government) (Greenwich and Woolwich, Labour)
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Thank you, Mr. Speaker. My department always strives to ensure the House is updated at the earliest possible opportunity. And earliest possible opportunity. And I note and appreciate fully. I note and appreciate fully the points you've made and ensure they are passed on to my ministerial colleagues. With your permission, Mr. Speaker, I'd like to make a statement on the government's draft Commonhold and Leasehold Reform Commonhold and Leasehold Reform bill. We made a clear and unambiguous commitment in our manifesto to act where previous governments had failed, and finally bring the feudal leasehold system to an end.

We did so on the basis of a firm conviction that it is only by extinguishing fully the historical iniquities on which the present leasehold system rests, that we can ensure that the dream of home ownership is made real for millions of households across the country. Today, the government has published and laid the Commonhold and Leasehold Reform Bill in draft for pre-legislative scrutiny by the housing, Communities and Local Government Select Committee. This ambitious piece of legislation will modernise property law, deliver a fair and efficient modern housing market and, most importantly, Mr Speaker transform the experience of home ownership for millions of leaseholders across the country.

The draft bill includes the following key provisions A new legal framework for Commonhold to reform and reinvigorate this radical improvement on leasehold ownership. A statutory restriction on new leasehold flats to ensure that in future commonhold is the default tenure. A new process for converting to commonhold from leasehold to make conversion easier so more homeowners can enjoy this improved form of ownership. The abolition of leasehold forfeiture and its replacement with a fairer system of lease enforcement. The repeal of draconian powers relating to rent charges on freehold estates, and the capping of ground rent for older leases at £250 per year, changing to a peppercorn after 40 years.

Let me expand briefly, Mr. Speaker, on each of these core measures, beginning with Commonhold. As you know, Mr. Speaker, Commonhold is a modern home ownership structure that is widely used around the world. It is not merely an alternative leasehold ownership, but a radical improvement on it. At the heart of the Commonhold model is a simple principle the people who should own buildings and who should exercise control over their management, shared facilities and related costs, and not third party landlords, but the people who live in the flats within them and who have a direct stake in their upkeep.

Commonhold ensures that the interests of homeowners are preserved in perpetuity. It transfers decision making to them so that homeowners have a greater say over how their home is managed and the bills they pay, as well as the flexibility to respond to the changing needs of their building and its residents. Mr. speaker, for a variety of reasons, Commonhold failed to establish itself following its introduction in 2004. As a result, there are fewer than 20 commonhold developments in existence today, and the 2002 legal framework is hopelessly outdated.

The provisions in the draft bill build on the publication of our Commonhold White Paper in March last year, which confirmed the detail of our Commonhold reform programme and responded to the Law Commission's thorough and expert review of Commonhold law. The result is legislation that will reinvigorate Commonhold through the introduction of a comprehensive new legal framework that will enable Commonhold to be used in the widest possible range of settings to ensure Commonhold becomes the default tenure. As our manifesto promised. The draft bill also includes provisions to ban the use of leasehold for new flats.

Once enacted, this will ensure that, other than in exceptional circumstances, all flats are provided as commonhold. These provisions will work in tandem with the ban on the use of leasehold for new houses contained in the Leasehold and Freehold Reform Act 2024, alongside the publication of the draft bill. Today we're publishing a moving to Commonhold consultation, seeking input from industry and consumers on precisely how we implement the new ban. The feedback received will ensure we can proceed with a smooth transition to commonhold for new developments, while at the same time protecting the supply of new homes and determining whether there is a case for any justified exemptions.

The draft bill also includes measures Mr Speaker to make it easier for existing leaseholders to convert their buildings to commonhold. The existing law already sets out a process for conversion, but it is one that requires consent from everyone with an interest in the block. This sets an unacceptably high bar and means that commonhold is not achievable if even a single unit, owner, lender, or the existing freeholder objects. The draft bill will introduce a new process for conversion, one which brings conversion into line with wider enfranchisement processes and will make conversion possible if at least 50% of qualifying leaseholders agree.

Mr. speaker, while the previous Government's Leasehold and Freehold Reform Act does provide leaseholders with important rights and protections on these benches, we have always maintained that it was a distinctly unambitious piece of legislation that left untouched serious problems, including the disproportionate and draconian threat of forfeiture as a means of ensuring compliance with a lease agreement. For too long, outdated forfeiture laws have allowed landlords to threaten people with losing their home and hard earned equity over small debts of as little as £350, or any amount if left unpaid for three years.

The draft bill contains provisions to abolish forfeiture and replace it with a modern, proportionate lease enforcement system that addresses breaches fairly, with appropriate safeguards and judicial oversight. Mr. speaker, you will know that before Christmas, we launched two comprehensive consultation seeking views on how best to implement new consumer protections for homeowners on freehold estates and the ways in which we might reduce the prevalence of privately managed estates over the coming years. To further enhance protections for homeowners on freehold estates. The draft bill will also repeal enforcement powers that apply to estate rent charges on them.

These powers, often difficult to find in deeds and poorly understood by buyers, can lead to rent charge owners taking possession of or granting a lease over a freehold home as a result of small sums outstanding. That is not just unfair, it creates real barriers to home ownership and property sales. We will remove these wholly disproportionate and outdated remedies for enforcing rent charges by repealing sections 121 and 122 of the Law of Property Act, 1925, including estate rent charges. Mr. speaker, the government is acutely aware that the cost of living remains a pressing concern for leaseholders across England and Wales, and that those who subject remain unfair and unreasonable practices need urgent relief.

That is why, last summer we consulted jointly with the Welsh Government on strengthening leasehold protections over charges and services. That consultation included proposals to reform the section 20 major works procedure, increased transparency over service charges and enhanced access to redress through the relevant provisions in the act. We thank all those who responded to the consultation and will set out details of how we intend to implement the measures in question as soon as possible. However, the government is determined to go further to alleviate the cost of living pressures facing leaseholders.

In our manifesto, we promised to tackle unregulated and unaffordable ground rent charges. The draft bill honours that commitment. As the House will know, historically, ground rents, which often entail no service being provided whatsoever, were of low or nominal value. However, over the past two decades, a practice has developed. A freeholders, including high and escalating ground rent clauses in leases. Such clauses are causing leaseholders considerable financial strain, and some are unable to sell or remortgage their properties as a result. The draft bill will cap ground rents at £250 per year, initially changing to a peppercorn after 40 years.

This will provide immediate financial relief for leaseholders with high and harmful ground rents, while the longer term change to a peppercorn cap will eliminate the two tier market between new and older leases, delivering a fair and efficient modern housing market. These reforms will necessarily have effects on existing contractual arrangements and investments, something which this government does not undertake lightly, Mr. Speaker. However, the government has a clear mandate to tackle unregulated and unaffordable ground rent charges, and our approach has been designed to strike a fair balance between the interests of leaseholders, freeholders and investors, maintaining the reputation of the UK as a safe place to invest.

Finally, Mr. Speaker, as I've made clear to the House on previous occasions, the last Government's Leasehold and Freehold Reform Act contains a number of specific but serious flaws that prevent certain provisions from operating as intended and that need to be rectified via primary legislation. While not included in the draft bill, our intention is to rectify those flaws in primary legislation. Among other things, this will allow us to commence the 2024 Act's enfranchisement provisions, making it cheaper and easier for leaseholders to extend their lease or buy their freehold.

Mr. speaker, to conclude, the publication of the draft bill, today is a historic moment. It marks the beginning of the end for the feudal leasehold system that has tainted the dream of home ownership for so many. I look forward to working closely with the Select Committee as they perform their invaluable role in scrutinising carefully this draft legislation, and I encourage hon. Members from across the House to engage with it and the accompanying consultation on banning new leasehold flats. Mr. speaker, I today.
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Gareth Bacon Portrait Gareth Bacon MP (Orpington, Conservative)
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Shadow Minister Gareth Bacon. Minister for his remarks and for advanced sight of his statement. Progress on leasehold reform is to be welcomed. Labour promised this when they stood for election 18 when they stood for election 18 months ago, so it is about time they got on with it. As the previous conservative government previous conservative government had started to. Mr Speaker, the previous conservative government began the process of fundamental reforms to the existing system of leaseholds by making it easier to extend a lease or to buy freehold, increasing the standard lease extension term to 990 years and giving leaseholders greater transparency over their service charges.

His Majesty's Opposition remain committed to giving leaseholders a fair deal what householders to have security for the future, and will continue to hold the government to account on this. Now the government made big promises at the last election to leaseholders. Do they believe that this bill is the summit of their ambitions? And what about the 2024 Leasehold and Freehold Reform Act? What are their plans to implement secondary legislation? There are opportunities to improve leaseholders situations that are available to the government now.

Why have they not implemented these changes? Surely if they were serious about reform for leaseholders, they would have picked up the 2024 act and run with it rather than doing nothing until now? The Minister has just said, and I quote, I have made clear to the House on previous occasions, the last Government's Leasehold and Freehold Reform Act contains a small number of specific but serious flaws that prevent certain provisions from operating as intended and that need to be rectified via primary legislation.

He then goes on, Mr. Speaker, while not included in the draft bill, our intention is to rectify these flaws in primary legislation. Perhaps the Minister could tell us what these flaws are, and if the government have already identified them, why are the corrections not included in the forthcoming bill? Surely now would be the time to rectify them. So if not now, when? And I would be remiss not to comment on one of the central principles of housing reform that actually needs to be some housing in order to reform it.

The Labour mayor of London is delivering the lowest house building in London since 2009, while Labour's national housing delivery is nowhere near where it needs to be to meet their 1.5 million homes target. What are they doing to ensure that there are strong incentives to build more? Where is the second planning bill that they have briefed out to the media that they will need to introduce because of their failure to get the planning reform right? First time? Mr. speaker, the Conservative Party is pro-development, which is why we have announced both the plans to review the London plan to improve on Labour's failings in London and to ensure national development is done on a brownfield first approach.

Now it is true. It is true, Mr. Speaker, that ground rent is an additional cost to leaseholders. But it is reported that the Chancellor of the Exchequer is against capping ground rents because she believes it will deter pension fund investors. What does the Minister have to say to that? Mr. speaker, Mr. Speaker, Mr. Speaker, the government are claiming that this will reduce people's bills and of course, that would be welcome. But if leaseholder ground rent bills are simply replaced by soaring council tax bills, with some local councils now facing more than 30% rises in council tax due to the government's grossly unfair funding review, how will people be better off in inner London, which has a high proportion of leasehold flats and councils there, such as Wandsworth, Westminster and Kensington and Chelsea, are facing the double whammy of staggering rises in council tax and council tax surcharge on top.

Are the government, in fact claiming to cut one cost on the one hand, but knowingly replacing it with even more costs on the other? Mr. speaker, I would be grateful if the Minister could answer these points in his reply. We will scrutinise the government's forthcoming Commonhold and Leasehold Reform Bill, and we will hold them to account on their promises on leasehold reform and housing. We look forward to studying the details and to the debates that will follow.
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Matthew Pennycook Portrait Matthew Pennycook MP, Minister of State (Housing, Communities and Local Government) (Greenwich and Woolwich, Labour)
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Minister. positive tone from the Shadow Minister in welcoming the bill, and I'm slightly reluctant Mr Speaker I'm slightly reluctant Mr Speaker on what is usually a matter of cross-party consensus to be too critical of the shadow Minister. critical of the shadow Minister. But it is a little bit rich to criticise this government, given that the previous government cherry picked reform in a way that was at odds with the Law Commission's recommendations to treat all three of their reports as a holistic package, and has left us with an act that, as I said, Mr.

Speaker, we have to make a series of changes through primary legislation to fix just so that we can implement the provisions that remain. So I won't take any strictures from the hon. Gentleman on ambition when it comes to leasehold reform on the 2024 act. I say very plainly to the shadow Minister. We switched on a number of the Act's provisions already immediately on coming to office, we enacted a series of provisions on rent charge arrears, on building safety, legal costs, on the work of professional insolvency practitioners.

On the 31st of October, we enacted further building safety measures. On the 31st of January, we switched on the two year qualifying exemptions for leaseholders. In March, we switched on the right to manage provisions, and we are working at pace to take forward the rest of that. Very significant package of secondary legislation was required, although some parts of those provisions, Mr. Speaker, do require us to make those fixes to the bill that sadly, the previous government left us with. The hon. Gentleman mentioned housing supply.

Again, I'm loathe to take lessons from a party which torpedoed housing supply in the last Parliament, Mr. speaker, by making a series of anti supply changes to the NPF, including the abolition of mandatory housing targets and the hon. Gentleman's criticism could be taken a little bit more seriously if his colleagues did not, week in, week out, come to me objecting to housing applications and telling me how our reforms will make it more permissive in their local constituencies. We're getting on, Mr.

Speaker. We're taking forward the reforms to the leasehold system that are already on the statute book. We're bringing forward through this bill the wider reforms necessary to bring that system to an end. And it will be to the lasting benefit of millions of leaseholders across the country.
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Florence Eshalomi Portrait Florence Eshalomi MP (Vauxhall and Camberwell Green, Labour )
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Justice Select Committee Florence Eshalomi. Florence Eshalomi. >> Thank you, Mr. Speaker. May I start by paying tribute to Minister for his hard work on getting us to for his hard work on getting us to this stage? I think there were a few occasions, Mr. Speaker, where the Minister saw me and he went the the Minister saw me and he went the other way because he knew what I was going to ask him, and we wouldn't be here without his his tireless work.

I also want to highlight what the Minister said in terms of this being a cross-party issue and paying a tribute to the former member for Worthing West, Sir Peter Bottomley, for his work in chairing the APPG leasehold for far too long. Many leaseholders up and down the country have been caught up in this medieval system, leaving them with soaring rents and unreasonable fees. People who bought their homes in good faith, seeing that nightmare now transpiring. And it's right that the government finally bringing a change that will help millions of people up and down the country.

The Ministers agreed to support our inquiry with the necessary evidence. Can the Minister confirm that he will support us by providing the government's response to the 2023 ground rent consultation in the coming days, so that we can get a better understanding on how this underpins the government's decision to cap ground rents at £250. Mr. speaker, there are some things that we were expecting to see in this draft bill. Yes, I have read it, which includes the Law Commission's recommendations on enfranchisement and the right to manage for many people.

Lordships recommendations on this on managing agents. Lord has called for a regulator for teeth with proper enforcement. Can the Minister clarify what work the government is doing to ensure that this will be in the final version of the bill, or where, if there will be addressed elsewhere? The Minister also outlined the rough timeline for implementation. Could we get more clarity on when we expect to see this, so that those leaseholders up and down the country, who've been waiting for a long time, will finally get the help that they desperately need?
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Matthew Pennycook Portrait Matthew Pennycook MP, Minister of State (Housing, Communities and Local Government) (Greenwich and Woolwich, Labour)
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Minister. the chair of the Select Committee, for those fair and pertinent questions. Let me answer them each questions. Let me answer them each in turn. Mr. speaker, we published a whole series of documents at 7 a.m. this morning, including the copy of the draft bill, but that also included a policy document setting out our rationale for the £250 per year ground rent cap. But we will, of course, make available other information, evidence and documentation to the Select Committee as needed and at the earliest possible opportunity when it comes to implementing other Law Commission recommendations made in their three reports.

Mr. speaker, the Leasehold and Freehold Reform Act 2024 implemented a significant number of the Law Commission's enfranchisement recommendations, a very small number of its right to manage recommendations and none of its commonhold. We can't do everything in this bill. Hon. Members who have had a chance to look, we've already seen it. It's a very large number of clauses already, but we are committed to enacting those remaining recommendations relating to leasehold enfranchisement and other recommendations over the course of the parliament. In terms of implementation, Mr.

Speaker, different provisions will come into effect at different points in time. For example, the rent charge provisions I've described in my statement. We aim to switch those on quite soon after Royal assent. Other measures will require secondary legislation. The ground rent cap, we expect to be in place in 2028, but we will work with the select committee. As I said, Mr. Speaker, to ensure that they can do the fullest robust job possible when it comes to giving this bill the enhanced scrutiny it deserves.
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Gideon Amos Portrait Gideon Amos MP (Taunton and Wellington, Liberal Democrat)
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Good day. Most Liberal Democrat spokesperson. spokesperson. >> Thank you, Mr. Speaker. Liberal Democrats welcome the introduction Democrats welcome the introduction of Commonhold framework, abolition of leasehold for new build flats, the end of forfeiture. All these the end of forfeiture. All these are positive steps in the right direction. Our manifesto has been calling for an end to unfair residential leaseholds since Lloyd George called for it, called it blackmail in his 1909 People's Budget. But while I welcome those those measures, we should be going much further.

The Secretary of State himself this morning called ground rents money for nothing and a scam. So why should leaseholders continue to pay £250 for nothing? The government's proposals need to go further for free builders trapped in the leasehold of unscrupulous property management companies. The blackmail of the Great property rip off is set to continue. There is nothing that will cap those charges in these proposals and since residential leaseholders will still be with us for some time, millions of leaseholders need better protection from landlords, costs being passed on to them.

They need capping of excessive service charges, like £400 to change a light bulb and £4,000 to mow the grass. And and help is needed for those trapped in unsafe and defective buildings. Hundreds of thousands who are excluded from the building safety regime. Will the Secretary of State therefore take forward? Will the Minister take forward the Liberal Democrat proposals and immediately abolish residential leasehold charges? Set ground rents at a peppercorn now and regulate property and estate management companies, as recommended in the report, and cap unreasonable service and estate management charges?
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Matthew Pennycook Portrait Matthew Pennycook MP, Minister of State (Housing, Communities and Local Government) (Greenwich and Woolwich, Labour)
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Yes, Minister. Democrat spokesman for those questions. I also share his passion. He often mentions Lloyd George. I share his passion for Lloyd share his passion for Lloyd George's radicalism on property law and other measures. Let me address let me address the specific points let me address the specific points he raises. Mr. speaker, during the passage of the Leasehold and Freehold Reform Act in 2023, I think it was I was clear that my instinctive preference when it comes to ground rents was for a peppercorn cap, fully eliminating ground rents.

And the changes we are making ensure that after 40 years that change occurs. But having considered all the analysis and advice available to me as a Minister, including the evidence gathered in response to the previous administrations 2023 consultation, I believe the policy we have set out is the right one. It is a clear that an immediate peppercorn cap would carry significant risks, including some which might impact upon leaseholders. And the government also recognises there is a significant difference between regulating the creation of new leases and intervening to affect existing contracts and investments on the functioning of the Cap itself.

Mr. speaker, I just want to make clear this is a maximum cash cap. If your lease is below £250 and doesn't include escalating clauses, your ground rents will not rise to 250. If your ground rents over £250. You will see at the point that these measures are brought into force, an immediate reduction that, as I say, will benefit millions of leaseholders across the country. It's a huge cost of living intervention and I hope the House can come behind it as the most just and proportionate way of addressing unregulated and unaffordable ground rent terms on service charges.

Lastly, Mr. Speaker, the hon. Gentleman will know we ran a consultation last year on how we can standardise service charges, how we can increase transparency around service charges to ensure that leaseholders can better challenge the reasonableness of service charges at tribunal. But we don't intend to bring forward a cap, not least because doing so could actually harm leaseholders, particularly those in enfranchised buildings, who might need to raise

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sums beyond the cap to to carry out essential maintenance works on their buildings. Angela Rayner the speaker.

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Angela Rayner the speaker. And can I start by thanking my hon. Friend for this extremely welcome statement? Because I know personally, firsthand how much he's put into this. However, we know, put into this. However, we know, Mr. Speaker, that vested interests have repeatedly resorted to law
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Dan Tomlinson Portrait Dan Tomlinson MP, The Exchequer Secretary (Chipping Barnet, Labour)
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Britain's high streets. We know how central they are to the strength and vibrancy of our villages, our and vibrancy of our villages, our towns and our cities. We know how hard small business owners work, hard small business owners work, and we know how badly they were let down by the previous government. down by the previous government. Shops shuttered, council funding cut, business rates left totally cut, business rates left totally unreformed. We will not let decline continue, and we are already taking steps to arrest it.

We are protecting high street businesses from upward only rent review clauses and introducing a strong new community right to buy to help communities safeguard valued community assets such as pubs and shops on their high streets. We are pushing ahead with high street rental auctions, which are helping bring long term empty shops back into use, where premises have been vacant for too long. Councils can auction the right to rent them, offering 1 to 5 year leases to new businesses and community groups, helping to create more vibrant high streets.

We also launched the Winter of action to combat retail Crime, a nationwide crackdown on crime and anti-social behaviour to protect shoppers and retail workers. As well as this, we are investing in local communities through the 5 Billion Pride in Place programme announced last September, and investing to support growth, including through new the new Local Growth Fund. Around 1 in 3 businesses also continue to benefit from small business rates relief. Madam Deputy Speaker and don't pay any business rates at all, while 85,000 benefit from from reduced business rates as this relief tapers at the Budget, we also extended the small business rates relief second property grace period for another two years, which is a really important change, meaning that properties meaning that businesses expanding into a second property will retain the support as they grow.

But we know that there is more to do. And before I turn to today's announcements, Madam Deputy Speaker, I want to run through the three main components of the changes to business rates that are taking place in April for all businesses, and to explain the steps that the government took at the Budget last year on business rates. First, the underlying and significant reforms to the system that the Chancellor set out as part of our commitment to transform business rates in England over this Parliament, we have implemented permanently lower multipliers for eligible retail, hospitality and leisure properties, with the multiplier falling by around 12 or 25% on the 1st of April.

Some of this is as a result of the overall reduction in multipliers between revaluation periods, but the further £0.05 reduction announced by the Chancellor is on its own, worth nearly £1 billion for the 750,000 retail, hospitality and leisure businesses that are the lifeblood of our high streets here. Here we are paying for this support for the high street through higher rates on the top 1% of most expensive properties. This includes many large distribution warehouses, such as those used by online retail giants.

Let's be crystal clear. Before our reforms, a mid-sized high street business faced the same multiplier, or tax rate as a warehouse used by an online giant. That was the system that we were left with. Now they will pay the mid-sized high street business around £0.38 in the pound, and the large warehouse will pay around £0.51 in the pound. That's 33% more. And this is a sizeable reform and it is here for good. The second component of business rates announced at the Budget was the revaluation.

All non-domestic properties are revalued independently every three years. For business rates purposes. New valuations will come into effect in April and I want to take the opportunity, Madam Deputy Speaker, to thank the independent valuers in the Valuation Office Agency who carry out the work. The government didn't take the easy approach of kicking the post-Covid revaluation into the long grass. Instead, we introduced a significant transitional support package because we knew that some sectors were seeing large increases in their rateable values after the pandemic.

We are capping bill increases in each of the next three years. For those seeing the largest rises and spending a total of £4.3 billion on this and other interventions. I want to say something specific here, Madam Deputy Speaker, about hotels. The government recognises that their rateable values have increased significantly since the pandemic, which means the caps on increases that we have implemented are particularly important for them. But it is right that we look at this further and we will therefore review the way that hotels are valued to ensure that it accurately, accurately reflects the market for this sector.

The third important point of context, Mr. Speaker, is the tapering away of the temporary pandemic relief for high street businesses. The previous government went into the election with plans to withdraw this relief overnight in 2025. That would have been a harsh and sharp removal of support. It would have pushed up bills for independent high street businesses overnight by 300%. That is reckless and it is irresponsible. Instead, we have taken a different approach. We extended the retail, hospitality and leisure relief this year at 40% and we are unwinding it over the coming years.

The jumping off point for any business currently receiving a 40% discount is their current bill, not their bill. Without relief. The Budget decisions then led to the following outcomes. First, over half of ratepayers will see their bills either flat or falling next year. That's over half second for properties that do see their bills increase from the 1st of April, most will see their increases capped at 15% or less, or £800 for the smallest third. Bills will adjust the new valuations, but our caps mean that this will happen gradually and high street businesses will benefit from permanently reduced multipliers for the long term.

This is a fair and a reasonable approach and is set out at the Budget. In total, we are spending over £4 billion in the next three years to limit the scale of bill increases for those who are either losing reliefs or seeing their rateable values increase in the coming financial year. Because of our interventions, the business rate system is raising the same amount of revenue as it was forecast to before the Budget in the spring of 2025, not billions and billions more as opposition MPs seek to claim more or less the same.

Madam Deputy Speaker, that is the shape of the policy that we set out at Budget. And because business rates is rather complicated, I hope you'll forgive me that I did want to set that out in full. However, this government does want to go further to support pubs. Pubs are the cornerstone of so many communities. They are essential to the social and cultural life of so many places across the country. And I've heard clearly from members on the government benches just how important they are.

I want to thank colleagues who have engaged constructively and privately with me on this issue in recent weeks, whether they represent constituencies in coastal or rural communities, towns or cities, their representations have been invaluable and their constituents should know that most of the politics they see in the papers isn't what matters. It's the conversations and the advocacy MPs provide in these corridors that can make the difference. In particular, the Member for Bournemouth East has been a relentless advocate for businesses in his constituency, as has the Member for the Isle of Wight West and the Member for Redditch.

And in her role as the chair of the APPG for pubs. Let me thank the Member for Warrington North for her engagement to on this matter. Mr. speaker, Madam Deputy Speaker, forgive me, pubs haven't had the support they needed for too long under the Conservatives. Members opposite claim to care about pubs, but where were they when the number of pubs fell by 7000? Between 2010 and 2024 they were in government. They let the number of pubs in our communities fall by a fifth.

The Conservatives also allowed the revaluation to go ahead with a business rates methodology for pubs that no longer has the support of the sector. Before the Budget, every pub sector body was broadly signed up to the methodology used for valuing pubs, and had lent its support to the principles set out in the Valuation Officer's Guide. But since the Budget, these same sector bodies have withdrawn their support. The government acknowledges their concerns and will therefore be carrying out a review of the pub valuation methodology, which will report in time to be implemented at the next revaluation.

While this review is ongoing and given, given the particular challenges that pubs have faced over the long term under the previous government, we are stepping in to provide support for pubs in the next three years. Today I can confirm that from April, every pub in England will get 15% off its new business rates bill, on top of the support announced at Budget pubs. Bills will then be frozen in real terms for a further two years. This support is worth £1,650 for the average pub just next year, and will mean that around three quarters of pubs will see their bills either fall or stay the same next year.

Then bills will be frozen in real terms for the next two years. This decision will mean

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order. To very gently say to the Minister, it was always open to him Minister, it was always open to him to ask for extra time, and we can't find any record of him having done so. He's got ten minutes already and there seem to be three more pages. So I am going to allow the opposition spokespersons more time as well, because this is an important statement that I think he wants to finish, but it's very unfair to exceed the time by what I reckon will be 50%.



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Minister last orders. Madam Deputy Speaker, let me

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Madam Deputy Speaker, let me apologise profusely for not letting you know in advance. This is the first time I've done one of these statements, and I will not make the same mistake again. And I'm glad that the same courtesy will be afforded to the Shadow Chancellor. I look forward to hearing his full 15 or so minutes of remarks. I'm sure they will be entertaining for sure they will be entertaining for all of us. I, I, I, I will make progress now, Madam Deputy Speaker, we can hear more from the Shadow Chancellor.

This decision will mean that the amount of business rates paid by the pub sector as a whole will be lower in 20 2829 than it is today. This week is also Independent venue week, so it is particularly appropriate that I can announce also that our package will apply to music venues, to many, live music venues are valued as pubs and many pubs are grassroots live music venues. It would not be right to seek to draw the line so tightly, so as to include some and not others.

I want to thank MPs who have made constructive representations on this issue in recent weeks. In the meantime, we are pressing ahead with wider regulatory reforms, building on the new licensing policy framework. At Budget, we are working with the sector to ensure that local authorities are using this to ease licensing decisions on the ground as part of our ongoing licensing reforms, I can also announce today that pubs and other licensed venues will be able to open until 1 a.m. or 2 a.m.

depending on when the game starts. For home games in the later stages of the Men's Football World Cup this summer, and we will legislate to increase the number of temporary events notices for pubs and other hospitality venues, whether that is to help them scream World Cup games or other community and cultural events. This government is committed to helping pubs build sustainable business models over the long term. In the spring, the government will consult on further loosening planning rules to benefit pubs, helping them add new guest rooms or expand their main room without planning applications.

We will also continue to engage with the sector to ensure other retail, leisure and hospitality premises have sufficient planning flexibility.
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Mel Stride Portrait Rt Hon Sir Mel Stride MP (Central Devon, Conservative)
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So Chancellor of the Exchequer Mel Stride. the mood of the House is that ten minutes is more than enough for the hon. Gentleman, although I should say that I am grateful to him for

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having given me advance sight of his statement. Could I say you have got some

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Could I say you have got some extra time if you do need it? And the same with the Liberal Democrat spokesperson.

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Speaker, that is much appreciated, Mr. speaker, is that it? After all this time, after it? After all this time, after weeks of telling our local pubs that help was on the way, this is that help was on the way, this is all they get a temporary sticking plaster that will only delay the pain for a few. While thousands of businesses despair as their bills sky rocket. The Labour Party's manifesto Mr Speaker promise to completely replace the business rates system.

They said they would create a system which levels the playing field for our high streets and supports entrepreneurship and investment. Well, we are waiting, Mr. Speaker, because so far what we have seen is the exact opposite of what our local businesses were promised. Business rates soaring across the board pubs, which, despite the temporary relief announced today, will still end up in time with bills over 70% higher than they are today. The Federation of Small Businesses have calculated that for a typical medium shop or restaurant with a rateable value of around £50,000, their business rates will increase by 71% over the coming years.

Hotels. Mr. speaker, it is over 100%. Our Ministers expect them to be grateful for some temporary relief, tweaks to multipliers and changes to licensing. Mr. speaker, we on this side of the House have been clear. Support must be permanent. We have to cut business rates for our high streets to give certainty to local businesses, and it must be far wider than what the government has announced today. Not just pubs, but the whole of the retail, hospitality and leisure sectors which bring life to our high streets and town centres.

We on this side of the house would introduce not just temporary reductions in rates, but completely abolish business rates for thousands of pubs, shops and

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restaurants across our country. That's exactly. What's needed. These huge tax

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What's needed. These huge tax rises we are seeing from this government are a choice, Mr. Speaker. It does not have to be Speaker. It does not have to be this way. The government have chosen to increase spending by vast chosen to increase spending by vast amounts, including on the benefits bill, a benefits giveaway of over £3 bill, a benefits giveaway of over £3 billion at the Budget to abolish the two child cap. These choices are why bills are going up, why businesses are going under, why jobs are being lost, and why our high streets are being hollowed out.

And let's not forget, Mr. Speaker, that this is not an isolated issue. Businesses are having to shoulder not just business rate rises, but a long list of other burdens being piled on by a government who simply do not understand how businesses work. Many of those facing the highest increases in their business rates were among the worst impacted by the Chancellor's jobs tax. They have already seen their business rates go up by as much as 140% last year, and they also face yet more costs from red tape from the government's employment rights legislation.

Indeed, analysis by UK hospitality suggests that on average, as many as six hospitality venues could close every single day this year. That is a tragedy for our high streets and our communities, and it is also a tragedy, Mr. Speaker, for our young people, many of whom look for their first job in the local pub or the coffee shop, and who will find those jobs simply do not exist anymore. So can I ask the Minister, where is the help for the wider retail, hospitality and leisure sectors? Does what has been announced today include gastropubs pubs with hotel rooms, bars, nightclubs and private clubs? Why is the government happy to stand by and watch while businesses close and jobs are lost? When will the guidance be published for businesses so that they know whether they will be eligible for this further relief and what their bills will be over the coming year? Why did Ministers not come forward with this relief for pubs at the time of the Budget, when they knew the level of increases many businesses were facing? There is no new information, Mr.

Speaker, that has been provided between the time of the Budget and this statement this afternoon. And can he confirm that because this relief was not accounted for at the Budget, today's announcement will need to be paid for through yet more borrowing? Mr. speaker, the government has proved today that either they do not understand the damage they are doing or they do not care. Today's announcement is far too little, far too late.
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Dan Tomlinson Portrait Dan Tomlinson MP, The Exchequer Secretary (Chipping Barnet, Labour)
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Minister. >> It is just not credible at all. Mr. speaker, to hear the opposition, Mr. speaker, to hear the opposition, the Shadow Chancellor, say that he would do things like scrap business rates. What did they do over the 14 years that they were in power? They kept business rates in place. They didn't reform the system. They introduced year after year of temporary reliefs that didn't work and that didn't last. 7000 pubs closed under their watch in communities up and down the country, and they expect this house to believe that they were just getting round to it.

Well, we don't believe it and we won't stand for it. Instead, on this side of the house, we will get on with the work, Mr. Speaker, of making sure that we can get our public finances in order, getting borrowing down and continuing to support businesses as far as we reasonably can with our £4.3 billion of support. He asked about the guidance. The guidance will be published today. I hope it has been published already, but if not, it will come very soon. Bills will be landing in the inboxes and doormats of businesses across the country in the coming weeks, and will reflect the changes that have been announced today.

Yes, this will be scored in the usual way at the Budget, and he talks of borrowing his plans to scrap business rates entirely funded by made up savings and other parts of public spending would mean a 30 billion or so increase in borrowing, a borrowing that we could not afford. Mr. speaker, we have on this side of the House set out significant plans today to support pubs to support those businesses that are the heart of our high street and have been affected by the particular way that they are valued.

And as I said in my statement, pubs, business rates, valuations are are are are not the same as the rest of hospitality which are valued on their bricks and mortar, whereas pubs are valued on their takings. And industry bodies have highlighted concerns with how the costs are accounted for in this methodology. And the government does want to look at that more closely. That's why we're launching the review. And while we've come forward with a significant package of support for pubs today.
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Daisy Cooper Portrait Daisy Cooper MP (St Albans, Liberal Democrat)
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Daisy Cooper Liberal Democrat spokesperson for.

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Thank you, Mr. Speaker. If the government is serious about saving the high street, then this can only be the start. We Liberal Democrats have been warning since the government's first Budget that high streets are going to be at risk of the various changes they have made the various changes they have made now over the last 18 months. A number of questions arise from this statement today. Mr. speaker, first of all, there are 11 pubs in my constituency which could not all be described as large in size, but do have a rateable value of high of more than 100,000 on account of the ridiculous valuation system, and they will still see their rates bills go up.

They will be published like this across the country, and they will only seem to be getting half of the percentage relief. Is that correct? Pubs can already have 50 temporary event notices a year, and extending that is simply a soundbite solution without a problem on hotels. I'm glad the government is looking at this, but what is the time frame? The Samuel Ryder Hotel in my constituency tells me their bill is going up by 157% in the first year alone, and they will not be the only one.

Will the new formula be in place for hotels in April, or will they be left in limbo? There is still nothing in this statement for the rest of the retail, hospitality and leisure sectors restaurants, soft play centres, high street shops who made business decisions, investment and hiring decisions based on the expectation of the full £0.20 discount. Mr. speaker, I welcome the announcement of a high street strategy. We Liberal Democrats welcome that and we will engage constructively. But will the Minister start now with our Liberal Democrat calls to direct the Competition and Markets Authority to look at the energy market, which is blocking hospitality businesses and other sectors from getting the best energy deals.

And look at our fully funded proposal to slash VAT until April 2027 to give our high streets a boost. Mr. speaker, getting answers and data from the government over the last few weeks and months has been like getting blood from a stone. Just 90 minutes ago, I asked the Minister if he would tell us what he knew and when. He said he would, but yet he hasn't. And finally, Mr. Speaker, on the pub methodology, the use of fair and maintainable trade, the use of turnover has long had its day.

But could I please, please urge the Minister to allow for parliamentary scrutiny? None of the current legislation relating to pubs or business rates allows for any scrutiny in this House or the other house. I ask the government about the valuation strategy, the valuation methodology. Back in July 2024, one of my first written questions after the general election. It's taken 18 months for the government to listen. Please will they allow this House to scrutinise their plans so we can get a long term fix to save our pubs?
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Dan Tomlinson Portrait Dan Tomlinson MP, The Exchequer Secretary (Chipping Barnet, Labour)
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Thank you, Mr. Speaker. The 15% reduction will apply to all pubs and as as as she will know the there are different there are different caps for the pubs depending on their size. But if if bills had been frozen then no bill would have fallen next year. Instead, because we've made the decision to apply the 15% reduction 70 around 75% of pubs will either still see their bills stay the same or falling. I do acknowledge what she says about the very largest pubs, but we will still be significantly reducing the increase that they would have expected this year, and then their bills will be frozen in full in year two and year three of the period before the revaluation review.

That I'm glad that she is able to welcome the results of that will be implemented for future revaluation. The hon. Member mentioned the temporary event notices. I would I would say that the recommendations of the licensing review that was carried out in conjunction with pubs and and and and with businesses in the sector, we are seeking to implement their recommendations. So she may think it's only something that doesn't touch the sides or doesn't make a difference, but pubs themselves told us that yes, in addition to making sure we could support them in the right way fiscally, that it's changes like this would be welcome.

And I hope that pubs who are able to will be able to make use of them. She asked you about the £0.20 multiplier. She is right to point out that we legislated for up to £0.20. We we do have to see these things in the balance. The decision to reduce the multiplier by £0.05 came with a £900 million price tag, so reducing to the full £0.20 would cost significantly more. And we think we have got in the round a package of support that both yes, has a lower tax rate within the system, a lower multiplier, but also steps in with these caps to support businesses if they're experiencing increases in their values or having to adjust to the slow unwinding of the pandemic relief.

She asked you about VAT and all. I'll say there and she'll expect this, but is that when her party had the chance in government, what did they do? They put VAT up and now they seem to be calling for it to go down. Mr. Speaker. And finally, on the question of what did I personally know? And when government Ministers, as the VOA set out, were provided with the details of the increases in the valuations. But at that time, we did not foresee and I did not foresee, that after the changes in the rateable values that were published at the Budget, we would be in a position where the pubs and their and their representative bodies would want to withdraw their support for the independently and previously agreed methodology.

Given that, and given the government's judgement that there are issues, issues that she refers to, we thought it was right to pause, to review their methodology and to make sure for them and for hotels, it's fit for the future.
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Julie Minns Portrait Ms Julie Minns MP (Carlisle, Labour)
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pedal cycles prescribed under the Electrically Assisted Pedal Cycles Regulations 1983, and of equipment capable of converting a pedal cycle into such a vehicle and for into such a vehicle and for connected purposes. Now, this bill is without doubt a mouthful, and it is without doubt a mouthful, and it may seem technical and dry, but at its core it is about safety, its core it is about safety, clarity and responsibility. It is about protecting pedestrians and other road users, lawful cyclists, constituents and our communities from vehicles that look like bikes, that behave like motorbikes.

It's about stopping the sale of illegal e-bikes and the kits that turn ordinary, everyday pedal bikes into illegal monster bikes. E-bikes, when they conform to the law, are a force for good. They make cleaner journeys, better public health and less congestion by law. E-bike motors should have a maximum continuous power output of 250W and cut out when the bike reaches reaches 15.5mph. Going faster than that is perfectly permissible without a motor. Indeed, I'm told that for some people it's entirely possible.

A fact I am sure I will see firsthand when the tour de France travels through my constituency next summer. But those athletes will demonstrate that these speeds will be reached without motorised assistance. The sad reality, as members know, is that there are illegal e-bikes on our streets in our constituencies right now, as I speak, that are reaching dangerously high speeds. Those e-bikes and the conversion kits used to create them are being sold with batteries capable of reaching speeds far beyond 15.5mph.

A bike seized and tested earlier this month in my constituency of Carlisle found that the bike was capable of 37mph. Another bike seized in my constituency was found to have a battery capable of achieving 56mph. Whilst nationally, police have seized e-bikes capable of 70 miles an hour. These are not minor issues. These are illegal vehicles which can and do kill. Last year in Australia, a pedestrian was killed after he was struck by an illegally modified e-bike.

Last October, a 60 year old woman was killed in New York by an e-bike capable of travelling at 30 miles an hour. Last summer in Greater Manchester, a 70 year old woman was left in a coma with life changing injuries after being hit by an e-bike advertised with a top speed of 47mph. And in 2024, an 86 year old man from Lancashire was hit and killed by an illegal e-bike. We cannot continue to let this happen. These, frankly, are illegal, unregistered, untaxed, un MoD monster bikes, bikes that have become a menace not just on the streets in Carlisle, but in community communities right across the UK.

Their speed and lack of traceability makes them the perfect accomplice in robbery, phone theft and drug dealing. Our local neighbourhood police teams have done a good job seizing and crushing these illegal machines, but they are fighting a losing battle. Cumbria's police, Fire and Crime Commissioner David Allan, who was in the gallery today, believes the time has come to stop this problem at source to ban the sale of these illegal e-bikes and the conversion kits that create them. And I agree and that is why I am introducing this bill.

Online marketplaces and overseas suppliers sell high powered e-bikes and conversion kits with minimal checks, scant safety information and no clear liability. Too often, buyers assume a product is legal because the website does not say otherwise. We already accept that some dangerous items simply must not be sold to the public. We ban the retail sale of flick knives because they are capable of killing and causing serious injury. We restrict the sale of F-4 fireworks to those who are trained to use them safely.

And we ban the use, import and supply of asbestos containing materials because it can kill. Those bands are about removing from the market products that are known to harm and kill. Monster e-bikes harm and kill. This bill is targeted and proportionate. It will continue to allow the sale and enjoyment of legal e-bikes, but it will shut down the sale and marketing of illegal monster bikes and the kits used to create them. It will give regulators and the police powers to seize and destroy non-compliant bikes and conversion kits at the point of sale.

And it will create clear offences and penalties for retailers of illegal products, cutting off the sale and marketing of illegal e-bikes removes dangerous products before they can reach our streets. This bill recognises that enforcement must be paired with support. It will give trading standards and the police and other regulators targeted powers to act against sellers and online marketplaces. It will require clear consumer information so buyers are not misled into thinking high powered machines are road legal. And it will help riders who rely on e-bikes for work to continue to access safe, legal e-bikes.

Mr. speaker, this is a practical, evidence led measure to reduce the harm we see in our communities to protect vulnerable people and to make our streets safer. It does, as I have set out, draw on the same logic that led Parliament to ban the sale of other dangerous items. It must be the case that when a product is capable of killing or causing injury, and its sale cannot be reasonably regulated, it simply should not be sold. Let us be clear lawful, safe e-bikes are part of our future.

What this bill does is introduce measured, necessary steps to make our streets safer, to protect our constituents, and to stop the sale of monster e-bikes.

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And I commend it to this House. The hon. Member have leave to

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The hon. Member have leave to bring in the bill. The question is that the hon. Member have leave to bring in the Bill. As many are of bring in the Bill. As many are of that opinion, say, I don't overdo it. Focus of the contrary. No, I think the ayes have it. The ayes have it. Who will prepare to bring in the bill?

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in the bill? Luke Akehurst. Liam Byrne. Anna Dixon. Tim Farron. Fabian Hamilton. Tom Hayes. Alex McIntyre Jim Shannon Bradley Thomas. And myself, Mr. speaker.

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Julie Minns. Electrically

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Julie Minns. Electrically assisted pedal cycles. Bill Second Reading. What day? 27th of February.

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27th of February. 27th of February. Don't you. Say? Right. We now come to the question Right. We now come to the question of time motion Minister. To move. Beg to move. The question is on the Order Paper, as many that opinion Order Paper, as many that opinion say. Aye. The country. No. The ayes have it. The ayes have it. The clerk will now proceed to read the orders of the day. Medical Training, Second Reading. Now. No. Secretary of State.

Yes.
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Wes Streeting Portrait Rt Hon Wes Streeting MP, Secretary of State for Health and Social Care (Ilford North, Labour)
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Hear, hear. of the Herculean efforts and dedication of NHS leaders and frontline staff who, even in the depths of winter, are delivering outstanding episodes of care. Hour after hour, day after day, among the encouraging signs of year on year improvement are waiting lists falling at their fastest in three years, down more than 300,000 under labour. Quicker ambulance response times, shorter waits in A&E and speedier cancer diagnoses for more people. December was the busiest month in NHS history for 999 calls.

But despite that, and regardless of the pressures of industrial action and winter pressures, ambulances arrived to heart attack and stroke patients nearly 15 minutes faster compared to last year. The progress we're seeing is a reminder that nothing positive for people who use the NHS ever happens without the people who work in our NHS, our investment and modernisation are starting to restore confidence and renew belief among frontline staff and with it hope, optimism and ambition are returning.

That is why, outside of the pandemic, staff retention is at its highest in a decade and vacancies are at their lowest since records began in 2017. Lots done. But as we know so much more to do, I will always be honest about the state of our National Health Service, what is going well and where we need to improve. And there's no sugar coating the fact that staff morale is still too low, and the way that some of our NHS workforce are still treated, and the conditions in which too many of them still work are nothing short of a national disgrace.

That is not only a stain on our NHS, it shames us as a country when those who care for us in our hour of need suffer. Bullying, harassment and racist abuse, have nowhere to rest, go to the toilet or get changed. Can't get a hot meal on a night shift. Have limited flexible working options. Must book holiday a year in advance. Need to log in seven times just to use a PC. Spend time form filling rather than looking after patients and face basic errors with pay and contracts.

Before Christmas, I had a doctor in tears in my constituency advice surgery, as she described the way in which she had been treated by one of her previous employers. It is no way to treat the people who kept this going when everything else stopped, and so we are taking action. Trusts are now implementing the ten point plan for resident doctors, and my department with NHS England is developing new staff standards to create better working practices and better conditions. We have awarded above inflation pay rises to everyone working in the NHS for this year and last year, beginning to recover the pay erosion seen under the last government.

And we've begun 2026 with constructive talks with the BMA's Resident Doctors Committee as we seek to broker industrial peace. I've also told NHS leaders that they need to step up when it comes to the conditions their staff face. They can't expect the Secretary of State to micro-manage availability of hot food in their canteen, for example. But there are workforce problems, Madam Deputy Speaker, that only government can solve. We've known for years that the treatment of resident doctors is often totally unacceptable, and the very real fears about their futures are wholly justified.

Every time I've met a resident doctor, either formally or informally, they tell me without fail how their careers are blocked because there are far too many applicants for training places. Not only do I think they

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have a legitimate grievance, I agree with them and I'll certainly give way to the hon. Gentleman. The Secretary of State, talking

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The Secretary of State, talking about postgraduate training. Essentially, I wonder what he's given to the new clause two in the name of my hon. Friend the Member name of my hon. Friend the Member for Runnymede and Weybridge. I've spoken to students who worked really, really hard all the way really, really hard all the way through medical school to get the best results. The best exam results perform highly, and they end up in an allocation system that pays no an allocation system that pays no attention to that whatsoever.

It removes merit entirely from the system. I think it was wrong for us to make that change. Has he got any sympathy for the idea that we put it back to being a merit based system?

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I certainly do have sympathy with that argument. Madam Deputy Speaker, we've begun moving the system in the right direction in system in the right direction in terms of giving applicants greater preference in placements, but it's preference in placements, but it's not lost on me that the way in which the system of rotations and which the system of rotations and placements and jobs works means not just moving doctors around the country, but uprooting families and the frictional costs of relocating from one place to another is part of the the challenge that resident doctors in particular face.

I don't think that that particular amendment and this particular bill is the is the right vehicle to address that issue. But I am very sympathetic to the arguments that the hon. Member makes and will again make during this afternoon's proceedings. We will take those arguments seriously and look to work together with the BMA and others to to to act and improve the quality of the training and rotations and jobs experience. UK graduates used to compete among themselves for foundation and speciality roles.

Now they are competing against the world because of the visa and immigration changes made by the conservative government post-Brexit. It is a situation compounded by the previous administrations total lack of workforce planning, which saw more students going to medical school without increasing the number of speciality training places. That is why we see the training bottlenecks that resident doctors face today. I'll give way to hon. Gentleman then to my hon.

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Friend the Secretary of State for giving way. A constituent of mine is studying medicine at Queen Mary studying medicine at Queen Mary University in London, but at a campus in Malta. Malta students compete complete the same GMC approved curriculum and assessments and license exams as London based students and graduates hold a UK primary qualification, he was given a formal guarantee that he would be a formal guarantee that he would be at no disadvantage in choosing to study at their multicamera campus.

Can the Minister reassure me that graduates like him will be prioritised on the NHS Foundation

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Years medical training programme? Secretary of State. Madam Deputy Speaker students studying in Malta will not be studying in Malta will not be prioritised in this bill. Of course, they will still be able to make applications. And the hon. applications. And the hon. Gentleman mentions the Queen Mary University. Their Malta website is clear that Queen Mary does not administer the UK Foundation programme and cannot control whether, or on what basis whether, or on what basis applicants are accepted into the program, and no one is guaranteed a post on qualification.

I'll make some progress because with respect to with respect to, hon. Members haven't yet set out the the measures that we're currently beginning to debate. So let me set out the rationale and then take interventions. I'll take one from hon. Friend. I wonder if the Secretary of State would share my residents utter disbelief that the last government created a system where thousands of UK medical graduates educated it costs £1 billion to the UK taxpayer, were suddenly forced to compete with overseas students, pushing many abroad for their careers and losing a big talent pool that should be powering our NHS and getting it back on its feet.

That's right, Madam Deputy Speaker. I've got to say many of my counterparts around the world cannot fathom how we ended up in this situation in the first place. They certainly don't do as we have been doing of investing so much in their own home-grown talent, only to then see them competing on equal terms with anyone from anywhere else in the world. But Madam Deputy Speaker, let me set out why we need this bill. There are workforce problems that only government can solve.

We know that for years, the treatment of resident doctors have been totally unacceptable, and we see the training bottlenecks that resident doctors face today. In 2019, there are around 12,000 applicants for 9000 speciality training places. This year that has soared to nearly 40,000 applicants for 10,000 places, with nearly twice as many overseas trained applicants as UK trained ones. As a result, we now have the ridiculous state of affairs where UK medical graduates, those whose training British taxpayers fund to the tune of £4 billion a year, who want to carve out a career in their NHS, are either being lost abroad or to the private sector.

Madam Deputy Speaker, if we don't deal with this, then the scale of the issue and the resentment it causes will just get worse. More taxpayers money will be wasted. More British medics will turn their backs on the NHS and it is patients and our NHS who will

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ultimately suffer. I'll give way to hon. Gentleman. Thank you, Secretary of State, for giving way. And he knows that for giving way. And he knows that we believe this is a pragmatic bill which will have a positive outcome for the health service in Scotland. We welcome the Bill. We are glad to We welcome the Bill. We are glad to support it. However, there are speciality fields which have a high number of international graduates such as GPS. Because of government such as GPS.

Because of government policy, there are significant challenges in supporting the onward retention of some individuals. For retention of some individuals. For example, the new requirements for settled status is now ten years, with some exceptions. For us, training programmes are often only three years, so I'm sure the Secretary of State does not want the UK to be a hostile environment for our overseas vital medical staff. So can I ask him to make representations to the Home Office

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so that they are aware of this anomaly? Secretary of State. Madam Deputy Speaker, I'd say

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Madam Deputy Speaker, I'd say two things to the hon. Gentleman. Firstly, and this bill certainly Firstly, and this bill certainly doesn't in any way detract from this fundamental point. The NHS has always been an overseas recruiter, always been an overseas recruiter, and we have always been fortunate to draw on global talent from around the world who come and give through their service, through their taxes and through their wider contribution to the National Health Service and to our country. And we will we will continue to welcome that, and people will continue to be free to apply.

I think we they will be applying in future on fairer terms to our own home grown talent. And of course, there's nothing in what the Home Secretary is proposing to do that will stop people who come through our universities have the skills that we need to contribute to our health and care system, from applying to jobs and settling and making the UK their home. What the Home Secretary is seeking to do, and what this bill supports her to do, is to reduce what is an over reliance on overseas talent and labour, which is contributing to levels of net migration that, if I may say, even bleeding heart liberals like me can see are too high.

And that is the issue that the Home Secretary is seeking to to deal with. I'll give way to my hon. Friend. Friend for giving way. And he's absolutely right that we need to deal with this pressing problem. And I support the aims of this bill. But as you can imagine, as the only current member of this House with Maltese heritage, I've had representations of all quarters, both in the UK and Malta about the impact on, on, on Malta. On this we have a special relationship, a health relationship between our two countries, including the affiliation of the UK Foundation Programme, the Maltese equivalent.

I understand that now is maybe not the time to have Malta on the priority group, but I note there is a power the Secretary of State will have under current clause four, sub sub clause six, which allows Secretary State in future to amend

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that. Is that something that the Secretary of State will think about in reviewing this in the future? Secretary of State.

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Secretary of State. My hon. Friend is absolutely, absolutely right about the measures in the bill, and he's absolutely in the bill, and he's absolutely right about the importance of our relationship with Malta, which is a relationship with Malta, which is a long standing and deep. And this long standing and deep. And this government places enormous value on. We will, of course, keep the workings of the measures in this bill under review. And he is right to say that the bill does provide flexibility to the Secretary of State to adjust as our needs may Gentleman.



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To the Secretary for giving way. The bill is basically a good one, The bill is basically a good one, and we all share in the intent to encourage home grown talent, because there remain in our National Health Service. So could the Health Secretary explain why it is that he appears to have set his face against British students who, face against British students who, for various reasons, train at, for example, Saint George's in Cyprus or Saint George's in Grenada, who then want to come back and practice in our National Health Service.

They want to come back and practice at home. Amendment nine on the Order Paper would deal with that conundrum. Why won't he support it?

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I'll just say to the hon. Gentleman, we set UK medical school places based on future health places based on future health system needs. We cannot control how many overseas campus places universities create, whether universities create, whether they're UK based universities or not, prioritising these graduates in the way that, he suggests, would in the way that, he suggests, would undermine sustainable workforce planning. It also undermines social mobility and fair access. These campuses are commercial ventures, receive no public funding, and students are generally self-funded.

We the nature of prioritisation is you set priorities and these are the priorities that this government is setting out. We must break. I've got to make some progress. Madam Deputy Speaker, we must break our overreliance on international recruitment. And as I've said, I am proud of the fact the NHS is an international employer. It is no coincidence that the Empire Windrush landed on these shores in 1948, the very year our NHS was founded, and we are lucky that we've got people from around the world who come and work in our health and care service.

Since Brexit, under the last government, we have begun to see something much more corrosive the NHS poaching staff from countries which are on the World Health Organisation's red list because their own shortages of medical practitioners is so severe. The continued plundering of doctors from countries which desperately need them. While we have an army of talented and willing recruits who can't get jobs, is morally unacceptable, and even if some opposite wants to defend that record and dismiss the morality argument, then I would also point out that this position is naive.

On economic grounds. Competition for medical staff has never been fiercer. The World Health Organisation estimates a shortfall of 11 million health workers by 2030. Shoring up our own workforce will limit our exposure to such global pressures without depriving other countries of their own home-grown talent.

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My right hon. Friend for giving way, and and I congratulate him on the excellent speech that he's making and the strong points that making and the strong points that he's delivering. I would like to associate myself with the my my hon. Friend for Stevenage remarks as regards Malta. As a member of the Health Select Committee, I've also been approached by Queen Mary's University. It just seems to me University. It just seems to me that we should be approaching this with a sense of fairness.

And if we with a sense of fairness. And if we have students who have entered into a GMC recognised course with the expectation of having priority access for foundation status, we should accept that those who are currently in training still enjoy that. Even if we change the rules for future people who might enter in those courses, is that something

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that he will consider? Well, as I've said, Madam Deputy Speaker, the position we set out is founded on fairness. And as I've pointed out, the base upon which people have applied these universities is made very clear universities is made very clear that these universities cannot guarantee places and that overseas applicants studying at UK universities, overseas campuses, universities, overseas campuses, the applicants can still apply. There's nothing to stop people from applying. But when it comes to prioritisation, we are prioritising UK trained medical graduates from UK based universities who have undertaken their training here in the UK, and I think that is the

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right priority to to draw, take the intervention from the hon. Gentleman. I'll come. To Gregory Stafford. Thank you very much, Madam

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Thank you very much, Madam Deputy Speaker. I thank the Secretary of State for giving way. He mentioned the need for more NHS He mentioned the need for more NHS and medical staff across the world and of course in this country as well. At the general election, he pledged to double the number of pledged to double the number of medical school places by 2030. Is that still a commitment and how far has he got with it?

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Secretary of State? Madam Deputy Speaker, I think the honourable with respect, the hon. Gentleman got his chronology slightly wrong. In opposition, a shadow Health Secretary, I propose we should double the number of undergraduate medical school places. That policy was then poached by the conservative government. As it was, they made some modest progress with it. We came into government, looked at their long term workforce plan, concluded it wasn't a particularly long term workforce plan. And we are we are revising it as we speak.

The number of medical school places will be will be determined on the basis of future need, and we'll be publishing our long term workforce

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plan in the not too distant future. I'll give hon. Lady friend. Thank the Secretary State for giving way. He rightly notes that giving way. He rightly notes that there is an international competition for healthcare talent. competition for healthcare talent. On Friday I met Doctor Osoba, who is a GP who trains future GP. She said how disheartening it is that said how disheartening it is that she trains future GPS whose intention is already to leave the UK. What is the Secretary of State UK.

What is the Secretary of State doing to make sure that British trained medics stay working in the NHS?

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The hon. Member puts her finger right at the on the button of of right at the on the button of of the issues at the heart of this bill. That is exactly the challenge bill. That is exactly the challenge that we want to address with this bill. This bill isn't a panacea. It doesn't solve all of the problems, doesn't solve all of the problems, but by reducing competition for speciality places from around 4 to 1 to less than 2 to 1, as this bill will do, will make it far more likely that people who've undertaken their training here in the UK will stay here and contribute to our National Health Service.

Of course, there's much more to do in terms of career structure, pay and conditions. We will go as fast as we can and as far as the country can afford, but we do recognise that we need to keep the great people that we have

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invested in, because that's clearly in their interest and in our national interest. Give way to my friend. Very grateful.

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Very grateful. Indeed to my right hon. Friend, for giving way. And in fact, my point is on exactly that issue. He point is on exactly that issue. He will be aware, because I've written to his department a number of times about this, that there is a particular challenge for many particular challenge for many disabled medics who may have had to take time out of their training because of a medical condition. because of a medical condition. They are told that they can obtain a certificate and go into training specialism.

But actually the computer is saying no, NHS England is not sorting this out. Can you please get a grip on this and fix it for my constituents? Thank you.

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I'm certainly aware of my hon. Friend's concerns, and I can give her that assurance, and I will her that assurance, and I will report back to her on progress. And, Madam Deputy Speaker, without action to prioritise UK medics, we action to prioritise UK medics, we will also make it tougher than it already is for those from working class backgrounds like mine to class backgrounds like mine to become doctors or for that matter, for them to even consider a career in medicine. The odds are already in medicine.

The odds are already stacked against them. They are less likely to know doctors. Their teachers may be less familiar with helping students into medical school. They will have fewer opportunities to do work experience and fewer people in their lives, telling them that they should aim high and reach for the stars. The result is that only 5% of medical school entrants are from lower income, working class backgrounds. Someone's background should not be a barrier to becoming a doctor. And so our job, especially as a Labour government committed to social justice, isn't just to make sure a few kids like me beat the odds.

It is to change the odds for every child in this country, so they can go as far as their talents will

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Member. Thank you. I thank the Secretary of State for giving way. It's vital of State for giving way. It's vital that we address this issue to ensure that UK trained doctors are being prioritised for vacancies over international applicants, and he's making some important points on that. But we need to see these places open for UK medics immediately. So I wondered if he could perhaps explain why this bill could perhaps explain why this bill won't be coming into action immediately on royal assent, but seems to include a provision for it to come into force on such a day or days as the Secretary of State may,

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by regulations, appoint Secretary of State. Yes, Madam Deputy Speaker, it's

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Yes, Madam Deputy Speaker, it's really important that the bill that we pass is workable, and there are we pass is workable, and there are a number of factors that may well interrupt our ability to move at the pace with which I want to move, the pace with which I want to move, to open up these places. One of those factors is the ongoing risk of industrial action. We know that the BMA are balloting for further industrial action at the moment.

We respect that process they're undertaking, and we are not closing the door to discussions while they undertake that. But we are clear that that is a further disruption risk. I hope we will be in a position where we can open up a new application round very shortly for current applicants, but that will be dependent on our ability to expedite the passage of this bill through both houses and making sure that the system is ready to implement it. And that's why bringing forward this bill on this timescale has been particularly important.

On that point. I'll certainly give way once more.

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I'm very grateful to he is being generous. Is he then saying that he intends to use this as some sort of intends to use this as some sort of lever or bargaining chip? In his discussion with the BMA?

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discussion with the BMA? Madam Deputy Speaker, I'm clear that this is about whether the system will be ready to implement the measures outlined in the bill. I must say, it is with a degree of cynicism that I have viewed the cynicism that I have viewed the Conservative Party's amendment on this. It was not so long ago that they were accusing me of being too kind to resident doctors when it came to making changes to pay or conditions without something in return, they seem to have completely changed their position.

I'm sure that that has. I'm sure that is not remotely cynical. Madam Deputy Speaker, I'm sure it's for entirely noble reasons. And but the I'll wait for the shadow health secretary to make his case. Let's just say I'm not entirely convinced the medical training bill implements the commitment in our ten year plan for health to put home grown talent at the front of the queue for medical training posts. Starting this year, it prioritises graduates from UK medical schools and other priority groups over applicants from overseas during the current application round and in all subsequent years for the UK Foundation Programme.

The bill requires that places are allocated to UK medical graduates and those in a priority group, before they're allocated to other eligible applicants for speciality training. The bill effectively reduces the competition for places from around 4 to 1, where it is today, to less than 2 to 1. I think that's a really important point for resident doctors to hear, Madam Deputy Speaker, not least because in the in the debate we had around the government's previous offer to the BMA, I think that point was lost amidst some of the broader and, frankly, more contested arguments between the government and the BMA around pay.

So it's not just the provision of additional training posts that reduce the competition ratio. It is the measures in in this bill. And I hope that that is a message that's heard clearly by resident doctors as they think about their their own futures immediately or in the coming years. For post starting this year. There must be prioritisation at the offer stage and for training posts starting from 2027, prioritisation will apply at both the shortlisting and offer stages. And Madam Deputy Speaker, in the ten year plan, we committed to prioritising international applicants with significant NHS experience for speciality places in recognition of the contribution they've made to our nation's health.

This year will use immigration status as a proxy for determining those eligible so that we can introduce prioritisation as soon as possible and from next year. Under the terms of this bill, we set out in regulations how we are defining significant NHS experience. I'll

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give way to my hon. Friend with significant NHS experience. Thank you, Secretary of State,

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Thank you, Secretary of State, and can I commend the speed of which he has brought this legislation to Parliament? I have I have been a GP trainer for 25 years, and I'd just like to say that 50% and I'd just like to say that 50% of, of, of GP trainees are in fact international medical graduates. And there's been some disquiet from them. And I wonder if you could just reassure our international medical graduates. They are welcome and in fact treasured within the health service as we go forward.



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Thank my hon. Friend is absolutely right about the contribution that international medical graduates make, and I've no medical graduates make, and I've no doubt that that will continue to be the case for many years to come. And Madam Deputy Speaker, I also And Madam Deputy Speaker, I also hope it's clear to those going through medical school or those through medical school or those aspiring to a career in medicine, that in terms of the future of healthcare in this country, general healthcare in this country, general practice is where it's at, and we are looking to shift the centre of gravity in the NHS, out of hospital, into the community with care closer to people's homes and indeed in people's homes with GPS.

As leaders of a neighbourhood health service, I hope that gives encouragement to GPS serving today about the future of their profession, about which they care enormously. But I also hope that that message resonates with people who are thinking about a career in medicine and what kind

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of career that might be. I certainly will give way. Sarah Pochin I thank the Secretary of State for giving way. Secretary of State for giving way. I recently spoke to a doctor in my constituency of Runcorn and Helsby constituency of Runcorn and Helsby who was concerned about resident doctors going abroad to get a training place in their chosen training place in their chosen subject or speciality. We at reform welcome this bill. So would the welcome this bill. So would the Secretary of State commit that we will prioritise our own UK trained resident doctors ahead of those trained abroad? And will he give me the assurance that this bill will help UK train resident doctors to secure a trading post in their chosen speciality?

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Secretary of State. Madam Deputy Speaker, I can give the hon. Member that assurance and the hon. Member that assurance and that's exactly what the bill does. Madam Deputy Speaker, I cannot, however, resist the enormous however, resist the enormous temptation to point out that while I welcome the support of the hon. Member and her party, I hope her party's position won't change now. They've adopted so many former conservative culprits who landed us with this system in the first place.

Whether that's the former Home Secretary, the right hon. Member for Fareham or whether that's the former immigration Minister, the right hon. Member for Newark, I'm afraid, Madam Deputy Speaker, reform looks rather more like the Conservative Party the country rejected at the last election, and I'm sure that won't be lost on people when they go to the ballot box. Ballot box in May. As my as my hon. Friend the care Minister says, from a sedentary position, reform UK are increasingly the Tories and yes, certainly the most, the most, the most successful recycling project currently taking place in the House of Commons.

Anyway, that was totally self-indulgent. It was very churlish given the hon. Member is supporting the bill, and I'll slap myself on the wrist and get back to serious matters at hand. Madam Deputy Speaker, it's really important that as we set out these changes that they will have no impact on doctors working in the armed forces who will continue to be a priority. Nor does this bill exclude international talent who will still be able to apply to roles and continue to bring new and vital skills to our NHS.

The principle here is home grown talent. It's not about where students are born, it's about where they're trained. And what this bill does is return us to the fair terms on which those home grown medics competed before Brexit. I'll give way to my hon.

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Friend for giving way, and I do welcome his approach to this bill, welcome his approach to this bill, but also how he has worked across all devolved associations in regards to that. But can I just regards to that. But can I just seek his reassurance in regards for those medical students who reside in Northern Ireland who identify in Northern Ireland who identify themselves as Irish, study in an Irish institution in the Republic of Ireland, that they will not be of Ireland, that they will not be excluded from coming back to work in the National Health Service in Northern Ireland, where we very

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much need all the talent we can get. Secretary of State I can absolutely give the hon. Member absolutely give the hon. Member that assurance. This absolutely covers medical graduates from UK covers medical graduates from UK and Ireland for for very obvious reasons. So, Madam Deputy Speaker, I welcome the broad support this Bill appears to have across the Bill appears to have across the House, because in order for the changes to benefit applicants in the current round, that is for post starting this August, this legislation needs to achieve Royal assent by March the 5th.

Any delay will risk vacancies in August and disrupt planning in NHS trusts, who rely on their new trainees to deliver frontline care. Doctors, too, need sufficient time to find somewhere to live, sought childcare and arrange other aspects of their lives before their post start. So I am grateful that Parliament has agreed to expedite this bill's progress, and I'm confident that we'll be able to work at pace with the majority that we have in this House and with cross-party support

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in the other place, I certainly will give way. I'm extremely grateful to him. Giving my consent. He's about to Giving my consent. He's about to reach the end of his remarks and we are keen to start the debate. But I do feel there's one thing it would be helpful to get clarity on before we begin, when are we going to see that workforce plan? It has been delayed a couple of times now. We delayed a couple of times now. We wrote to the department at the in November, asking for some explanation as to why it's been delayed when we can expect it.

delayed when we can expect it. Could he give us some clarity? Because that is the context in which, of course, this very, quite narrow technical thing that we're

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discussing today needs to happen. The Secretary of State. Thank you, Madam Deputy Speaker. It's a fair question from the chair It's a fair question from the chair of the Select Committee. We are taking longer than I would have liked with the with the workforce liked with the with the workforce plan. I hope it reassures the hon. Member and the House that we've taken more time, because that's taken more time, because that's what Royal Colleges and the trade what Royal Colleges and the trade unions and clinical leaders and NHS leaders asked us to do, they're strong urging was to get it right rather than to rush according to a political timetable.

And I thought

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that was a fair challenge. It will be published this spring. Foreign Secretary.

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Foreign Secretary. I certainly will. Thank you for giving way and I welcome this legislation. Does he welcome this legislation. Does he agree with me that the fact that the government has listened to the concern that resident doctors have about training places and has acted about training places and has acted at pace to bring forward this legislation, shows that we are committed as a government to fixing committed as a government to fixing the problems left behind by the conservative government. And would he agree with me that the BMA should consider this in going

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forward with any potential further action? I do agree with my hon. Friend,

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I do agree with my hon. Friend, and I just say to for the for context, for particularly members context, for particularly members of the BMA and and resident doctors to bring forward legislation in to bring forward legislation in this way and at this pace is not easy. We have a packed legislative easy. We have a packed legislative programme as a government, and the clock is ticking on getting everything through that we want to in the time that we have available.

And that's why I'm so grateful to business managers in both houses for facilitating this. It's why cross-party support is going to be particularly important, particularly in the other place where we've got lots of expertise to draw on as well, including on the Crossbenches. And we've done this because fundamentally, we agree with the case that the BMA and resident doctors have been making. And in terms of where we are in our current discussions with BMA representatives, it's been very clear immediately prior to the last round of industrial action and in the conversations that follow since that when it comes to jobs, we're not that far apart.

We recognise the problems, we're working together to address solutions and on pay. There remains a gap between the expectations of the BMA and what the government can afford. All I ask of resident doctors and their BMA representatives is some understanding and a bit of give and take, about the range of pressures on the government and on the National Health Service, many of which require funding. And that's why there are choices and trade offs. But I hope they know, and I hope they have noticed, that regardless of the fact that we remain in dispute on these issues, and regardless of the fact that we've had a number of rounds of industrial action, I haven't slammed the door in their in their faces and and stopped talking.

We've continued to talk and talks have been good natured and constructive, and I haven't thrown my toys out of the pram either and just said, right, well, we won't proceed with this bill. And we've continued to work to enact solutions that we think are good for resident doctors and therefore good for patients and good for the NHS. And I hope that this will be the spirit in which we can work together. The goal is to be in a place with the BMA and with resident doctors particularly, but this applies to other groups of the workforce where we can work together and make progress outside of dispute, and where we can gather around tables as partners rather than as opponents.

That's going to take some gear shifting from where we have been to where we want to be. But I know that both the government and the BMA have entered the New Year in that spirit, so we will continue to make progress. So, having stressed the urgency, I want to address the commencement clause included in the bill, which has already been raised. But let me just set out why it is there. First and foremost, it's a fail safe. We are running to an extremely tight deadline here, and I do not want to be in a position where a law is enacted and we're unable to implement it in a timely, orderly fashion.

Secondly, there is a material consideration about whether it is even possible to proceed if strikes are ongoing because of the pressure they put on resources and the disruption that's caused operationally, particularly among those who the people that I require to help me deliver the measures in this bill. And of course, I'm keeping my options open. We're in a good place with the BMA in terms of the spirit in which we've entered the latest round of talks, but we do not yet have an agreement on their disputes and we're waiting for the outcome of their ballot.

So I'm not going to do anything now. That unnecessarily makes it harder to end the strikes. So I would say in relation to the opposition amendment to remove the commencement clause, I actually think it's designed to make industrial action more likely, not less likely. It tries to bind my hands and make this job even more difficult. It looks like political game playing at a time when we're trying to save the NHS, and it does look like party interests before national interests, and I really hope that they will consider whether or not this clause is really necessary.

British taxpayers spend £4 billion training medics every year. We treat them poorly, place obstacles in their way and make them fearful for their futures. We're forcing young people who should be the future of our NHS to work abroad, or in the private sector, or to quit the profession entirely. So it's time we protect our investment and our home-grown talent. This bill will ensure a sustainable workforce, cut our reliance on foreign labour, halve competition for places, give Home-grown talent a path to become the next generation of NHS doctors and I commend this bill to the House.
16:19
Stuart Andrew Portrait Rt Hon Stuart Andrew MP (Daventry, Conservative)
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The question is that the Bill be >> The question is that the Bill be now read a second time. Shadow Secretary of State. >> Thank you very much, Madam

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Thank you very much, Madam Deputy Speaker. And let me start by saying right in the outset that in saying right in the outset that in the spirit of being sorry, no, no, I'm most definitely not defecting, let me say, in the spirit of being constructive, that the opposition supports the principle behind the medical training privatisation Bill. Doctors trained in Britain, funded by the taxpayer, should have a fair, clear and consistent route to progress in our NHS.

Britain trains some of the best doctors in the world. And yet, as we've heard already, too many are leaving. Not because they want to, but because they cannot access the training places they need. That simply wastes talent, damages morale, and ultimately affects patient care. But support in principle is not a blank check. This bill must work in practice and not just look good in a headline. And we should also be honest about why we are here. Much of what is in the bill has been promised by the government for since their election, in planned reviews and ministerial statements, and the fact that it is now only being brought forward suggests that this is catching up and not leading.

Now the first test is delivery. You cannot solve the shortage by changing the queue unless the government delivers the 4000 new specialist training places as promised, including the 1000 places needed early. This bill will not fix the bottlenecks. It will simply shift frustration from one group of doctors to another. And that is why we are proposing constructive amendments to the bill that we believe are workable and fair. The next test is clarity. The real impact of this bill will be determined by the rules that sit beneath it.

Who qualifies, how experience is assessed and how decisions can be challenged. Now we welcome the focus on foundation training, prioritising UK and Irish graduates for foundation training is sensible. It strengthens the pipeline and it improves workforce planning. But it will only work if there are enough placements and the system is transparent. And that is why amendment eight would clarify that a UK Foundation programme must mean a programme where the majority of training places to training takes place in the United Kingdom.

That is a necessary safeguard against loopholes. Turning to amendment nine that would ensure that from 2027, British citizens on UK foundation programmes are prioritised in a meaningful way that must apply at interview, where selection decisions are often made not only at the final offer stage, and addresses many of the points that hon. Members opposite have been raising. So I would encourage them that when we divide on amendment nine that they support it. We are also concerned about doctors serving overseas with the armed forces, and I was pleased to hear the Secretary of State talk about them, because they certainly should not be penalised because of that.

Part of their training takes place abroad. Based on service. So amendment ten would expand the definition of a UK medical graduate to include those undertaking placements as part of armed forces posting outside the British Isles. And I hope he might have a think about considering that just to give that reassurance to our armed forces. And I know that he he he will care about that too. So these are practical changes that improve fairness and operability, and we do hope the government will adopt them.

We also support new clause two from my hon. Friend the Member for Runnymede and Weybridge, which would make clear that once priority groups are established, training places should be allocated on merit based on academic achievement and clinical performance, rather than by a lottery or a computer generated ranking. Divorced from real performance. And again, I hope the government will look at that seriously. And so I ask the Minister when she's summing up, if she can put on record that merit will remain central to selection.

Another issue that cannot be ignored is the impact on medical schools, especially those that do rely on international students. New clause three would require an annual report to Parliament on the number of international students at UK medical schools, and the financial consequences flowing from the bill's provisions. International students pay higher fees and help sustain our universities. So if those numbers fall, what funding model would replace them? So again, in a summing up, I ask the Minister what assessment has been made of the impact on medical school finances and how many international places do the government expect to fund in future, and on what basis now? Madam Deputy Speaker, this bill cannot stand in isolation.

Workforce planning depends on more than allocating training posts. It requires enough trainers and clinical supervisors, viable rotas that support learning, and facilities that make training possible. The revised NHS Workforce Plan must set out how those needs will be met, and how the extra training places will be staffed and supported. And with NHS England set to be abolished in April 2027, we need to hear from the government who will lead workforce planning and accountability thereafter. Now, Madam Deputy Speaker, our approach is straightforward.

We will support measures that are fair, practical, strengthen patient care and respect staff, and we will press the government where we feel that proposals are rushed, undefended or left vague. Backing doctors means giving them a route to progress and ensuring the system is properly planned and properly resourced. So I repeat that in in in principle, we do support this bill and we want doctors trained in Britain to build their careers in the National Health Service, which does bring me on to the issue of enactment.

The government, as we've heard, proposes that the bill should take effect when the Secretary of State decides, rather than on the date of royal assent. Now, I said at the time when the Secretary of State said he wanted to introduce this bill, and that it would be urgent that we would encourage and support that. But if this bill is truly urgent, if Ministers want it to affect this recruitment round, why would they not commence it immediately? The Secretary of State should not be playing politics with people's jobs.

It's not right for doctors, including those not involved in industrial action, to be treated as bargaining chips, or for Parliament to be treated in this way, to give him the tools that he needs, because he did the first set of negotiations so badly, so will the Minister support amendment one? So the bill takes effect on royal assent and commit to enacting it as quickly as possible. And perhaps you could also answer, when does the Secretary therefore intend to commence this bill? If she cannot give the House a date today? What makes the bill so urgent that it needs to be pushed through Parliament in a single day? Will the government proceed with this legislation, even if no agreement is reached with the BMA? And if industrial action is paused, will the government still honour its commitment to prioritise UK medical graduates? Madam Deputy Speaker, Many doctors took industrial action because they felt their career progression was blocked.

This bill could play a part in rebuilding that trust, but trust will only be rebuilt if Ministers deliver, publish the detail and follow through and they must be straight with the House. If this bill is urgent, it should commence on Royal Assent. If implementation takes time, the government should publish a timetable and the steps required to deliver it. To do anything else, frankly, would be discourteous to Parliament. Yes, of course, I'm very grateful to my friend. I think maybe the Secretary misunderstood how traumatic this process is for the young medical graduates who are going through this performance.

Does he agree with me that the sooner this comes into force, the better it is for the for those young people, some of whom are finding the current situation incredibly difficult and do not know what the successor scheme is going to look like, and the delay is adding to that unhappiness. Absolutely agree with my hon. Friend. This is why I said right at the outset that we would be constructive, because we had heard from many that they are anxious about their future.

They don't know what's going to happen. So the sooner that we can get this, give them that certainty, the better. And that was the premise on which we were offering support for it. So I'm grateful to him for making that point. So I'm going to conclude, because I am conscious that others want to take part. But prioritisation without capacity will not fix the workforce. Crisis promises without delivery and headlines without planning will not retain the doctors our NHS needs.

The government must fund the extra places, set out the operational detail and begin this form reform without delay because that was the premise that he said when he came to Parliament just a few weeks ago, he said we needed to get on with it urgently. He encouraged business managers to give the time. Well, if that's the case, let's get on with the job.
16:30
Preet Kaur Gill Portrait Preet Kaur Gill MP (Birmingham Edgbaston, Labour )
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Preet Kaur Gill thank you, Madam >> Preet Kaur Gill thank you, Madam Deputy Speaker, and I welcome this bill. I have long argued that a strong state must be rooted in work, strong state must be rooted in work, in contribution and fairness, and that principle stands behind the medical training bill. For too long, medical training pathways have drifted away from that principle. The taxpayer invests heavily in medical education, clinical placements and postgraduate training. Yet we have not been honest about who ultimately benefits from that investment.

And at a time when the NHS is under immense pressure, that is not sustainable, the Secretary of State set out the scale of what we're dealing with. The taxpayer currently invests over 4 billion every year in medical education, with more than 1 billion in undergraduate clinical placements and over 3.3 billion in postgraduate foundation and speciality training. That is, public money spent so that British patients have the doctors that they need. But since visa restrictions were lifted in 2020, we have seen a fundamental shift in how medical training places are allocated in the 2025 recruitment cycle, over 25,000 overseas trained doctors applied for training posts, compared with over 15,000 UK graduates competing for the same nearly 13,000 round one and two positions.

And overall, as we heard from the Secretary of State, applications for 2026 exceed 47,000 applicants, a dramatic surge. So this bill does one straightforward thing it prioritises UK medical graduates for training posts, both foundation and speciality, where the NHS has already invested heavily in my own constituency, we see this clearly. University Hospitals Birmingham is one of the largest NHS trusts in the country, and just under 30% of my constituents work in the health sector, which is double the national average.

We are home to the University of Birmingham Medical School, one of the best in the country, and the scale of public investment in training, in supervision and infrastructure is enormous, and rightly so. And this Bill recognises that basic truth that when the taxpayer pays, the public should see the return and prioritising those most likely to work and stay in the NHS is not exclusionary. It is common sense. It is how we rebuild a health service that is resilient, staffed and fair.

On that point, our.

**** Possible New Speaker ****

Great, great. I entirely agree

**** Possible New Speaker ****

Great, great. I entirely agree with her that that she that we need to keep Brits working in our National Health Service. So does National Health Service. So does she agree with me that we need to add to the priority list British nationals who, for one reason or another, are training in medical schools other than in the UK, in schools other than in the UK, in Prague, in Malta, in Cyprus and in the Caribbean. The reasons for them training. There are many and varied, but they are British and their intent is to practice in the National Health Service.

And yet they're being deprioritized by this measure.

**** Possible New Speaker ****

I'm not the chair of the select committee. I think the Secretary of State set out his position. This is State set out his position. This is really important. This is about UK taxpayers money being invested into training doctors. And we've got to training doctors. And we've got to make sure that UK trainees are able to get those training places once they graduate. And that is inherently the issue here that we inherently the issue here that we are talking about.

But let me be clear, this is not a criticism of international staff. The NHS would not and could not function without the dedication, the skill and compassion of people from around the world. And we should say that plainly and with gratitude. Every day they hold our system together. But a mature, confident country can value that contribution while also saying this that we cannot substitute long term workforce planning with permanent reliance on overseas recruitment. That is not fair on British trainees, not fair on source countries and not fair on the NHS itself.

We heard from the Secretary of State that the World Health Organisation estimated an 11 million shortfall in health workers by 2030, as every country competes for the same limited workforce. And this government understands that putting British workers first is not something we will apologise for. It is what the public expect. The Prime Minister has been clear a serious Labour government must align migration, skills and training policy with the national interest. We cannot simply be passive and we must shape our domestic workforce to ensure that NHS can continue to function.

The same principle should apply wherever we are overly dependent on skilled migration, because domestic training has, and we know it has been neglected under the last 14 years under the Conservatives, investing in people here and expecting that investment to strengthen Britain is not ideological. It is responsible government. The powers conferred to the Secretary of State in this bill are important. The Royal College of Radiologists 2024 census found that 83% of cancer centre heads of service in the West Midlands were concerned about patient safety as a result of workforce shortfalls.

In 2024, only 19% of clinical oncology training places were filled in the West Midlands. And can I ask the Secretary of State, will he outline outline how he intends to use the powers in this bill and work with the Icbs to ensure access to training matches, regional workforce needs and health demands? Madam Deputy Speaker, above all, this bill is about respect. Respect for the taxpayer, respect for the NHS workforce and respect for health service that must be planned for the long term, not patched up year on year.

And this is exactly the kind of reform the public expect from a Labour government. Serious about work, serious about

**** Possible New Speaker ****

contribution and the future of our NHS. Thank you. Liberal Democrat spokesperson

**** Possible New Speaker ****

Liberal Democrat spokesperson Helen Morgan. Thank you very much. Madam Deputy Speaker. I'm pleased to broadly welcome this pleased to broadly welcome this bill. It seeks to prioritise graduates from UK and Irish medical schools for foundation and speciality training places. And on speciality training places. And on this point Liberal Democrats are in support of the government. But we do have some concerns about how it will be delivered and the real world consequences for our NHS, for patients and for the doctors who keep our health service going.

Taxpayers invest around £4 billion every year in training young doctors, and yet far too many are left competing for too few posts. In 2025, around 12,000 UK trained doctors competed alongside 21,000 international doctors for just 9500 speciality training positions. Many highly skilled young doctors ready to serve in the NHS were left
16:37
Helen Morgan Portrait Helen Morgan MP (North Shropshire, Liberal Democrat)
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without a pathway into specialist practice. This is clearly unfair and unsustainable. It's hardly surprising that so many doctors decide to leave the country altogether, seeking opportunities altogether, seeking opportunities elsewhere where their training and wellbeing are valued. This is a tragedy for them and a tragedy for tragedy for them and a tragedy for patients. So yes, prioritisation is right, it is fair and it is long right, it is fair and it is long overdue. But Madam Deputy Speaker, reorganising UQ doesn't shorten it and nor does it make it move any faster.

The reality is clear the NHS has a workforce shortage, with specific crises in some specialities, and this bill alone cannot solve it. A detailed long term workforce plan, which ensures which ensures training is providing the skill mix the NHS needs for the future, is required as soon as possible, and I look forward to the Minister confirming the date of that. In her closing remarks, the government shortly before Christmas committed to 4000 additional speciality training places in its negotiations with the BMA, including 1000 brought forward.

But after the collapse of those negotiations, it remains unclear whether these places will materialise. Patients cannot wait for certainty and neither can exhausted staff. So will the Minister confirm these places and go further, addressing the other issues that have prevented doctors from working in the NHS, such as restrictive rotas, workplace violence and flexible working, dealing with such issues might prevent those doctors who secured speciality training places from moving abroad once their training is completed, ensuring taxpayers money isn't wasted.

And doctors whose experience is local and relevant remain in NHS service. But turning to the Bill in detail, we have concerns about clause 71, which allows Ministers to change eligibility for prioritisation through the negative procedure, enabling sweeping changes as to who can access training places without proper parliamentary scrutiny. Given the scale and sensitivity of NHS workforce. Excuse me workforce pressures such decisions must not be made behind closed doors or at the whim of a future health secretary who may have less desirable motives than the current one.

That is why the Liberal Democrats have tabled amendments requiring Parliament to approve any future changes through the positive procedure. We've also troubled by the government's decision to apply the new rules partway through the 2026 speciality recruitment cycle in 2026. The bill allows for prioritisation at the office stage for medical speciality training places. I'd like the Minister to clarify, please. In her closing remarks, does this mean that international doctors already working in NHS who've paid for exams secured visas may be uprooted? Their lives and their families would suddenly be pushed to the back of the queue? Mid cycle.

These doctors keep our hospitals running. Today they entered the system in good faith and it seems unfair to change the rules. Midway through the process. I'd be grateful if, in a closing remarks, the Minister could outline the expected impact on NHS service provision. If those people who have been deprioritised during the application process decide to leave en masse and provide reassurance to my constituents in North Shropshire, that patient safety and patient outcomes won't be affected, Liberal Democrats will prefer implementation to begin in 2027 at the interview stage, and protecting both fairness and patient safety.

I wonder if the Minister might also elaborate on the impact of the bill on universities, which offer medical degrees elsewhere in the world? I think we have all been contacted by Queen Mary University and the implications are potentially serious, where if graduates who are undertaking an identical GMC registered UK medical qualification and NHS training and have always been considered UK graduates are suddenly have their expectations changed? As I've mentioned, retention is just as critical as recruitment, but unfortunately outside the scope of this limited bill in the year to September 2023, 10.7% of NHS staff around 154,000 people left their roles.

Burnout is rife, morale is low, and too many staff are working in buildings that are crumbling around them. We've been contacted by GP trainers, worried that the doctors they are currently training plan to leave for Australia or Canada as soon as they qualify. The promised workforce plan must address this problem to international comparisons. Lay bare the scale of the problem. England has just 3.2 doctors per 1000 people, well below the OECD EU average of 3.9. We would need 40,000 more doctors to meet that benchmark.

Prioritising UK graduates is sensible but will not on its own, deliver the workforce. Patients urgently need. That's why Liberal Democrats have tabled an amendment requiring a speciality by speciality workforce assessment, shortages of acute and general practice, radiology, cancer care, mental health and more. And transparency is essential if training places are to be directed where need is greatest. It's neither right nor remotely sustainable that at a time when patients struggle to see a GP, qualified GPS are unemployed. Yet that is happening now, with vacancy freezes and financial pressure creating an NHS where shortages sit alongside unemployment.

The government's decision to raise national insurance is only exacerbated the problem, forcing some practices into layoffs or closure. In my North Shropshire constituency, several GP practices have described to me how they cannot take on additional doctors because they are constrained by the outdated physical space in which they operate. The Liberal Democrats would fund 8000 more GPS, ensuring every patient can see a GP within seven days or 24 hours if it's urgent, because you can't fix the NHS without fixing the front door.

Madam Deputy Speaker, NHS staff are the backbone of our health service. They deserve better working conditions and a fair career path. We will continue fighting for an independent pay review body for safe and modern buildings, for flexible working from day one, and for practical support such as reduced car parking charges. So staff are not penalised simply for turning up to care for us. We will always stand up for our NHS and for the people who make it work. While we support this bill, we will push to ensure that its inflammation implementation strengthens our health service as much as possible.
16:43
Jack Abbott Portrait Jack Abbott MP (Ipswich, Labour )
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Thank you. Yeah. Jack Abbott. >> Thank you. Yeah. Jack Abbott. >> Thank you, Madam Deputy Speaker, and it's a pleasure to speak in support of the Medical Training (Prioritisation) Bill. This bill goes to the very heart of the future of our National Health Service, the doctors upon whom our Service, the doctors upon whom our health service so crucially depend. And this bill is about fairness, protecting taxpayer money and building a home grown NHS workforce. Sustainable for the long term. It is about making sure that those who have trained here have the opportunities to become the next generation of doctors working in our health service, but every year it is becoming harder to get a training place.

As a graduate of UK Medical School for both foundation and speciality training programmes since 2019. Competition for postgraduate training places have increased by a staggering amount. In 2019, there was around 12,000 applicants for 9000 places, but in 2025 the situation became even more stark. There are now more than 30,000 applicants, over 12,000 UK trained doctors and nearly 21,000 overseas doctors who are still competing for less than 10,000 places. That is an enormous and unsustainable change.

And for some specialities, the competition is much, much fiercer. The aspiring neurosurgeons, for example, had to compete against 26 others to secure a place, and there were 737 applicants for just ten cardiothoracic surgery training places. And these aren't abstract statistics. And behind every number is a person who spent years training, often at great personal and financial cost, only to find their opportunities for career progression drying up. Some take time out, some seek experience abroad, and some leave medicine altogether, and many do not have a choice.

They forced by a system that has become so congested that getting a training post in something you are passionate about and trained in is completely unattainable. And every time a doctor leaves the NHS, there's no guarantee that there will be coming back. The Secretary of State, I know, is incredibly committed to increasing medical school places, and we desperately need more doctors. But we have to be honest with ourselves. We cannot expand medical school places without addressing the growing crisis of competition for training places, and it is within that central context that the Medical Training (Prioritisation) Bill must be understood.

And now there's been a direct correlation between the lifting of visa restrictions in 2020 under the Conservatives and the dramatic rise in competition for foundation and speciality training posts. And maybe that was one of the Conservatives Brexit bonuses that they so eloquently talked about. Now this needs to be addressed. Otherwise, we risk training doctors for a system that cannot support them. We're recruiting doctors from abroad at a time when there is already a substantial pool of eligible applicants who have trained in the UK or already working in the NHS, and that cannot be right.

General practice is particularly reliant on international doctors, as has already been mentioned by my hon. Friend, with half of the first year trainees having qualified outside the UK in 2024. But let me be clear, because this point matters enormously. International medical graduates have always played and will continue to play a vital role in our NHS, and many of our hospitals and services simply could not function without them. And this bill in no way diminishes that contribution, nor does it seek to close the door to international talent.

But this bill does ask fair and reasonable questions. When we were spending almost £4 billion every year to train doctors in the UK, is it right that those doctors are increasingly unable to access the very training that they need to progress? Is it right that huge amounts of taxpayers money are spent training doctors, only for that investment to be lost when doctors are forced out of the system, or choose to go over to go overseas or into the private sector. And again, if we're honest with ourselves, how progressive is it really that we poach doctors from other countries which desperately need them, while we have our own brilliant and willing recruits who can't get jobs here? So if we are serious about building an NHS that is stable, resilient and fit for the future, then we must be serious about retention and recruitment too, so that we must ensure that those we train are able to stay specialised and build careers and lives here at home.

Because what is the alternative? We train thousands of talented, hard working young people at significant public expense, only for them to hit a wall, feel undervalued and either leave the NHS or leave medicine altogether. And every doctor we train in the UK who chooses to leave is an enormous loss for our health service and our country. It is such a waste. It's a waste of talent and it is a waste of money, and we cannot afford to lose our next generation of doctors.

The future of the NHS depends on it and yet this is where we are headed. Unless we do something now and it is urgent, prioritisation is not about exclusion, it is about safeguarding public investment and guaranteeing the long term sustainability of our NHS, NHS workforce. It's about making sure the NHS remains an attractive place for young doctors to build a career, and it is about making sure doctors in this country feel valued, something the previous conservative government failed miserably on. This bill sends an important signal to the young people in this country considering a career in medicine.

We want you to build a long and fruitful career right here in the UK, in our NHS, it says to all those currently picking their A-level options of deciding whether they want a medical degree is right for them. Your hard work will be rewarded and we want you to succeed. Yes, this this bill alone is not a silver bullet. It will not solve every workforce challenge facing our NHS overnight, but it is a sensible and necessary reform that will go a significant way to dealing with a deeply concerning and growing problem.

So if we care about the future of our NHS, then we must care about the doctors in it, and we must care about the doctors who will sustain it in the years to come too. Therefore, for the sake of our future health and viability of our NHS, I urge all members to support this Bill here.
16:49
Ben Spencer Portrait Dr Ben Spencer MP (Runnymede and Weybridge, Conservative)
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Gloucester Ben Spencer. >> Thank you, Madam Deputy Speaker, and I'll start by doing a sort of what is traditional declarations in that I'm now a non-practising that I'm now a non-practising doctor and my wife is a doctor. And I'd like to start by thanking the Secretary of State for his comments Secretary of State for his comments and thinking through some of the content of and the merits of my new clause two regarding allocation based on merit. I hope he does. As this goes, this bill proceeds through this place and any other place.

He continues to focus on that, because I think these are very important points for my Second Reading speech. I'm not going to focus on the details of new clause two. I'll hold that back to the Committee stage. Instead, I wanted to to make some more general comments. In a sense, I think this bill treats the symptoms of what has been happening in medical workforce. I don't think it's a cure for the fundamental disease or problems which we have over the years, which in part are down to a, I think, a creeping deep professionalisation of the medical profession.

But I also think it's down to the way that we've approached doctors, we've approached their appointment to placements, we've approached how we assess their skills and their CVS, and how these then lead to different appointments in different places. The fact that doctors are really thrown from pillar to post, in terms of being subject to the whims of a computer or a training programme, one of the most important things in people's lives, I think, is, or at least what gives most work satisfaction time and time again comes out as being shown as autonomy.

And unfortunately, we've slept walked into a situation where in pursuit of a weird sort of type of furnace in terms of allocation of jobs, one that work towards more equality of outcome as opposed to equality of opportunity, doctors have found themselves unable to to be able to, to compete and have a lot more control over their lives. And this this has real material impact on people. You know, where you are allocated to your foundation school, where you're allocated to your speciality training.

But crucially, within those allocations, you could the geographical regions are, are are huge. And that would mean uprooting, moving your family, your social network and within a training scheme. There really is no power that a doctor can exert in terms of choosing preferences. It used to be my understanding because I I'm a creature of NMC and Mtas in terms of when I was going through and applying for posts that we let doctors just competitively apply for different posts and put together what was a sort of portfolio of CV.

And that all changed in terms of this allocation. Now for training programme schemes and these national contracts, something which I've been campaigning for now for quite, quite some time. Quite some time. Don't get me wrong. You know, I think the way that they behave is absolutely appalling. I categorically and unreservedly condemn the the approach that they've taken, not just in this government, but in terms of previous governments over various disputes over junior doctors. But I think the fact that the doctors have found themselves in a situation where they need to have a militant trade union, I think is a consequence because the training schemes and training programmes, national contracts, don't treat doctors as professionals when it comes to applying and going for jobs.

And it also means that the training providers, the trusts, the IX's can't provide options that doctors might want or want to be able to compete for. So they can't say, well, you know what? We're really good research unit. And so we're really going to have an offering that is to try and pursue a certain type of doctor who wants to go down the academic pathway. We can't have we don't have medical, we don't have, you know, trusts or regions that can say, well, actually, this is an area where there's quite a lot of socioeconomic deprivation.

So we want doctors who are interested in subspecialities, but also, you know, for for all sorts of different reasons, there's parts of the country which are oversubscribed and parts of the country which are undersubscribed. We can't use what we use in every other walk of life, which is changing remuneration to encourage people to go to replace us. We can't also say, you know what, let's look at flexible working arrangements. You know, as part of my medical school rotations, I was in Barnstable.

And, you know, I could only imagine, just like Barnstable, if it had recruitment challenges. And I don't know if it does or it doesn't, you know, whether people are into surfing and making sure that people could get involved in other activities outside of medicine, because medicine is important. But there's, dare I say, as a as a former doctor, more important things than people's careers in terms of particularly looking at work life balance. We have a system that doesn't enable this to happen. And I think the behaviour of the BMA is, in a sense a consequence of this dismantling of what I would see as normal human experience and approach to the selection and the allocation of jobs.

This has real consequences locally. So my local trust, Ashford Saint Peter's struggle to recruit because of the proximity to London, which has London waiting. And since we are on the border of London, if you're looking purely financially, it makes more sense just to pop into London and work there. If that's the main priority, then then being employed in my area. And by the way, Runnymede and Weybridge as house prices, which are equal to a big chunk of London, we have cost of living, which is equivalent to a big chunk of London, but there's no approach to regionalisation.

So what I would say to Secretary of State, and I'm really glad that he's in his place to hear my my contribution today, something I've said to many previous Secretaries of State when he is in these difficult negotiations with the BMA. I'm hearing from doctors about the challenges and the real workforce experience, challenges that they're having. Wouldn't it be better if we trusted doctors and for that matter, I think anyone who's subject to a national contract to make decisions for their own lives, and we devolve decisions around pay and teas and sees to a certain form of regional unit for medicine, the obvious solution would be this.

But you could have different solutions in terms of, you know, ways of going an approach. I think the ICUs devolution would make most sense, but there's other ways and opportunities of doing so. That way it moves out of the government essentially getting stuck in the middle of doctors who are making difficult decisions about their careers, having to balance and judge different T's and C's of work and the employer, which is different. NHS trusts being unable to use normal mechanisms that any other employer would do to incentivise and recruit people coming in.

If we don't do that, the consequences, unfortunately, are bills like this that we're debating today ever increasing state intervention to try and in the absence of a market system, impose a command economy. And I know he would have seen this as well in terms of issues, in terms of dealings with locum doctor prices, the fact that we have and struggled with high locum payments for so long is because we do not allow the doctor employment market to resolve itself through adjustments in contracts.

I think as a system we would save a huge amount of money overall if rather than having a huge amount of money going for locums and we suppress, we have a sort of national contract system for doctors. We let the market sort it out. So I'll finish with this. I will support this bill. However, I see this more as palliation as opposed to a definitive treatment which we need to solve the workforce problems going forward and address.

**** Possible New Speaker ****

Lewis Atkinson. Thank you. Madam Deputy Speaker. I welcome the government bringing forward this legislation, not just forward this legislation, not just in response to the significant current concerns that doctors have today about access to training today about access to training places, but also is an important part of the reset and reset longer term approach to ensure that we term approach to ensure that we have an NHS workforce that's fit for the future. I'm going to go off script before I start and just
16:58
Lewis Atkinson Portrait Lewis Atkinson MP (Sunderland Central, Labour)
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script before I start and just maybe respond, if I may, to some comments that the shadow Secretary of State made and you rightly point out that this bill is about prioritisation, not capacity, immediately, but in pretty much week 1 or 2 of NHS managers school, the one of the core techniques that you're taught is about capacity and demand modelling and the capacity of our medical workforce going forward is a fundamental assumption around that is the retention, how long they will work over the course of their careers.

And the GMC are absolutely clear that an international medical graduate will, on average, work for a shorter period of time than a UK medical graduate in the UK. They are more likely to leave. So I would suggest that it is entirely sensible that the government is bringing in this legislation now in advance of its NHS workforce planning, because this fixes a core assumption of that, because, you know, I've been in a situation managing cancer waiting lists and being at fear of the lower GI oncologist in short supply who's getting on announcing their retirement and not having a clear succession plan, and knowing that I've got a list of patients that I'm responsible for the performance of their.

So this bill to me is not just the right thing to do, but it provides absolute clarity around medical capacity going forward that will allow the government to do the proper capacity and demand work that it needs to do to to build the NHS of the future. Yeah, in terms of the immediate situation, I've heard the views clearly expressed by medical graduates in Sunderland and across the country about the bottlenecks they face when trying to secure foundation and speciality training places.

Many are left in prolonged periods of uncertainty, unable to progress despite years of study. Now we risk talking about trainees here and giving the impression that the contribution that these talented young people make is all, will all be in the future. Where of course, in reality, the trainees people in training positions provide a huge contribution of direct service to the NHS. Today they form the core of medical workforce in hospitals up and down the country. And again, when I was an NHS operational manager, getting to know the new rotation of core, foundation and speciality training doctors every time as they rotated around wasn't just a lovely thing to do to meet inspiring and motivated young people.

It was also hugely important because the care of the patients on a day to day basis, that in the specialities that I was responsible for, was largely provided by those people in those training courses. But it also highlighted to me that experience how over over a decade over the under the last government, there was a total failure to put in place a proper care and a framework for those foundation and speciality doctors which left UK trained doctors competing in increasingly crowded pools.

And the the Secretary of State has given some of the numbers already. I mean 20, 25, over 30,000 doctors competing for just 9000 5500 training posts. That is not a system that shows proper regard for the commitment of medical graduates for their wellbeing, let alone one that is designed to meet the future needs of the country or the NHS. We invest hundreds of thousands of pounds training each medical student, but too often we fail to retain them. That represents not only a loss of talent but a loss of public investment.

But I think it's important, as others have already, to put on record, the recognition of the enormous benefit brought by medical professionals who've chosen to come to the United Kingdom and dedicate their careers to the NHS. And I know that will continue even after this legislation. Healthcare is a team sport, as I always say, and when you're working in a team and under significant operational pressure, my experience is the commitment of everyone to go the extra mile no matter which country you trained in, no matter what nationality you are, is always exemplary.

And that's the case throughout the NHS that I know. The contribution of international medical and indeed wider clinical staff to our NHS is invaluable and it must never be diminished or forgotten and I know that will continue, but it's important. So it's important that the discussion of this bill does not is not interpreted as a slight on their contribution or commitment, but on aggregate, as I've said, the GMC has been clear that international graduates are essential to the functioning of our health services.

They are statistically more likely to leave the UK workforce within six years of joining, compared to those who train here. And that reality makes clear the level of risk and overreliance on the current system that's unpredictable and ultimately unsustainable. So this bill to me is about balance. It's not about exclusion. It's about ensuring that the significant public investment we're making in training doctors in this country translates into a stable and sustainable workforce for the years ahead. So I want to talk a little bit now about the importance of medical workforce reflecting our society.

And of course, everyone.

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I'm just very conscious and others will know it. And I brought this up number of times in the this up number of times in the chamber and has to do with Wales as an example, where they paid the student fees and they train them, and then they give an obligation to and then they give an obligation to stay with the Welsh Health Service over a period of time. And one of my constituents did that and I know my constituents did that and I know her well.

She went there and she did it and she stayed. And what happens, of course, Madam Deputy happens, of course, Madam Deputy Speaker is she meets someone in in Wales who she falls in love with, and then she wants to stay there. So we lose her in Northern Ireland. But the point I want to make is this if by paying the fees it retains the staff, is that not something not just a Wales should do, but indeed that Northern Ireland should do? Scotland and England within this Bill, and that

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we have before us tonight. I think, the hon. Gentleman for his intervention. And I think there his intervention. And I think there is some merit in that, not just for medical training, but for across medical training, but for across the clinical workforce as members of acknowledged, we pay significant amount of public sums training clinical staff. But but the graduates themselves incur graduates themselves incur significant student debt. If a UK trained undergraduate student decided then to go abroad, the UK taxpayer has invested a significant amount in their training that's lost.

It's it strikes me that there is an opportunity somewhere for the government to to think about as part of its wider workforce planning, how that could be balanced in the sort of incentives that he describes. I think that's also pertinent to my next point around the importance of a medical workforce reflecting our wider society. And that's, I think, particularly pertinent in the working class communities of the North east of England. I want to make sure that a young person doing well at state school in Sunderland has as much encouragement and access to get in, to study medicine and, crucially, to then progress through the ranks to the highest grades as much as anyone else in the country.

And we've heard some talk of international medical schools, I can I can absolutely assure the House that there are not state school educated kids in Sunderland thinking that they're going to pay privately to study in Grenada or anywhere else, for that matter. And as the Secretary of State rightly pointed out, when we talk about diversity in the NHS at the moment, while there has been welcome improvements, that diversity, often we fail to consider socio economic background in that the first line of the NHS Constitution states the NHS belongs to the people, but sometimes it can feel like it's staffed by a pretty unrepresentative slice of the people, particularly in medical roles.

In that spirit, I want to recognise the excellent work of the University of Sunderland Medical School, which has placed widening access at the heart of its mission. Building on a 100 year history of wider clinical training, the school opened in 2019, shortly before the Covid-19 pandemic, a period that starkly exposed our overreliance on overseas recruitment and underlined the importance of growing our own workforce. By 2022, 40% of the University of Sutherland's intake were local students, and it now ranked sixth in the UK for student satisfaction.

But it's no good. Universities like mine doing that excellent work at widening participation at recruitment stage. If then when we get to special foundation training and speciality training, those students are disadvantaged in competition. So in my view, this bill will help ensure that talented talent nurtured by institutions like Sunderland is retained and prioritised for the benefit of our NHS. I'd also just, I think, highlight that increasingly, medical schools like Sunderland are placing a huge emphasis on training their medical students in a multidisciplinary environment, alongside the trainee nurses of the day, trainee pharmacists of the day, etc.

so they're prepared to work in multidisciplinary environment that our NHS rightly demands. I'm not sure that's always the case. As advanced in all international undergraduate courses. So I think it's right that this a UK based training approach, is prioritised to ensure that multidisciplinary ethos that we that we have in the NHS is prioritised in the future. You know, other colleagues have mentioned the wide variation of special specialist training fill rates and GP recruitment has been mentioned as part of that.

What I think is also worth saying is that those national statistics about speciality training are must really significant regional variations as well. The GP speciality training fill rate has been as low as 62% in the northeast of England. And when, as we've heard, over 73% of applicants for GP speciality training were international in 2023, doing something about that has a disproportionate effect in regions like mine. My constituents want to have the confidence that there will be a long term, stable GP workforce that will be part of our community and live as part of our community for a long term.

I cannot tell them in all candour that the status quo delivers that, and I think we must make changes of the type that this bill sets out. So I hope that by introducing effective, regulated and strategic and training pathways, this bill can improve retention, strengthen workforce planning in our communities, including in areas such as women's health where demand is rising but training provision has not kept pace. And when I look at the shape of the NHS elective waiting list. It's no coincidence to me that some of the trickiest waiting time problems, for example in specialities like Gynae, coincide with areas where we've had particular recruitment and training challenges in recent years.

So, Madam Deputy Speaker, I will close with that. But in closing, I would just re-emphasise again that link between capacity and demand that I hope the Minister can absolutely give some words to about in advance of the workforce plan, and maybe she could say a little bit as well about the medical training review, that phase, one of which reported recently in NHS England, and how the department will continue to

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work with that. Thank you Katie Lam. Thank you, Madam Deputy Speaker.

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Thank you, Madam Deputy Speaker. The NHS has a deeply unusual setup when it comes to its workforce. The government sets the rules for who can qualify as a medical can qualify as a medical professional, decides how many medical training places to offer and controls the flow of medical and controls the flow of medical graduates into the NHS. It decides how much to charge medical students and under what conditions. And and under what conditions. And since the NHS is by far the country's primary employer of medical professionals, the government also has effective
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Katie Lam Portrait Katie Lam MP (Weald of Kent, Conservative)
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control over the pay and conditions of those who qualify, and is responsible for deciding where responsible for deciding where medical trainees go and when. As a result, the health service workforce is not subject to the same labour market conditions as same labour market conditions as other organisations. The government controls both the supply of and the controls both the supply of and the demand for its own workforce, so it is very welcome to see this legislation before us, which legislation before us, which rightly gives priority to British trained doctors for NHS training posts, particularly at the early stages of their career.

Those who decide to practice medicine in this country should have reasonable confidence that if they wish to do so, they will be able to build a career here. This bill goes some way towards addressing the current situation in which British trained doctors are being squeezed out of the system in favour of overseas recruits, despite the fact that the government controls both the supply of new British graduates and the number of training places in 2025, 15,723 British trained doctors were set to compete for 12,833 NHS training posts.

This is already a competitive environment, but the NHS is focussed on overseas. Recruitment meant that those British trained doctors were also forced to compete with another 25,257 overseas trainees. It is clearly absurd that the British government should restrict the number of training places offered, while also increasing demand for those places through a policy of overseas recruitment. Having spent hundreds of thousands of pounds to train each medical student in this country. This is particularly true when we know that doctors trained overseas are two and a half times more likely to be referred to the GMC by their employer than doctors trained here.

Many overseas recruits are hard working and well-meaning, and many are excellent at the work that they do. But we must be honest about the fact that relying on overseas recruits instead of training more medical professionals in this country is not always a like for like swap. Both medical trainees and patients would benefit from a system which trains more doctors here and ensures that those British trained doctors are given a reasonable chance at moving quickly into an NHS training post. That system should also reward ability and allocate training posts based on merit.

The current system of random allocation not only fails to reward our most talented medical graduates, but also creates profound uncertainty for those at the start of their careers. Last summer, one of my constituents qualified as a doctor. He graduated with one of the very highest marks in the year, in the top three from one of the most competitive medical schools in the country. He is clearly an outstanding student and will make an incredible doctor. In any sane system. He would have been placed immediately and been able to choose his location and specialism, to keep him incentivised and happy within the NHS, and to make the most of his obviously considerable talents.

Instead, because of the mismanagement of places and the lottery system, he wasn't placed at all in the first round of allocations. He wasn't placed in the second round, he wasn't placed in the third round or even the fourth. With less than four weeks to go, he still had no placement and no sense of where he would be spending the next few years of his life, including whether he might be able to live close to his partner, who was also a doctor, and also graduating with him.

This is an insane way to treat our most brilliant graduates, so I hope that the government will change its mind and amidst its other good changes, accept the amendment proposed by my hon. Friend the Member for Runnymede and Weybridge, which I have also signed, to ensure that training places are in future allocated on the basis of merit. If this Bill aims to provide certainty to British trained doctors that they will be able to build a career in this country, which is a noble aim, then it should also recognise that the current system of randomly allocating training places is one of the biggest causes of uncertainty in our system.

It would be far better for both doctors and patients to have a system which instead prizes excellence, providing a clear basis on which medical trainees can be allocated, and creating a system which rewards the most talented graduate doctors. It is right that the health service prioritises British trained doctors. It is also right that across every area of the public sector, we

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reward talent, effort and merit. Julie Minns. Thank you, Madam Deputy Speaker, and can I place on Deputy Speaker, and can I place on record my interest? I am the mother of an NHS nurse. It is a privilege of an NHS nurse. It is a privilege to speak in today's debate and to do so on behalf of my Carlisle constituency, which I am very proud constituency, which I am very proud to say has recently taken a transformative step with regards to medical training.

With the opening of the Pears Cumbria School of Medicine, this new graduate school of medicine is being jointly pioneered by Imperial College London and the University of Cumbria, and I would like to put on record my thanks to Professor Martin Lupton, Professor Mary Morrell and Professor Brian Webster Henderson, whose vision the medical school is, and to Sir Trevor Pears and the Pears Foundation, whose generosity has made their vision a reality. As with the Medical Training Prioritisation Bill before us today, the Pears Cumbria School
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Julie Minns Portrait Ms Julie Minns MP (Carlisle, Labour)
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of Medicine purposefully prioritises home grown talent. The school also seeks applications from students from non-traditional backgrounds, encouraging applications from groups less well represented in medicine and as part of the school's commitment to widening access. The four year graduate programme does not have any GCSE or A-level requirements. any GCSE or A-level requirements. The reason for this approach is simple it stands the best chance of year in, year out, generation after generation. Carlisle and Cumbria producing our own doctors.

These doctors will often come from the surrounding communities in part because of where they are trained. They will be deeply committed to the local area and its people and in geographically remote areas such as ours, the ability to train and retain our own doctors is critical. Madam Deputy Speaker, this matters enormously. Cumbria faces some of the most entrenched health inequalities in the country, and we have struggled for years with recruitment and retention across both primary and secondary care, and our hospital trust relies heavily on locums.

We know all too well that the traditional model of medical education, centred on large metropolitan teaching hospitals, simply does not produce or attract the workforce that rural areas like mine need. Which brings me back to the bill before us today. The government is right to prioritise UK graduates for foundation and speciality training places. This bill represents a significant and very welcome step towards restoring confidence in the training pipeline. Addressing the growing mismatch between the number of medical graduates and the number of available posts, and ensuring that those who have invested years training in our NHS are not left without a route in which to progress.

It is a sensible, fair minded reform that will bring much needed stability to a system that has been under real strain. But for Carlisle and Cumbria, the issue is not only who gets priority, it is where the training posts are located. At present, although foundation training can be delivered locally, it can only be delivered where accredited F1 and F2 posts exist. In Cumbria, the number of those posts is limited. North Cumbria Integrated Care Trust is able to provide places for some foundation trainees, and others will find F1 and F2 posts in primary and community care settings, but further accredited places will be required at foundation level.

And I would ask the Minister in her response, to explain not just how the new powers will prioritise UK medical graduates and members of the priority group, but how the powers might be used to widen the availability of accredited F1 and F2 posts in areas like Cumbria, where there is a shortage of doctors. Even if we successfully retain Pears Medical school doctors in Cumbria for their foundation programme training the risk of losing them when they come to their speciality training programme is even greater because doctors overwhelmingly will choose to settle near to where they complete their training, particularly their specialist training.

And Cumbria will never be able to provide every speciality training pathway within the county to retain our home-grown talent. We simply do not have the population size or the case mix to deliver all specialisms in our trusts. However, it does not mean that we cannot design a system that keeps trainees connected to Cumbria throughout their training, and I therefore urge the Minister to look at how the regulation regulation making powers granted by this bill can address this. Pears Medical School believe a new approach to specialist training is the way forward, and I've recently written to the Secretary of State seeking a meeting between himself and representatives of the medical school to explore this approach, and I very much hope he will soon accept that meeting.

I also ask Ministers to look seriously at how speciality training can be structured, so that trainees who complete F2 in Cumbria are supported to remain based in the region, even if their specialist rotations take them elsewhere for short periods. That could mean funded return to base arrangements. Rotational models anchored in Cumbria or formal partnerships between specialist centres in UK cities and community providers in Cumbria. In other words, we need a training pathway that allows people to specialise with Cumbria, not away from it.

Because if we do not do this, if we allow the system to pull trainees out of Carlisle at the very moment they are beginning to put down roots, then we will simply recreate and repeat the cycle that has left rural areas like mine short of doctors. For too long, the Cumbria the Pears Cumbria School of Medicine is a once in a generation opportunity to reshape the medical workforce in Cumbria, but it will only succeed if the training programmes are aligned with its purpose.

So, in welcoming the Bill, I urge Ministers to please ensure that it's the implementation of this bill meets the requirements and needs of remote community communities. Prioritisation is important, but place matters too.
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Layla Moran Portrait Layla Moran MP (Oxford West and Abingdon, Liberal Democrat)
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be staying here. And I understand also why we have to expedite this. Talks with the BMA are ongoing. We know that we want to avert strike action. I sincerely hope that they and all resident doctors are hearing this debate, are seeing how Parliament is listening to them. And I hope together we can avert further industrial action. It has done nothing to help the recovery resident doctors and students who are going through this, it's not technical at all. It is their real lives that it's affecting.

Marco and Oxford's medical student wrote to me last year saying he was, and I quote, particularly concerned about the prospect of unemployment from being unable to secure a training position. He pointed out that countries like Canada, the US and Australia always already had structured approaches, and in England we've been failing, falling behind. And another constituent, Yasmin, said I studied for six years and graduated with over £70,000 worth of debt. I completed my foundation programme in a crumbling district general hospital, where I was routinely overworked and trying to care for patients in corridors under conditions that, frankly, felt unsafe.

I worked extremely hard to provide the best possible care. Yet despite these circumstances, despite these circumstances, and yet now, after two exhausting years, I find myself unemployed. Yasmin told me that many of her colleagues had been forced to take nonmedical jobs simply to survive working in administration, hospitality and other sectors, and some never will return to medical practice at all. So if our brightest and most committed young doctors are worried about unemployment or leaving the profession altogether, then clearly the system is fundamentally broken and needed reform.

So this bill is a necessary step. But we also need to be mindful, notwithstanding the good reasons why we're bringing and supporting this today, that there may well be unintended consequences and that it's implemented fairly. And so I'm particularly concerned by the impact on overseas doctors who have already made significant life decisions based on the rules as they currently stand. Lamia, one of my medical many medical graduates in my postbag this week said over the last two years I've organised my professional life around the UK's published requirements completing examinations, securing GMC registration and investing significant personal and family savings, even incurring personal debt.

I also declined a stable job opportunity abroad to focus on the rules as they were based at the time. She points out that to then suddenly change things retrospectively, she feels, is an injustice. So the sooner that the government can clarify what significant experience means, and perhaps in her remarks, the Minister might make an indication as to what they're looking at. Is it one year? Is it two, is it five? Is it ten that can start to have an effect on people's future life choices? There's also the issue of overseas campuses.

On British universities. We've heard from a number of people already on this point. Graduates from institutions like Newcastle University, Medicine Malaysia, Queen Mary University of London in Malta and Saint George's in Cyprus are excluded from the Bill. The Vice-Chancellor of Newcastle University, Professor Chris Day, wrote to me saying that these graduates complete the same medical degree, receive the same, receive the same accreditation and the majority then go on to train and work in the UK. As these students studied in English to UK standards, they transition into the NHS quicker and effectively compared to international counterparts, and the point he makes is that they are incredibly effective very quickly within the NHS.

Now, I heard the Secretary of State explain why these students are being excluded. They cannot determine how many places they will provide. But to flatter my friend from the committee, the Member for Chelsea and Fulham, who isn't here but I know will appreciate the flattery. He's absolutely right. We could and the Minister could tightly draft an exemption just for those who've already started. Now, I heard what the Secretary of State said about, you know, the terms and conditions on the website.

Never guaranteed. But come on, guys, we all know how this works. If we've bought a product, understanding that for years and years it worked a certain way, and then halfway through it changes. Given that it could just be a year or two while this washes through the system that those who had made the commitment huge amounts of money in good faith, thinking that this would help, I do think that there could be some movement here, just for a small, a relatively small number of people, and it would, in a couple of years time, wash through the system.

I hope the government is just listening to those voices. I'm not sure it's a necessary battle and can be sorted in future regulations down the line. Now, as I raised the other concern I have, and I've raised this with the Minister, but also to the Secretary of State directly in that statement before Christmas, when we were talking about the strikes, is I am concerned about the signal this is sending to our overseas doctors, and I think we need to. The more that we can all say this, the better.

They are absolutely critical to our NHS. Last week, the GMC CEO, Charlie Massie gave evidence to the Health and Social Care Select Committee and was clear doctors who qualified overseas make up around 42% of the medical workforce. Now, of course, that's not this number, but any even small proportion who now might not want to work in our system will leave gaps that we simply cannot fill. And any conversation about prioritising UK graduates should also explicitly recognise the immense contribution that they make.

So I want some concrete answers on this. Yes, we can keep saying it, but is there any measure that's going to be put into place? How are we going to show our appreciation? We must bear in mind that these are highly mobile individuals to have come here in the first place. And I understand, you know, there's the mantra this is prioritisation, not exclusion, but in effect, if they find themselves excluded from some of the more popular specialisms, in particular, they may decide that they would rather leave the country and pursue that specialism elsewhere rather than stay and be part of this country.

We need them. And so there are unintended consequences potentially in the short term. My question specifically is has there been any modelling done? How have we have we worked out how this might feed through the system if it's negligible? What does that mean in concrete terms? Our concern as a committee is that even a small number could have adverse consequences down the line. And then the very final point I want to make is on that workforce plan. I'm confident our letter to the Minister is on her desk and I hope will be soon expedited.

It would be better just to flesh out some of the detail the Secretary of State set out today what the delay is. He says spring, let's we know that these things change, but just exactly what is happening behind the scenes so that we can get an understanding of what are the issues that are now being incorporated that weren't before. I would agree that we've got to get this right, and it's not right. First time. We've had so many workforce plans already that I understand why there is scepticism in the Royal colleges and elsewhere that, you know, this is the one that's going to work.

So absolutely, let's get it right. But in the interim, while making changes like this without the bigger picture, then I fear that we're going to end up doing more damage. And this comes at a context of England. We've got 3.2 doctors per 1000 people, OECD average is 3.9 is 4.5. In countries like Germany, the BMA estimates we need another 40,000 additional doctors. And so the 4000 places announced by the Secretary of State doesn't even begin to get there. But the other issue, of course, is the leaky bucket.

It's retention. Every time I meet anyone in the sector when they say, how do you solve the workforce issue? I understand why the government focuses on training because it's the thing they can affect. You know, they can actually dial that up. Well, it won't be down, but it'll dial it up and up and up and up as they can find them. But the thing that really matters here is retention. And so to have the context, having a conversation about training places and inputs, when you're essentially turning on a drip, drip of a tap, when you've got a big old hole at the bottom of the bucket and you just have to look at GPS.

So we had a session on shift to community. And boy, if we're going to deliver the shift to community, do we need home-grown doctors as part of it? Totally get that. A third of GPS saying in a Royal College GP survey might leave in the next five years, stress being the leading factor, 44% citing unmanageable stress and 73% saying safety as the result of the high workload. Patient safety being another thing causing them moral injury that is mimicked across all the different specialisms and absolutely is something that we need to address.

Not for this bill. I appreciate, but it does have a material effect on whether or not this is actually going to solve the problems that the government says it does. So I'll simply end by saying, welcome this bill. Urge the government to think again on the overseas campuses, even in a short time, limited, very tight way. But let's make sure that we also end again by saying how much we value our international doctors, how much we want them to stay. And I, I'm looking forward to hearing more from the Minister rather than just warm words.

I'm sure she'll provide. But what else could we do to make sure that they believe that the NHS is a place where their career can thrive, not just make it slightly more bearable than it was before? Because we all want the NHS to succeed. I'm sure they do too, and want to stay and be part of it.
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Jen Craft Portrait Jen Craft MP (Thurrock, Labour)
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Jen Craft thank you, Madam >> Jen Craft thank you, Madam Deputy Speaker. People are the backbone of our NHS and I'm incredibly grateful to all the healthcare staff who work in our NHS, particularly in Thurrock, who care tirelessly every day, often in difficult conditions for my constituents. As a lifelong Thurrock resident, I've experienced their excellent care as a patient and now as an MP. I can see firsthand when visiting services in our area that despite the immense pressure they are under, they perform all the time to a high level.

This bill is about supporting our excellent NHS workforce, prioritising home grown talent to ensure there is a pipeline for the next generation of fantastic doctors and nurses. It is right this is introduced as emergency legislation because the former government left the NHS in a critical condition. The Tories botched policies on immigration that saw students and junior doctors who study in the UK competing against the world for foundation and speciality roles. Visa and immigration changes mean thousands more international workers applied for coveted training positions in the NHS, and in 2019 there were 12,000 applicants for 9000 speciality training places.

But that figure has now soared to nearly 40,000 applicants for 10,000 places, with twice as many overseas trained applicants as UK trained ones. And these bottlenecks mean that we are losing home grown talent. We're losing people who grew up in our communities, studied at our schools and our universities and know our NHS back to front from personal experience because they move to jobs abroad or in the private sector. This bill begins to correct those mistakes. It implements the commitment in our ten year plan for health to put Home-grown talent at the front of the queue for medical training posts, ensuring that UK graduates are prioritised for foundation and speciality training places.

And it is a signal of this government's intent to improve terms, conditions and opportunities for doctors. A down payment on the tangible process offered in the deal. The BMA unfortunately rejected in December, and it marks a critical step in supporting long term sustainable workforce planning for the NHS. Ending our, let's face it, unethical addiction to hiring from abroad. And there's also an economic case. Each year we spend £4 billion on training up medical students and doctors, only to not offer these graduates a training place to continue their career in our NHS.

By ensuring we retain this talent, we ensure it is patients in the UK who benefit from this investment better for local doctors and better for the taxpayer. In Thurrock in particular, retention of staff is vital. We have a critical shortage of GPS and an acute hospital trust ranked among the bottom in the country. It has always been difficult to recruit doctors in our area, not least because if staff get a job ten miles down the road or even one mile in some cases down the road, they can earn significantly more.

Benefiting from London weighting. And last year I held a roundtable with local GPS and asked them why they chose to work in our area and how I can encourage more young doctors to make a base here. Many young people growing up in Thurrock say they would like to return home after medical training. They're ambitious to improve our NHS and they want to serve their community, they want to live and they want to work in the area they grew up in. Ensuring these graduates are prioritised to local places and have local career training, advancement and ongoing professional development would be absolutely key to unlocking a sustainable, long term workforce for our area.

So I urge the Secretary of State to use the opportunity that both this bill and the upcoming workforce plan affords to ensure that the right professionals are in the right geographic places to fill historic gaps in provision. And I would also urge the Secretary of State to use the upcoming workforce plan to ensure that training, recruitment and retention in all professional areas is considered and planned for, particularly in these professions, which are often so vital but often overlooked. Allied health professionals spring to mind, particularly in paediatric care, where waits for diagnosis often are felt acutely, such as speech and language therapists, physiotherapists, occupational therapists.

They all must feature, and I would like to add a personal plea to the unique and important role of learning disability nurses already under strain and which the charity Mencap, among others, warns could collapse in three years time without urgent government action. They are crucial in making sure that some of the most vulnerable people in our society receive safe, effective healthcare and in avoiding preventable deaths. So I really do welcome that. The I welcome that the Secretary of State has brought this bill forward today, and indeed, the efficiency and speed that it has taken to turning around this pace.

And I urge him to use the same efficiency and speed to bring forward the workforce plan, drawing on setting the right direction of travel to recruit home grown talent, retain Home-grown talent and train home grown talent. I would encourage the Secretary of State to bring forward the workforce plan as soon as possible to make sure that those vital gaps in provision are addressed to support our communities via our

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fantastic NHS well into the future. Gregory Stafford. Thank you very much. Madam Deputy Speaker.

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Madam Deputy Speaker. At the heart of this bill is a simple test. Does the bill improve simple test. Does the bill improve care for patients? Every delay in training, every cancelled clinic, every rota gap caused by workforce every rota gap caused by workforce instability ultimately lands on the patient. It means longer waits, greater travel distances and in too many cases, care that comes too late. Recently, I was contacted by
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Gregory Stafford Portrait Gregory Stafford MP (Farnham and Bordon, Conservative)
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my Farnham and Bordon constituent doctor R. I'll call her a UK doctor R. I'll call her a UK trained medical graduate. Like thousands of others, she completed her studies in good faith, her studies in good faith, expecting a clear and credible pathway into the NHS. Instead, she now finds herself in a system where now finds herself in a system where Non-training posts are disappearing. Competition ratios for training places are rising sharply, and the places are rising sharply, and the holding pattern roles that once allow junior doctors to remain clinically active while reapplying have all but vanished.

This is not a niche concern affecting a handful of individuals. It is a systemic failure that directly impacts patients. When trained doctors are unable to progress, fewer reach consultant and GP level in the years ahead. Services become overstretched, continuity of care is lost and waiting lists grow even longer. So that is why I support the intention behind the bill prioritising UK medical graduates, ensuring that the UK Foundation programme is genuinely delivered in the United Kingdom, and restoring confidence in the medical training pipeline are all necessary steps.

If we are serious about rebuilding capacity in the NHS for the benefit of patients. I have supported amendments to this bill because I think they strengthen those aims. They ensure that UK medical graduates are properly recognised as such, that training programmes are UK based in substance rather than in just name, and that the allocation of training places is grounded firmly in merit, clinical knowledge, aptitude and performance. Patients quite rightly expect their doctors to be selected on ability. Doctors expect fairness and those principles should command support across this House.

I also welcome the new clause tabled by my hon. Friend the Member for Runnymede and Weybridge, which addresses growing concern among doctors and patients about the erosion of merit based progression. When merit is undermined, morale suffers, and when morale suffers, retention suffers, performance suffers, and ultimately patient safety suffers. So, Madam Deputy Speaker, the context for this bill matters. Residents doctors have received a cumulative pay rises approaching 30% over recent years, among the highest in the public sector. Despite this, industrial action has continued.

It is increasingly clear that the BMA is determined to extract every possible concession from the government, using sustained disruption as leverage. While I don't align myself with some of the Secretary of State's more inflammatory language, I do share the realisation he has belatedly reached repeated above inflation pay settlements have not brought this dispute to an end, and further concessions risk rewarding brinkmanship rather than restoring stability for patients. However, in pressing its case so aggressively, the BMA has inadvertently shone a spotlight on a genuine and serious problem in the system a broken training and progression pathway that leaves UK doctors without secure routes into the NHS.

And that problem is real. It affects patients and it must be addressed regardless of the outcome of the pay negotiations. That is precisely why this bill matters, and why it must not be treated as a bargaining chip. Yet that is exactly the risk created by the way the bill is drafted. It will only come into force when the Secretary of State gives permission. In theory, that may appear sensible. In practice, it allows a patient benefiting reform to be delayed, diluted or deployed as leverage in negotiations.

Now, before Christmas, Ministers openly discussed this legislation in the context of talks with the BMA. The implication was clear progress on training reform was conditional. Now, months later, with industrial action ongoing, it appears the same dynamic may be emerging again. And that approach undermines confidence among the doctors and far more importantly, undermines care for patients. If a measure will improve the NHS, if a outcomes, patients and need capacity and certainty. If the government genuinely, genuinely believes that prioritising UK graduates will strengthen the workforce, why is the commencement of this bill discretionary at all? What assurance can she give patients that these reforms will not be delayed indefinitely while negotiations continue? Patients have already endured significant disruption from industrial action.

Hundreds of thousands of appointments and operations have been cancelled or rescheduled without further pay concessions. Can the Minister explain how this bill will reduce the risk of future disruption, or is she effectively accepting that patients may face continued instability? There's also the question of scale. The BMA itself has said that this bill does not go far enough to close the gap between applicants and the available training posts. So what assessment has been made of how many UK graduates will still be unable to access foundation or speciality training even after this legislation is passed? And what does that mean for the patient? Access to care in coming years.

Patients in many parts of the country already struggle to access GP psychiatrists and emergency medicine specialists. So how will the Secretary of State and the Minister at the Dispatch Box ensure that these reforms do not inadvertently worsen shortages in hard to recruit specialities or underserved areas? Finally, there is the question of credibility if this bill is genuinely good for patients, good for workforce stability and good for the NHS, why should its implementation depend on ministerial decision at some undefined? Undefined point in time? Why not give doctors and patients certainty by bringing bringing it into force immediately on royal assent? Madam Deputy Speaker, this House has a responsibility to put patients first, not to leave patient care hostage to industrial negotiations.

That is why I strongly support amendment one, which would ensure that the bill comes into force at the moment of royal assent. It removes unnecessary delays and ambiguity and the risk that these reforms will be postponed indefinitely. While workforce and pay disputes continue, UK medical graduates, hospitals and training bodies need certainty that the rules apply from day one so that allocations, protections and those trained in military postings and fairness measures can begin to operate without delay. This ensures that the reforms designed to strengthen transparency, meritocracy and workforce take effect when they are needed most, and that clarity is particularly important given the absence of a published NHS workforce plan.

We need certainty for doctors, which deliver stability for services and obviously stability for services delivers better patient care and better outcomes, and that is the standard by which this bill should be judged. And it is the standard it must meet.
17:44
Lizzi Collinge Portrait Lizzi Collinge MP (Morecambe and Lunesdale, Labour)
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Lizzi Collinge. >> Lizzi Collinge. >> Thank you, Madam Deputy Speaker, it's a pleasure to speak in support of the Medical Training of the Medical Training (Prioritisation) Bill Bill. Our NHS faces a workforce in many specialities. We all know this. And in my constituency the workforce problem has combined with other factors to mean that my constituents are not seeing the improvement in waiting times, that other parts of the country have seen. The progress that's been made on this nationally is absolutely astounding, and I think we should be very proud on these benches of that progress.

But there are pockets left where that progress hasn't been made. To me, that is absolutely unacceptable. And I would welcome more conversations with Ministers about how we can tackle this. And I will, of course, continue to raise this with the local NHS. But alongside this workforce workforce shortage, we also have the bizarre situation that doctors needing training places are struggling to get one, particularly UK graduates. Competition for foundation and speciality training places has grown partly because of a 2020 change to visas, which lifted restrictions on overseas applicants to these training places.

This was done. I'd like to believe, in a good faith attempt to increase NHS workforce and plug speciality gaps, but the way it was done meant that what actually happened was UK graduates, instead of competing with perhaps one other person for a place, ended up competing with six other people for a training place. This is clearly unhelpful, particularly when we have invested so much already in their education. And of course, the doctors themselves have brought on have taken on a lot of debt to get to go through their initial training.

So faced with this level of competition and unable to continue their training in the UK, many medical graduates are being pushed to seek employment abroad or even worse, leave medicine altogether. This pressure is uneven across the system, with some specialities heavily oversubscribed, while some are left with unfilled posts. If you look at oncology, you see a 15% staffing shortfall and Madam Deputy Speaker. For many years I was the deputy chair of Lancashire Health Scrutiny Committee, so I saw in real time Tory incompetence in the health service.

And this particular example just adds to the litany of failures in health over 14 years. They made us poorer, sicker and less able to get early help. Now, this bill addresses the specific failure around training places for doctors to ensure that UK graduates can continue to train in the UK. It introduces a system of prioritisation for UK medical graduates, delivering this Labour Government's commitment to a more sustainable medical workforce. It protects that public investment, reduces excessive competition and ensures that our home-grown talent can become the next generation of NHS doctors.

Now, this is no disrespect to the fantastic medics who come here to work from abroad. They do such a fantastic job and our NHS would not have survived without that workforce. But prioritising UK trained graduates would bring us into line with international norms, where favouring domestically trained clinicians helps countries ensure they have a stable workforce. And to be honest, we just shouldn't be nicking other countries. Doctors, particularly countries that have underdeveloped health systems. I don't believe it's in line with our values to do so.

And considering the UK taxpayer invests around £4 billion every year in training doctors, seeing all UK graduates in training posts should of course be the aim of any sustainable workforce policy. A fifth year medical student who wrote to me aptly described this bill as essential to safeguard what he calls fair access to training opportunities amongst UK graduates and also ensure that the NHS workforce pipeline survives long term. I'm glad to see the government is addressing this with the urgency it deserves.

And of course, doctors are only one part of the health service. We've got many professions that work together to care for patients, but doctors are of course a vital part of the NHS and we need to ensure that UK medical graduates are able to progress their career. And this, of course, goes alongside all the other work the Labour government is doing to make us healthier as a nation, whether that's controlling tobacco and vapes, helping people to afford healthy food or enabling earlier access to primary care.

Madam Deputy Speaker, I urge colleagues across the House to support this bill Robin Swann.

**** Possible New Speaker ****

You very much, Madam Deputy. Speaker, and as an earlier contribution indicated that I will be supporting this Bill. And I do think the Secretary of State and the Minister for the engagement they have had with the devolved institutions in bringing us to this institutions in bringing us to this place in such an expedited time in regards to what it intends to achieve, because today's bill and achieve, because today's bill and in particular its implications to Northern Ireland and for the medical workforce, planning right medical workforce, planning right across these islands is crucial.

And I think this has been discussed. The bill introduces that UK wide
17:49
Robin Swann Portrait Robin Swann MP (South Antrim, Ulster Unionist Party)
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duty on providers of medical training to prioritise applicants who have graduated from medical who have graduated from medical schools in the UK or the Republic of Ireland. So while health is a devolved matter, Northern Ireland, devolved matter, Northern Ireland, I absolutely recognise that this legislation is essential to legislation is essential to preserving a joined up and UK wide approach to medical training and recruitment, because for too long recruitment, because for too long we have seen those increasing pressures actually on training pathways, with locally trained graduates facing uncertainties and actually bottlenecks when moving from undergraduate education into the foundation on speciality training.

So I do really hope that this bill will ensure that those who have trained within the UK and the Republic of Ireland actually have systems that are clear and reliable and are into employment within those same systems. And that's why I do particularly welcome clause four, which does reference the UK medical graduate and specifically the other priority groups. And I do have concern, Madam Deputy Speaker in regards to the specific drafting of amendment nine, which does come in the name of His Majesty's Official Opposition, because if Northern Ireland, in any way through default, were excluded from these arrangements, it would face that invidious choice either to accept increased competition from limited training places or withdraw from national recruitment altogether, and the latter would place a significant administrative and financial burden on local bodies, particularly our Northern Ireland Medical and Dental Training Agency, and could actually risk undermining those long established recruitment structures.

So I do welcome the fact that this measure does not impose additional costs on the health services in Northern Ireland, a system which we know is currently already under unprecedented financial strain. Instead, it simply changes the order in which applications are considered for existing programmes, and in doing so, it actually helps protect the investment already made in our medical education. And I would seek assurance from the Minister of State while she is in this place in regards to the creator of our the creation of our graduate entry medical school that we've seen in Magee back in 2021 with the last the first cohort of graduates coming through in June, 2569, second degree doctors and surgeons.

And in that scheme that there will be nothing to hinder their progression into the workforce in this bill. And I'm sure she's engaged with the Northern Ireland Minister in regards to making sure that there are no impediments into that workforce. So ultimately, this bill does support locally trained doctors and maintains the integrity of our national recruitment systems. So therefore, I fully support the bill, along with its extension to Northern Ireland through the legislative consent motion process. And I genuinely wish the Minister of State well, and I commend her on the constructive approach taken to recognise Northern Ireland's devolved competencies, while ensuring alignment across the entirety of the United Kingdom.

But I do seek assurance and I will be supporting the opposition's amendment in regards to the timing of bringing this legislation forward, because this legislation, in my view, is not just the right thing to do, it's the timely thing to do in regards to tackling workforce recruitment, and it shouldn't be used in any negotiations with the BMA in regards to resolving what is another issue out there. So I do seek assurances from the side of state, as of other speakers, that this bill is brought forward in the manner it should be, because it's the right thing to do.
17:53
Peter Prinsley Portrait Peter Prinsley MP (Bury St Edmunds and Stowmarket, Labour)
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Talk to Peter Prinsley. >> Thank you, Madam Deputy Speaker. I welcome the government's plan to change the law. It was obvious to me and to others that such a change me and to others that such a change would be needed, and it was one of the things that the newly elected doctors spoke to Ministers about last year. Now imagine that you've graduated from a medical school, excited at last to be called a doctor and looking forward to finally getting to work. After years of intense study and countable numbers of examinations and fierce competition.

Now, when this happened to me at Sheffield University, our pre-registration posts were organised by the university, so we were just simply distributed around the local hospitals, in familiar locations with our classmates, with consultants who knew us. And we began, rather hesitantly, to work as doctors. But suddenly we had responsibilities for life and death. Now something changed. Young doctors now are simply sent by chance to a region of the country they never visited, with little notice and far from friends.

Ironically, they're now called resident doctors. But actually, this is the very last thing they are, since the residencies long since disappeared as the shift system replaced the on call rate as the doctors mess disappeared and hot food no longer was available. Now they're, if they're lucky, an office chair in which to rest and a sandwich dispenser in a cold corridor. No friends nearby, nowhere to live and nothing to eat at night. So not really the best start. And these are the young doctors on whom your life may depend.

So we really must do something to look after the health workers who look after us. All the health workers. That doesn't just mean paying them properly. Although we obviously must do this. But today we are speaking about our doctors, for it is the young doctors who face a very uncertain future. Now, after Brexit, many of our European doctors just left. The deficit was filled, as so often in the past by doctors from the rest of the world, especially in hospitals remote from medical schools such as my own hospital, the West Suffolk Hospital at Saint Edmunds, and the hospital where I worked for so many years, the James Paget Hospital at Great Yarmouth, where there are we have always depended upon brilliant doctors from many nations, many of whom became my long term colleagues and some of my best friends.

Now, immigration rules altered after Brexit, effectively enabling worldwide applicants for a very limited number of posts. And as we've heard, although competition is healthy, it's certainly not healthy for it to go from about 2 to 1 to more than 4 to 1. And as we've heard also, this is absolutely the cause of the bottlenecks. UK graduates simply can't progress. They're obliged to repeat years, often in unstructured and unrecognised clinical fellows leave the country or give up medicine altogether. And the government has rightly recognised that this must change.

Medical training is a continuum, a continuum. The end result is a general practitioner or a hospital specialist. By the way, I much prefer the name specialist to consultant 5 or 6 years of undergraduate training and 8 to 10 years of postgraduate training and continuing, and it makes no sense to graduate so many students and fail to accommodate them in postgraduate training. So the measures to prioritise the graduates of our UK medical schools is simply common sense, and I support it along with, as I understand, almost everybody in the house.

But finally, let me just issue a word of warning new medical schools. And I understand there are many new medical schools, including the one at Cumbria, which I didn't know about, means that we've got more graduates than ever, which is a good thing because we've got insufficient doctors. But the health system must create additional training posts and also more substantive posts for general practitioners and hospital specialists and incentives to create these posts, especially in general practice, so that our new neighbourhood health centres, which I like to call bedroom health centres, can be fully staffed, open late at night and we will see an NHS renewed.

That is our aim. We will achieve it.
17:57
Beccy Cooper Portrait Dr Beccy Cooper MP (Worthing West, Labour)
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Doctor. >> Very much. >> Thank you speaker, and it is an honour and a privilege as always, to follow my hon. Friend, the now to follow my hon. Friend, the now retired ENT surgeon, I think from Bury St Edmunds and Stowmarket. It has been a pleasure to listen to my colleagues in the House debating this bill this afternoon, and as has been said across the House, I generally absolutely welcome this bill and I'm very glad to see it come forward. I have heard from many of my junior colleagues about the issues that, again, my hon.

Friend has set out so eloquently, and we do need to care for our UK graduate workforce. We absolutely know that in recent years, NHS workforce planning has not been done well, and that has led to an increase in number of medical students training, which we welcome, but without commensurate increase in jobs at the end of that training, which makes no sense. Training is expensive and UK graduates should be able to access employment at the end of their training. That common sense must go alongside, as many colleagues across the House have said today that the recognition that healthcare professionals are part of a global workforce, and there will continue to be some natural flow of our colleagues, my medical colleagues heading to other parts of the world to deploy their skills, and they will continue to be a global health workforce in our own national health service.

And we should not underestimate the mutual learning that results in this arrangement. I'm the chair of the APPG of Global Health and Security, and we're currently undertaking an undertaking, an inquiry with our Global Health Partnership colleagues looking at net current benefits derived to the UK from international recruitment and the future reciprocal benefits for both the UK and countries of heritage. It goes both ways, so we should not underestimate this and balance does need to be found. And I think this legislation more than achieves this.

We are prioritising UK graduates, we are increasing the placements available and we are continuing to recognise international skilled personnel already experienced in the UK health service that we value, and we do not want to lose. This, of course will need close monitoring alongside the NHS workforce Plan implementation. All this has been said and I just wanted to reinforce this. What has not been said in this House this afternoon, and I would just like to bring it to the attention of the Minister, is the public health workforce.

And as a declaration of interest, I am still a public health consultant or specialist on the General Medical Council register. The public health workforce is exempt from this prioritisation in this bill, and that is because we are very fortunate to recognise that public health benefits from not only medical graduates like myself, but also a non-medical workforce. And there are benefits benefits from this mix. And the global nature of public health is realising that international mix. But I would state that public health training is hugely oversubscribed in the United Kingdom.

And so I would ask that the Minister makes further consideration to this exemption to ensure that UK graduates do not continue to face the issues that have so eloquently been outlined that are currently being faced by their fellow medical colleagues. Thank you.
18:00
Simon Opher Portrait Dr Simon Opher MP (Stroud, Labour)
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Doctor Simon Opher. >> Doctor Simon Opher. >> Thank you. Thank you very much, Madam Deputy Speaker. I will keep this short because many of my points have already been said, but points have already been said, but I think that there's two main problems here. There's about priority for medical graduates. And priority for medical graduates. And to be honest, I was a little bit surprised about a year ago when I found that actually they weren't prioritised. And this is clearly something that isn't reciprocated around the world.

And this is something that we need to change. And the other problem is our training numbers. If we're training a number of medical students up to graduation, we must make sure that those training numbers fit in to our postgraduate training. Otherwise it's crazy. And that's the situation we find ourselves in. So many. I've been a GP trainer for about 25 years. Many of the the doctors I've trained as GPS have gone off to Australia and actually my favourite one has gone to New Zealand and is staying there when I keep enticing her back, saying how great it is, how the NHS is improving.

But actually GP training is a very unique. It involves 18 months in general practice on a one on one apprenticeship type system, and I think it's one of the best in the world in the UK. And what it does, it teaches continuity of care for patients, and it also teaches skills to bring back the family doctor. It's about the doctor being the gatekeeper to the NHS and also protecting the patient against the NHS and overinvestigation. So I always think an MP is a little bit like a GP in fact, because they have to know a little bit about absolutely everything.

And that's the same for an MP as well. And I'd just like to give a shout out to my Stroud GP trainers group, who visited Parliament last year, and also to the 8000 GP trainers in this country who do a fantastic job, often going above and beyond their responsibilities. But I'd also like to say something about the international medical graduates. I've had a number of these, and in fact 50% of those in the UK are at the moment, international medical graduates.

Some are in Teesside, I understand, is 100% are international medical graduates and we are depending on these people to provide some of our general practice. I've had fantastic trainees from India, Spain, Germany and Algeria who have all made fantastic GPS in the NHS. And I do believe, as I've said before, that we need to make sure that they are welcome and treasured in the NHS because they are constituting a really large body of GPS in our system. So although we need to prioritise UK graduates, we mustn't put off international graduates from coming and helping us to deliver a new NHS.

So I'd like to say just one other thing about medical training, if I may. The as we go through as postgraduate medical training goes through and it's important that we recalibrate this. So the number of training spots exactly matches our medical graduates. And this is particularly true for anaesthetists. There's bottlenecks in anaesthetic training whereby and if we could relieve those bottlenecks we'd get more anaesthetists training and we could start to bring down our waiting list. But this will involve a decent workforce plan, which I understand we're developing and proper planning for the future so we can get our waiting list down and deliver a better NHS for for everyone.

So to conclude, after years of failure and neglect of our home grown talent, this government is taking action so that our doctors can train, stay and serve the communities that need them most. So I urge members to support the bill.
18:04
Jessica Toale Portrait Jessica Toale MP (Bournemouth West, Labour)
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Yes. >> This bill matters enormously in my Bournemouth West constituency. The NHS is one of the largest local employers. Our hospitals, community employers. Our hospitals, community services and care settings are the backbone of our local economy. We also have outstanding institutions Bournemouth University, Bournemouth, Poole, Bournemouth and Poole College and the Health Sciences University. Ready and willing to provide strong local pipeline of medical and health professionals. But I've met professors at the School of Midwifery at Bu worried about whether their graduates will get a first placement.

Specialist nurses unable to progress their careers, and early career psychiatrists forced to look for work far from home. And this is not for a lack of demand for these services in the local area. If we train doctors here, fund their education through British taxpayers and ask them to commit their lives and careers to the NHS, we owe them a fair chance to build those careers within it. Now, the shadow health secretary has said we should not play politics with people's jobs and I agree, but we have to recognise that the situation we're in now is a direct result of their ill thought through visa changes in the wake of the mess left by their post-Brexit settlement for the UK, the fact that we now have more than double the number of overseas trained applicants than UK trained applicants for a limited position, is a consequence of that.

Under the Conservatives, we became too reliant on pulling the immigration lever to solve our workforce shortages, and their policies meant that UK medical graduates are being squeezed out. Too many lost to the private sector or overseas, not because of a lack of talent or commitment, but because the system didn't work for them. So I was proud to campaign on a commitment to train more local young people and to encourage companies to hire locally before looking overseas. And the same should be true to the NHS.

So I'm pleased that this bill is doing that and I want to be incredibly clear, like many in the House have, that this is not about blaming or disrespecting migrant workers, international doctors and and our immigrant communities who work in all elements of our NHS are valued and respected. Immigration has enriched my town. The people who have come to the UK to care for our elderly, nurse our sick and heal our injured are important parts of the vibrant and diverse community we have in Bournemouth, and I want to thank them for their service.

We should also be proud that the NHS is a world renowned employer and a real part of our soft power influence. Countries around the world aspire to the type of universal healthcare offering we have in the UK. Our specialist train health professionals around the world and I know that for many doctors around the globe, time spent working in the NHS is a badge of honour. But poaching doctors from countries that desperately need them, while UK trained doctors cannot progress, is morally wrong.

It undermines global health equity and erodes trust here at home. So it is right that we prioritise skilling our own people and other countries recognise that reality as well. The United States, Canada, Australia all prioritise domestic graduates for training opportunities. Now this bill is also consequential for me as a Labour MP in a constituency that has never voted Labour before, Bournemouth and Poole are often seen as affluent areas, but they contain real inequalities and serious barriers to social mobility. In places like Westshore and Alderney, parents tell me they feel forgotten.

They worried when their children do the right things, work hard, get the right grades, but are constantly told they can't compete or are locked out. So if we want young people from council estates to believe they belong in medicine, we must back that belief with opportunity. We cannot claim to be the party of social mobility and dignity and work if we don't put the ladders in place. So the conservative record is clear. Expanding medical places without expanding training posts, liberalising visas without the workforce planning, and leaving UK graduates to carry the cost.

This bill is a necessary correction. It is fair, it is responsible and it is morally right for our NHS, our communities and for the next generation. And I just want to say to any students or recent graduates considering Australia, if we get this right, we have just as impressive beaches in Bournemouth. Even if I can't always guarantee the weather.
18:09
Josh Newbury Portrait Josh Newbury MP (Cannock Chase, Labour)
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Newbury thank you, Madam Deputy >> Newbury thank you, Madam Deputy Speaker. This bill at its heart is about fairness, fairness for the doctors who train in this country and for the patients who rely on and for the patients who rely on the care provided by our fantastic NHS workforce. Before Brexit, NHS workforce. Before Brexit, graduates from our British medical schools predominantly competed amongst themselves for foundation and speciality training posts. But since Boris Johnson's disastrous visa and immigration changes made under the previous conservative government, that picture has changed completely.

As we've heard, doctors trained here are facing huge barriers to progress their career and care for patients up and down the country. And many are turning to jobs either abroad or within the private sector. And that isn't because they lack the ability or the commitment, but because of how the system was left to drift by the previous government. Until it has got to this point of being set up against our graduates, we rarely hear concerns about the doctors who train here, but then end up going abroad.

But an awful lot. We hear about that a lot, but a lot less about the doctors who remain here in the UK. They're passionate about our NHS and they want to dedicate their careers to it. They want to build their lives and their whole family, but they also often find that they simply cannot secure a training post. This isn't a new problem. It's a reality that's been behind the flight of doctors overseas for many years. But only now do we have a government that is committed to tackling it.

So I commend Secretary not only for bringing it for this bill, but committing to missing out on Home-grown talent that we have because of the previous government's changes to immigration, which led to the so-called Boris wave. Whilst, as we've heard, international medical graduates contribute hugely and are very welcome, visa changes have had a destabilising effect on British trained doctors who now face double the competition for every single post. We're training more doctors now than ever before, but we have failed until now to match that ambition with a system that supports them.

As we've heard, we spend around £4 billion a year training doctors in the UK, a huge investment of public money. And it's only right that taxpayers see that investment translating into doctors building their careers in our NHS. But the prioritisation that the Secretary of State referred to is about sustainability and keeping things fair for our UK trained graduates, not about shutting out international talent. The NHS is rightly proud to be a major international employer, and people from around the world will continue to bring vital skills to our health service.

Of course, anyone who can apply now will still be able to apply. I'd also mention that many countries we are recruiting from also desperately need their own doctors. We should be proud that people want to come and work here, but it's morally unacceptable to pinch doctors from other countries which need them. Meanwhile, leaving our brilliant and willing doctors unable to get training places. Of course, this bill builds on action the government has already taken to boost the NHS workforce. When the government came into office, we heard concerns from GPS and patients alike about a dire need for more GP surgery capacity.

Whilst many qualified GPS were out of work so Labour removed the red tape around the Additional Roles reimbursement scheme and more than 1000 additional GPS have since joined our primary care workforce. When the government heard from nurses who were just about to qualify and are struggling to find work, despite a clear and chronic need for more nurses. It brought in the graduate guarantee and now the government is acting again. Following his constructive approach to negotiations with the British Medical Association, the Health Secretary offered a package of support, including quadrupling the number of specialist training posts being created in the coming three years and funding resident doctors, Royal College exam and membership fees.

Now, despite a rejection of that deal, he is making good on his commitment to British graduates back on a level playing field, giving them a fair shot at taking the next step in their careers. With competition ratios that are reasonable and workable, this bill will make sure that the NHS retains the talent. It's developed through excellent medical schools like at Keele University in Staffordshire. Rather than losing that talent to overseas recruitment or forcing doctors out of the profession altogether, the BMA has welcomed extending prioritisation to the foundation programme, which the government expects will significantly reduce the number of placeholder offers faced by final year medical students.

I hope that as their members vote on whether to take further strike action, they will see that the government doesn't make pie crust promises. We are taking the steps we said we would to fix the issues that they have raised. Now, I know this bill won't fix every workforce challenge overnight, but it is certainly a big step in the right direction. It will reduce competition for training places, and most importantly, it will send a clear message to the resident doctors who trained in this country that if you want to progress your career here, the government will back you.

And so for those reasons, I am proud to support this bill.
18:13
Danny Beales Portrait Danny Beales MP (Uxbridge and South Ruislip, Labour)
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Danny Beales. >> Thank you, Madam Deputy Speaker. >> I'd like to thank the Secretary of State and the Minister for today's statement and Bill and delivering on the promises made previously in this place in response to the proposed industrial action a couple of months ago. And it's welcome to see the pace the government has moved in, progressing these important changes, I think, shows the commitment of the government to backing doctors and medical professionals in this country, and I think there's a lot to welcome in the provisions in this bill.

Members here have talked length and with expertise, a lot of personal, professional expertise about the challenges of the medical training system. And as a member of the Health Select Committee, alongside the chair and others who've spoken, we often also in the committee hear about the need for a proper workforce plan and to address the long term issues the NHS has had around training and development, which has, to be frank, failed staff and failed patients. I think it is important to reflect, as others have, on the important and vital contribution that doctors and nurses have made from around the world.

That is the case as well. In my own constituency at Hillingdon Hospital, in GP and community based health services, my mum recently had and fortunately recovered from a stroke at UCL in central London. And as ever, it was doctors and nurses and speech therapists and allied healthcare professionals from almost every single country around the world that helped her and supported her to recover. And I am sure that they will continue to serve our National Health Service with dedication and commitment.

And I think this whole House, I'm sure, is thankful for their service to our NHS. But as we have heard, it is absurd that thousands of British doctors trained by our NHS at great expense, funded by the British taxpayer, are currently unable to find jobs in the NHS after graduation. So in a time of crisis for the NHS, we don't have a penny to spare and every pound needs to go even further. It's a great waste of talent and capacity and it's not fair to young doctors either in the system who are being beaten, beaten to entry level NHS positions by doctors from overseas with decades of experience.

So I'm glad.

**** Possible New Speaker ****

I thank the hon. Member for giving way. I wonder whether he's given any thought to residents like given any thought to residents like George and Dennis in my constituency, both British citizens constituency, both British citizens brought up here, but actually went to work abroad, either because they are dual citizens and wanted to be able to learn in double language, able to learn in double language, or because of the Covid delays and who will not be included and actually wonder whether they should actually wonder whether they should be included within this second tier of graduates from places like Iceland and Liechtenstein.

I wonder if he's got any views on whether we should be excluding British citizens.

**** Possible New Speaker ****

I think that that contribution, I'm actually about to turn to a specific issue about British citizens very shortly, so I hope I'll pick up those issues very shortly. But I would just reflect shortly. But I would just reflect that more generally. There isn't anything progressive about our system, which promotes a brain system, which promotes a brain drain from some of the most deprived and underdeveloped deprived and underdeveloped communities in the world with significant health needs to have doctors and nurses on significant scale come from those systems.

Take away the resources spent in those systems on education and training for our benefit in the West and in a developed country isn't genuinely progressive at an industrial scale. And so I think it's important to welcome the provisions in this bill in addressing those challenges. But as the hon. Member in the Liberal Democrats has raised, I would like to press the Secretary of State and the Minister now in her place on the specific language of the bill, which seeks to prioritise graduates from medical schools in the United Kingdom, rather than UK based or or UK citizens who are medical graduates.

I've been contacted as other members in this place have already raised by a number of my own constituents affected by these potential provisions, and that includes Alicia, who is a British citizen schooled here, grew up here, her family live in Ickenham in my constituency, and she's a first year medical student at Queen Mary University of London's campus in Malta, which my hon. Friend from Stevenage mentioned earlier on. When she enrolled last year, she was given a guaranteed by the university that she would face no advantage compared to students on the London based campus.

And we've heard that, of course, there can never be any guarantees. There's not a legal contract this government makes with individuals that this House we know is sovereign and can and and can make different decisions in time. But I think there are issues of fairness about the retrospective applications of decisions that we do make that can affect people's lives, particularly at crucial points like studying or getting a job, making those crucial decisions which have major impacts on their future life chances.

She studies a British curriculum. She'll be awarded the same degree as her peers on the London campus. However, if the bill's current wording is interpreted strictly geographically instead of institutionally, it would mean that she is categorised as an international medical graduate. Despite being a British citizen studying at a British university on a British medical degree. So I would ask the Secretary of State to look at this specific issue in greater detail, ask her and officials to take away this point and look at modelling the number, or sharing at least the modelling of the number of UK citizens we project would be affected this academic year by those changes.

And if, as has been suggested by, for instance, Queen Mary, this is 40 or 50 individuals, whether further changes could be made which may ameliorate this impact on UK citizens, at least in a transitional way that wouldn't bind us in future academic years. Yet to begin, and also ask the officials take away to have discussions with Maltese counterparts about our important and ongoing strategic relationship in health and other key areas. To conclude, Madam Deputy Speaker, there is much to welcome in this bill.

I know that medical colleges and societies strongly support many of the provisions, and I hope that they will be a start of a broader process of a comprehensive workforce plan that will address the many challenges in workforce planning, in training and development, the numbers of bottlenecks that exist throughout the workforce system. And so we have a training and development system of medical professionals in this country that delivers positive results for patients and better and fairer outcomes for those applying to study, learn and train as well.



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Thank you Neil Duncan-Jordan. Thank you, Madam Deputy Speaker. And as the final contribution And as the final contribution contributor, I shall try and strike a slightly different tone in the debate. Now, over the last few days, I've been contacted by a number of constituents who are likely to be constituents who are likely to be affected by today's emergency bill. Now, one of those is Doctor Khan. Now, one of those is Doctor Khan. Doctor Khan works as a resident doctor at Poole General Hospital's
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Neil Duncan-Jordan Portrait Neil Duncan-Jordan MP (Poole, Labour)
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emergency department. He trained overseas and has been working in the NHS for almost three years, and the NHS for almost three years, and he also has a young family living in my constituency as an in my constituency as an international medical graduate in the NHS. He's concerned that the proposed emergency legislation on proposed emergency legislation on UK medical graduate graduate prioritisation will have a negative prioritisation will have a negative impact on people like him. Now, while I support a sustainable domestic medical workforce, implementing these changes mid-cycle in 2026 after applications have closed and commitments have been made is, I believe, a breach of procedural fairness.

There are some further concerns that my constituent has raised that I'd like to share the technical proposal to use immigration status, such as indefinite leave, to remain or citizenship as a proxy for NHS experience is both blunt and unnecessary. The Oriel application system already specifically collects data on whether an applicant is more than six months of NHS experience. This existing evidence based metric should be used to prioritise those already contributing to our health service, rather than relying on immigration status.

Now, many of Doctor Khan's colleagues have relocated to this country and planned their lives based on rules in force. When the applications opened in late 2025 to change the rules. Now, while we are in the middle of the interview window, causes immense personal distress and undermines our long standing commitment to fairness, and there is a genuine risk to the workforce. Our NHS relies heavily on our international staff, and today's bill risks damaging the UK's reputation as a fair employer and could lead to an exodus of skilled professionals that the NHS, in my view, cannot afford to lose.

So will the Minister consider when she responds, providing clear transitional protections for the 2026 cohort that are already here? Consider that any new criteria should be implemented prospectively for 2027, and that any measure of NHS experience should utilise the data already collected, rather than blunt immigration based proxies. A few days ago, I asked a written question as to the impact that the proposed changes to rules around indefinite leave to remain for health workers would have on the viability of the NHS ten year workforce plan.

The response from the department was that no such assessment had been made. I fear, Madam Deputy Speaker, that we are now making the same mistake again. Those who are already here and making a contribution need to be acknowledged for their service, and I would welcome any assurances that the Minister could give to Doctor Khan and all those like him that

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are already a valued part of our NHS. Brings us to the front bench contribution. Shadow Minister, Doctor Caroline Johnson.

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Doctor Caroline Johnson. Yes. Thank you, Madam Deputy Speaker, and I'm pleased to respond on and I'm pleased to respond on behalf of the opposition. But before I do so, I should declare my interest as a consultant paediatrician and a member of the paediatrician and a member of the British Medical Association. Madam Deputy Speaker medicine is a vocation, but it's also an art as well as a science. And training takes a long time after in general, five years as a medical student, new resident doctors need to train further in specialisms such as orthopaedics or ophthalmology, or like myself, in paediatrics.

Postgraduate training varies in length and structure between specialities, but in broad principle is divided into foundation, programme and
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Caroline Johnson Portrait Dr Caroline Johnson MP (Sleaford and North Hykeham, Conservative)
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specialist training. The Foundation programme is two years long and teaches a variety of skills. Specialist training is more Specialist training is more specific and there are well over 60 different specialities in which people can choose. And it's these people can choose. And it's these two phases the foundation programme and specialist training that the and specialist training that the bill refers to. We have a situation where there's been a huge surge in the number of applications for the number of applications for training post.

One of the reasons for that is there's been a substantial number of increases in the number of medical school places that's caused by action by the previous conservative government to improve the number of doctors in the long term. The previous government opened five medical schools in Sunderland, Anglia, Ruskin, Kent and Medway, Edgehill and very close to my constituency Madam Deputy Speaker in Lincoln. The first students for those universities graduated in 23, 24 and 25, increasing the number of students looking for posts.

There was also widespread expansion in the same time around existing medical school places. And of course, there was the pandemic. During the pandemic, students who applied for medical school and accepted offers found themselves unable to take their exams, and the teacher assessed grades meant there was a huge increase in the number of successful applicants who got the grades compared with that which was statistically expected. And so the government lifted the cap and there was a huge amount of medical students at that period, and many of those qualified last summer.

So that's the reason why there was a huge increase in the number of local graduates. And then aside, at that point, the Secretary of State, in response to my hon. Friend the Member for Farnham and Bordon, talked about his pledge to double medical school places. There doesn't appear to have been an increase at all in the number of medical school places this year, and there was a statement from Department of Health and Social Care at the weekend to suggest that it's not a government commitment.

He was asked to be standing by his pledge and he seemed to say no. So be grateful if the Minister could clarify, because in 2024, I had a visit to the Royal Derbyshire Derby Hospital, the Secretary of State said. And this site here in Derby will be part of delivering the doubling of the number of medical school places that Labour is committed to, to make sure the NHS has the staff it needs to treat patients on time. So on the 4th of July and then he encouraged people to vote in the general election.

So can he confirm, does he stand by his pledge? And if he does, why does he expect to start delivering upon it? But UK factors Madam Deputy Speaker are not the main cause for the rise. In fact, the BMA has published figures it's got from FOI, which shows the number of UK graduates applying for training programmes, went up from 9273 and 23 to 12,305 and 25, an increase of about a third. But over the same period, the numbers of international medical graduates applying for specialist training went from 10,402 in 20 23 to 20,000 803 in 2025.

A doubling of applications and this surge in numbers has less British graduates facing unemployment, so may pursue a career as overseas and not return. While valuable contribution, the valuable contributions are appreciated from the international medical graduates. Many do complete training and go to return to their home nation, which could leave us with a potential shortage in the long term of consultants and GPS. So the government is right to step in to prioritise local talent, and as such, we support the principles behind the bill.

But there are some issues and some questions. Firstly, the Foundation programme applications are in progress. The application window closed in October. On the 8th of October. Pre-allocation outcomes were due in mid-December. Foundation school applications due 26th of February also also delayed. The Foundation programme website states. Allocations can only occur once the bill receives Royal Assent. That delay in itself, the uncertainty associated with it, is difficult enough for young doctors and their families. But the Secretary of State is adding an extra layer of uncertainty by adding clause eight, the right to withhold activation of the bill to a day of his choosing.

Why is he doing that? Madam Deputy Speaker and what is the foundation programme? And those are people who run it to do. Should they wait on a willy? Won't he? When will he? When will we allocate it? Will he not? Should they allocate places anyway on the basis people need to know, as you said already, where they live and and and sort their the arrangements out all will they have to reallocate it if he activates it after they've allocated on the basis that he hasn't done it yet.

This is not the way. Madam Deputy Speaker, to treat professional, hardworking people. And as my hon. Friend the Member for Fareham said in his speech, this is not just about doctors, it's about patient safety, patient safety now and in the future. The Conservatives have submitted an amendment that will activate the bill at royal assent. I would urge the Secretary of State to do what's right for the country and for patient safety, and to support it. Secondly, Labour have forgotten the British people, those we represent and should prioritise.

I will say more as we consider the amendments specifically, but under their bill, foreign nationals completing a primary medical degree in Iceland, Norway, Liechtenstein, Switzerland and the UK are in the priority group. But a British citizen who trained in the USA, Canada, France or even Malta's campus of a UK medical school would not. The conservative, the hon. Member for Sunderland, talked about the likelihood of international medical graduates leaving the UK after training. But surely this is an argument to ensure that British trainees, wherever they train, if it's a suitable degree, are prioritised.

The conservative amendment ensures that British people are always front and centre, and we would urge the opposition to and we would urge the opposition to back it. The hon. Gentleman raised the issue of British citizens earlier on in his speech, and I would like to clarify. For the avoidance of doubt, we know that as, as as when we say British citizens, we do mean those from England, Wales, Scotland and Northern Ireland. There are other clarifications. I'd be grateful if the Minister could address in her winding up.

First of all, military doctors, what position is in place to ensure that military resident doctors are able to access the posts they need? And what impact will this bill have upon them, particularly as if the world is more dangerous now? They spend more time in the future overseas than they do at the present time. As conservatives Madam Deputy Speaker, we believe in meritocracy. And as such, I support new clause two in the name of my hon. Friend for Runnymede and Weybridge.

We all want excellent doctors, and I'll say more about this as we go into Committee stage, but a random allocation does not encourage excellence in produces stress and it produces uncertainty, does not encourage excellence. So I support this amendment. To summarise, Madam Deputy Speaker, we agree with the principle of the bill, but we encourage the government to accept amendments that encourage excellence, to think through the detail, to put politics aside and do what's right for the country, to prioritise British citizens and to activate the bill immediately at

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Royal assent. Minister.

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Minister. Thank you. Deputy Speaker.

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Deputy Speaker. And it's a pleasure to close. On behalf of the government. And I really welcome. The support of the opposition
18:33
Karin Smyth Portrait Karin Smyth MP, Minister of State (Department of Health and Social Care) (Bristol South, Labour)
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>> The support of the opposition spokespeople here this afternoon. The chair of the Select Committee, and I'd like to put on record my thanks to them for meeting me in advance of this bill and and for sharing their concerns with us, because there clearly is. And from the many contributions this afternoon, there clearly is a broad base of sympathy and support for the measures in this Bill to support our NHS staff right across the House, because these staff have been at the sharp end of every ill conceived policy of the past 14 years, since the previous government lifted those visa restrictions.

As outlined by my friend from Bournemouth West in 2020, and the last government's failure to do any proper workforce planning has led to patients struggling to find a GP appointment while GP struggle to get a job. Bottlenecks for resident doctors and an overreliance on overseas workers, and a refusal to foster our own home grown talent. So while I also welcome that support, I do find it slightly ironic that some of the opposition speeches were around the need for clear and consistent rules and clarity.

That is exactly what we are intending to do now to fix that mess. We will be bringing forward wider issues in the workforce plan, which has, the boss said earlier, will be in the spring. That is as a result of the the concerns, particularly the Royal Colleges and other stakeholders around training and making sure we do that, that properly and we will obviously be bringing that forward in due course. And, Madam Deputy Speaker, I'm going to just time is of the essence, I'm afraid, so we can pick up more in the committee stages.

Madam Deputy Speaker, when I was a manager in the NHS, I worked alongside many doctors from overseas and I want to be very clear in messages this afternoon from this Dispatch Box Dispatch Box, you are of course, welcome here. The NHS is and always will be one of the most diverse employers in the world. This bill is about bringing future generations into the health service and giving them a secure future. I think we all know they need. It is about sustainable workforce planning, so patients are no longer at the mercy of the market.

And it is crucially about fairness. How is it fair that every year the taxpayer picks up a £4 billion bill to train our medics who can't get jobs? These taxpayers deserve a return on their investment. How is it fair that the medics in this country who put themselves forward to train, make sacrifices, get into debt and work long hours just to find themselves trapped in bottlenecks? Now, colleagues, there are a number of points I am going to try and address in due course.

Can I just commend my friend for Sunderland Central, both for his experience in outlining some of the capacity and demand issues that people like him as managers have to face? And also, the really important point about our workforce needing to reflect our society and the great work at Sunderland. I was very pleased to meet the leaders at Sunderland and Doctor Wilkes to to look at the work they're doing so that we can take that elsewhere. That's exactly what we want to do. And I commend my friend from Carlisle, mum of the nurse, as she outlined to us in putting on record the work of the pair's Cumbria School of Medicine and the example of growing doctors steeped in Cumbria, and those health inequalities.

And I'm absolutely pleased to meet with them to discuss that further. Why do we need emergency legislation? I think the Member for Thurrock was also right to highlight the soaring numbers that we are seeing and the way we are losing people and recognising that it was all going back to front. We do need royal assent by March the 5th at the very latest to ensure change happens this year. We don't want medics to face another year of bottlenecks. Speciality training offers will be made from March and any delay will risk vacancies in August.

So this emergency legislation gives the NHS the certainty and stability it needs to carry on bringing down waiting lists and keep us on the road to recovery. And those people who are applying for those posts need enough time to make decisions about their lives where they will move, finding accommodation, sorting childcare and they deserve enough time to get on with that. In terms of the prioritisation for training posts, a number of colleagues have raised these issues. So let's be clear for post starting this year for speciality training posts.

For post starting this year, we will prioritise UK medical graduates and others using their immigration status as a proxy for having significant experience of working in the health service. Now, colleagues may wonder if there's a bit of a pulling strings to include Irish doctors in that prioritisation, but I can assure you that is not the case. Madam Deputy Speaker Ireland is included in that because of our special and long standing relationship with Ireland and very similar epidemiology. And as the. I can thank the Member for Southampton for the important points he raised around Magee and working with devolved institutions.

I can assure him officials have worked very closely with officials in Northern Ireland on this, and if there are any other issues, please, for him to raise that. But we have worked very closely on that point. From next year, 2027, immigration status will no longer automatically determine priority. And I accept some of the points from my friend from tool. It is, it is it is perhaps crude is the term he uses, but it is a proxy for this year. Next year we will bring forward regulations to prioritise whether someone has significant experience as a doctor in the health service or by reference to the immigration status.

And I know this is a point raised by the chair of the select committee and many others, but we will continue to work with all partners and the devolved governments to agree that criteria in time for the autumn application round. Now, on this issue about international staff, at a point made by the chair of the Select Committee, my friend from Birmingham Edgbaston, member for Uxbridge and South Ruislip all raised and as did others, the issue of foreign doctors. Let's be very clear. International staff play an important role our NHS and they always will.

The NHS might be the most diverse public body in the world and we would not have it any other way. But we are recruiting doctors from abroad, sometimes even from countries that are sure to medical staff when there is already a pool of applicants at home. As my friend from Morecambe and Lunesdale said, we're not about nicking other people's workforces. Home grown doctors are more likely to work in the NHS for longer and be better equipped to deliver health care tailored to the UK's population, because they better understand.

Having been trained in the UK's epidemiology. It is not fair for British taxpayers to spend over £4 billion training medics every year. A point made again by my friend from Worthing West in Cannock Chase. It's not fair for doctors who struggle to get into speciality training places. Other. And as my friend from Birmingham Edgbaston said, it is a responsible government that gets a grip of this. So, Madam Deputy Speaker, I will refer back to more of the amendments in the Committee stage which we are moving on to, but we are seeing the green shoots of recovery, our NHS, as we repair the damage done by the last 14 years of the NHS.

We are turning another page on that decline. But because the decision to lift the restrictions in 2020 has done untold damage to the system, to staff morale and contribute to a national mood of cynicism, pessimism, especially among the young. We do need to act, and I think these points were well articulated by the Member for Weald of Kent and so expertly, as always, by my friend the Member for Bury St Edmunds and Stowmarket. So I do want to end by talking about the many young people who will be affected by the changes we are setting out today.

When I speak to young people in my family, and my friend from Ipswich said that these are not abstract statistics but personal costs. When I speak to people in my family, my constituency or even in my parliamentary staff, those who have uniquely breached that first barrier of getting to a medical school from a state school in their locality. I'm disheartened to hear how many of them feel their careers would be better served by moving abroad. And in the 1970s, James Callaghan said if he were a young man, he would emigrate.

I don't want young people to take that path. I would rather say to them, by all means travel, see the world, enjoy that time. But my niece is currently in Australia. We sometimes call this the bring home bill. Madam Deputy Speaker, there are great opportunities for you all in this country and we want you all to be rebuilding the NHS with us. The NHS must play its part in training our young people and keeping top talent in the UK. And if colleagues agree, that's worth doing.

If they want to keep our people here, they should all join us and vote for this bill.

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The question is that the bill. Be now read a second time. As

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Be now read a second time. As many as are of that opinion say I. I of the contrary, no I think the ayes have it, the ayes have it. Order under the allocation of time order of today. We now move to order of today. We now move to

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Order.

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Medical Training (Prioritisation) Bill. I remind members that in committee members should not address the chair. As Deputy Speaker, please use our names when addressing the chair. Madam chair, Chair and Madam Chairman are also acceptable. We begin with the question that clause one stand part of the bill with which it will be convenient to consider all amendments. New clauses and clauses stand apart as on the selection and grouping paper. The question is that clause one stand part of the

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bill. I call the Minister. Thank you, Madam Deputy Speaker.

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Thank you, Madam Deputy Speaker. And in the interest of time, which I appreciate is difficult for I appreciate is difficult for colleagues, I'll start, and I perhaps will address most of comments in the amendments in the comments in the amendments in the end of hearing from other colleagues. I think we've got the colleagues. I think we've got the gist of, of of most of those issues, but can I just be clear that in this session that I'm restating our firm commitment to this bill and clauses or clauses stand part of this, this bill? I think the if I can turn to some of the clauses that are perhaps need some that are perhaps need some expansion apologies.

If I can turn to particularly on to clause four. And to be clear how we're defining a UK medical graduate and the priority group for the purposes of this bill. The a UK medical graduate in this context does exclude those who have spent all or the majority of their time training for their medical qualification outside the British islands. This means that where a person has obtained a primary UK qualification but has studied mainly overseas, they will not be eligible for prioritisation as a UK medical graduate unless they fall into another group who's to be prioritised under the bill.

While internationally educated graduates from overseas remain an important part of the workforce and can continue to be recruited under the bill. We are committed to growing home grown talent who are more likely to work in the NHS for longer and be better equipped to deliver health care tailored to the UK's population. I think on other clauses that colleagues outlined, if I can just refer briefly to clause eight, which sets out the territorial extent and commencement for the bill.

As I've noted previously, this bill does extend to England, Wales, Scotland and Northern Ireland, and we have worked closely with the devolved governments to ensure that it meets all needs and provide consistency, and we are grateful to them for their support in bringing these measures forward so quickly. This bill will engage with the legislative content, moment consent motion process, and the devolved governments have committed to commence this process with their parliaments to ensure the necessary systems, planning and operational capacity required for successful implementation are in place.

The Bill will be commenced on a day or days. The Secretary of State may appoint by regulations and, as my right hon. Friend, Secretary of State for health outlined during his speech for Second Reading. This is an important fail safe to ensure we're not in a position where a law is enacted that we cannot implement effectively at the particular time. And if I can just expand on that, and I'm happy to do that. After we talk about the amendments, the key issue here is around the ability of the NHS and the training providers to be able to deliver the measure.

That's why it's a fail safe. So we need to be very clear at that time that they are in a position to deliver, to deliver that people have talked about the strikes and so on. That would be one consideration. There are many other considerations. We are asking them to do something very difficult very quickly, and in order to make sure they have the capacity and the capability to do that and to do that safely, as was outlined by other people, we reserving that particular measure to be laid at a later time, rather than that at the end of this session and Madam Deputy Speaker, I will come back to the other amendments when I close momentarily after we hear from other colleagues.
18:46
Caroline Johnson Portrait Dr Caroline Johnson MP (Sleaford and North Hykeham, Conservative)
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The shadow Minister. >> Pete Wishart she doesn't. >> Madam chair. Madam chair, I'd like to talk to the amendments placed by the opposition. So placed by the opposition. So amendment nine, first of all, amendment nine would require that from 2027, priorities given to British citizens on UK foundation programmes, as well as interviews and places on the speciality training programmes. Clause. Clause four defines what is meant by medical graduate a UK medical graduate is defined as a person who holds a primary UK qualification within the meaning of the Medical Act 1983, section four.

However, it does not include a person who spent all or a majority of the time for that training training for that qualification. Outside the British Islands, the Secretary of State has stated intention to prioritise UK medical graduates, but has failed to protect all British citizens. In doing so, our amendment would ensure that British citizens who study on an eligible medical course overseas would still be prioritised in the bill. There are many scenarios where it may be the case that we need to ensure we're protecting British citizens.

For example, a spouse, partner or child of a serving member of the UK armed forces who's complete their relevant training overseas while the relative is posted perhaps, perhaps in Cyprus or perhaps a student to the Queen Mary, University of London, who has completed the MBBS course at their multicampus but received a UK medical degree, or a British citizen who studied in the US or France, perhaps owing to family location, or given that the largest bottleneck is not in training places, but getting a place in medical school at all.

In some cases, students, British students who've gone to study overseas because their of their fervent desire to become a doctor. These are all entirely possible and plausible scenarios of British citizens who have completed their relevant training and wish to bring their skills back and relocate to their homeland for the rest of their career, but they may not be currently covered by the government's prioritisation model. The government's prioritisation model is currently based on where the degree was taken, rather than necessarily on who did it as well.

The Secretary of State must ensure that we do not overlook our own citizens if we are to fairly address the competitive landscape for training posts. The position is therefore pressing amendment nine to be accepted by the government. Amendment ten is a probing amendment to explore the effects of the bill on military personnel. As a member of Parliament with an area of large with a large number of armed forces community, I know that medical trainees have an integral part of our serving community.

The world is becoming an increasingly dangerous place, and we may see junior trainees sent abroad early in their career than is currently the case. It's clearly wrong to penalise those very people who are working amongst our armed forces and caring for them in their brave work, they ought to be provided with optimal opportunities, and Secretary of State has a duty to make sure they're not overlooked in this regard. I'd be grateful if the Minister is able to cover that in his response.

Her response? New clause three would require that the government make an annual report to Parliament about the impact of the bill's provisions on the number of international students at UK medical schools and the financial impact on UK medical schools. We talked about the bottleneck and the balance between UK and international students training at UK medical schools. Clearly, becoming a UK graduate will now come with significant premium. So what impact is that going to have on British children getting to to complete their choices and become doctors if they want to? What incentives does it provide to universities to increase the number of international students, and what effect will that have overall on UK medical schools? I also want to talk about new clause two.

Madam Deputy Speaker, in support of new clause two, put forward by my hon. Friend, the Member for Runnymede and Weybridge. And that talks about places for UK Foundation speciality training programmes and the importance of allocation on merit, because we all want the very best doctors. I want to talk a bit about the Foundation programme itself now. When I became a doctor Madam Deputy Speaker, that was, believe it or not, 25 years ago this year, my experience was that I applied for a job as a junior House officer, as it was called.

Then I applied for the jobs I wanted. I was interviewed by the consultants who would have been supervising my training, and then I was offered the jobs. The experience of students today is very different. First of all, they have a they allow, they are allowed to put in a preference. They are allowed to say which which which deanery, which foundation area they would like to work in. But that's all. After that it goes into a computer system, and the computer system gives them a rank, a single rank, not based on anything they've done at university, not based on whether they got good results or they worked hard or anything like that.

And then the computer system will go through on a first pass, and if the first choice is available, it will give them their first choice if it's not available, because by the time they get down to them on the list, those places have gone. It will just miss them for now and go on to the next one. When it's completed its full pass down the whole list, it will start again and when it comes to them next time, it will give them the highest preference that's still available.

Once they've been allocated a foundation deanery, the process starts again within the locality. When I say locality, I mean that in the loosest possible sense, really, because if we're applying for the Trent rotation, for example, one could be posted in Lincoln or Boston or Nottingham or Derby or Burton. The individual doctor has essentially very little no control and very little often preference over where they'd like to be. And my hon. Friend from the Weald of Kent talked about a student in her locality who had gone through and not been able to get a place, despite being top of top, I think a third in the university class.

And I think it's clear that that's not that's not fair, giving people no, no opportunities to to control what their futures. And by the way, if there's no right of appeal. So having been given their place, it's that or no place. The hon. Member for Sunderland Central talked about ordinary children from the North-East, and as an ordinary child from the North-East, was an ordinary child from the North-East. I agree with him that it's important that people have opportunity, but it's equality of opportunity, not equality of outcome that matters.

And I worry that this system creates an equality of outcome. Equality of outcome. And so the party support my hon. Friend's amendment in that regard. The opposition Front Bench has also tabled amendment one. Amendment one requires that the bill's provision takes effect on the date of Royal Assent, as opposed to a date at the discretion of the Secretary of State for Health and Social Care, which is how it currently stands. The bill is deemed to be necessary a piece of emergency legislation for the government in order to prioritise medical graduates in the United Kingdom for places on medical training programmes.

When he announced the bill in an attempt to avert industrial action by resident doctors in December, the Secretary of State told the House they had been working intensively with his team to see how quickly we can introduce legislation here. The bill is presented does not commit to a date when these measures will be enacted in, says the. Instead, the power lays in the Secretary of State's hands, giving him a clear bargaining chip. With future negotiations, it is clear that the government intends to pass this legislation urgently, as they've said, but without a commencement date, there are clear concerns.

This bill is just a negotiating tactic to prevent further industrial action by resident doctors that can be scrapped at a later date. There remains the prospect of further industrial action. Despite this legislation being introduced, the Secretary State should not be asking Parliament to pass a bill that has no intention and no intention of enacting. If the BMA doesn't play ball and hold off strikes either. The Secretary of State thinks his emergency legislation needs to get on and make it enacted, or he doesn't.

It's vital that it's enacted straightaway, as students are due to be given places now for their training programs. They need to decide where they're living. They cannot have a situation where their lives are on hold and measures to prioritise. UK doctors are held off to a time when he feels like he's finished dangling a carrot in front of the British Medical Association. The opposition are clear, well supported with principles. The bill. It must be used for offers that are made this year.

Amendment eight clarifies that the definition of a UK Foundation programme in clause five means a programme where the majority of training takes place. Inside the United Kingdom, a Foundation programme is defined as an acceptable programme for provisionally registered doctors within the meaning of the Medical Act 1983, section ten. It's vital to clarify that the UK Foundation Programme is a program where a majority taking place inside the United Kingdom. The reason for that, Madam Chair, is that currently the GMC cannot approve foundation programmes overseas and if it does not explicit that a foundation programme needs to be in the United Kingdom, that creates a loophole where a foundation programme could be approved overseas and later back into the system, thus circumventing the measures that they've tried to put in place.

I encourage the Minister to look at that carefully as the bill progresses. In summary, Madam Chair, we support the bill, but we have some concerns about some of the clauses and have made some amendments that we hope the government would look carefully at.

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Thank you. OK. I call Liberal Democrat spokesperson Helen Morgan.

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Thank you very much, Madam Chair. The amendments tabled in my name raise some concerns about the impact on fairness, transparency impact on fairness, transparency and smooth functioning of the NHS, notwithstanding the Liberal Democrats overall support for the bill. First of all, I want to bill. First of all, I want to address clause seven one. This clause would allow Ministers to change who is eligible for prioritisation through the negative procedure, meaning such changes could be made unilaterally without meaningful scrutiny. In practice, this hands the Secretary of State the power to redraw the boundaries of opportunity, the power to decide
18:56
Helen Morgan Portrait Helen Morgan MP (North Shropshire, Liberal Democrat)
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who gets prioritised for medical training places without Parliament ever having a say for a decision that affects people's lives, that affects people's lives, careers and the future capability of our health service. I think that's unacceptable. And while I that's unacceptable. And while I don't doubt the intentions of the current Secretary of State and frontbench team, it opens the door to the risk of political whim or prejudice influencing who gets to access career defining opportunities in the future. That's opportunities in the future.

That's why Liberal Democrats have tabled amendments two, three, four and five to reverse this and ensure any changes must be subject to full parliamentary consent. Secondly, Madam Chair, I want to address the timing of the bill's implementation. The government intends to apply these new prioritisation rules midway through the 2026 speciality recruitment cycle. So let's reflect on what that means in practice. Doctors already working in the NHS have entered this cycle under one set of rules. They've paid for exams, secured visas, arranged travel, recruited their families and committed themselves to the NHS to change the rules.

Halfway through the process would not only be potentially destabilising for services, but it would be very unfair to those individuals, many of whom are plugging urgent staffing gaps. Right now, we're all already facing real workforce pressures. The last thing our NHS needs is a wave of dedicated doctors forced out by uncertainty or pushed to leave the country because government moved the goalposts after applications had already begun. For these reasons, we believe the bill's provisions should come into force from 2027. We must protect frontline services and we must protect the integrity of the application process to address this problem directly, we have tabled amendments six and seven.

These amendments would safeguard those already in the 2026 application cycle, ensuring that they're not prioritised. Because that's a simple matter of fairness. Madam chair, we've also tabled an amendment to improve the transparency and long term impact of this bill across We face severe shortages not just in general practice, but oncology, mental health and many other specialities. I will give way.

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To give way because last year, research by the Royal College of Radiologists found that 76% of Radiologists found that 76% of England's cancer centres had patient safety concerns due to workforce shortages. And whilst we welcome the government's recent welcome the government's recent commitment to end the postcode lottery of cancer care, I wondered if my hon. Friend agrees with me that really, the government needs that really, the government needs to publish an assessment of the bill's impact on doctor numbers, broken down by speciality, to ensure that cancer treatment is not

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ensure that cancer treatment is not delayed by staff shortages. Well, I. Thank her for her intervention and I agree with her fully. And that's why we've tabled a new clause one requiring the government to publish a report on the impact of this bill on the number of applicants who both foundation and speciality training and, crucially, to break this down by speciality. If applications fall as a result of these changes, the government would be required to assess the impact on the total number of fully qualified doctors entering the NHS.

This report would be produced annually after three years, allowing time for a full training cycle to complete. It's a sensible safeguard ensuring that we do not inadvertently exacerbate the very workforce shortages we are trying to address. Finally, Madam Deputy Speaker, Madam chair, sorry, I want to return to the core principle at stake. We are not opposed to the bill's objective. In fact, we support the principle of prioritising those who trained in the UK. But that principle must be implemented fairly, transparently and with proper oversight.

I will touch briefly on the amendments tabled by the Official Opposition. Amendment nine would require British citizens to be prioritised for places on UK foundation programmes and for interviews in places on speciality training programmes from 2027 onwards, while amendment eight would require a UK Foundation programme to be a programme for which the majority of training takes place inside the United Kingdom. And I'm not convinced these amendments are consistent with each other. Surely the purpose of the bill is to ensure that the £4 billion spent every year on training doctors in the NHS is an investment in the NHS, and those who are prioritised for speciality training have experience of both the workings of the NHS and the epidemiology of the UK and their own locality.

And amendment eight looks broadly sensible in that context. But amendment nine would prioritise British citizens regardless of their place of training or NHS NHS experience, and this seems to me to be potentially counterproductive to that aim. So we will not be supporting amendment nine. In conclusion, Madam Chair, amendments two, three, four and five tabled in my name would strengthen parliamentary scrutiny by placing replacing the negative procedure with the affirmative procedure and showing any future changes to eligibility. Receive proper examination. Amendment D ensures that devolved nations also give consent for any changes are laid before Parliament.

Amendment six and seven ensure the fairness of the process in the current year, and new clause one seeks to ensure that the Bill is meeting its objectives of lessening the workforce crisis by speciality. These changes don't undermine the bill. They strengthen it. They protect fairness, protect parliamentary sovereignty and protect the NHS workforce from unpredictable and disruptive changes. So while we support this bill, we urge the government to adopt these amendments. They will ensure the legislation works for patients, for staff and for the long term strength of our NHS.

Thank you.
19:01
Ben Spencer Portrait Dr Ben Spencer MP (Runnymede and Weybridge, Conservative)
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Doctor Ben Spencer. as always to serve under your chairmanship and I beg to move that new clause two in my name and in the name of many others on this side of the House, I'll declare I'm now Non-practising doctor and my my wife is a doctor. I'd like to start off by saying that I believe that ambition should be encouraged, and success is dependent on the talent and the hard work of the individual. But the sad truth is, unfortunately, in a vocation, in one where we really want to have the brightest and the best and encourage and support that.

The signal being beamed out by the NHS and its various arms and quangos is quite different, and we've already seen this over the years in terms of how the NHS treats competence and excellence amongst doctors, where someone could be the best doctor in the world and be treated just the same as someone who is just about competent, no other workforce or or operation would approach employment and celebrating, supporting success in that way. But I don't think I've ever seen as egregious example of a complete ignoring to the extreme of talent and merit.

Then the preference informed allocation system. Now, the shadow Minister has laid out some of the details behind it. I would really encourage members across the House to look up preference informed allocation and read how it works. The soulless, computerised algorithmic method by which it treats human beings and allocates them to a random number. This random number, which is then the sum total of their dreams, their hopes, their ambitions in terms of placements, or as they make their first steps into their medical career.

Pia looks to me preference informed allocation that something better suited to the dystopian sci fi programmes that I enjoy watching, you know, it's better suited to to Logan's Run or The Prisoner or people allocated by numbers. It is not the way that we should be treating people in this country. It is outrageous that this has been brought in to force, and we in this House should stand up for merit, and I really hope that the Minister will affirm and Dispatch Box today that the government will dismantle this awful, awful scheme.
19:04
Karin Smyth Portrait Karin Smyth MP, Minister of State (Department of Health and Social Care) (Bristol South, Labour)
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The Minister. >> Thank you, Madam Deputy Speaker, I am grateful to members at this hour for their contribution to to the wider debate and for the the wider debate and for the considered amendments that have been brought forward. So I am going to respond briefly to, to those points of amendments have been put forward on amendment six and seven. They seek to widen the scope of who is prioritised for speciality training. Start in 2026 by prioritised applicants who worked as a doctor in the health service in the 13th of January.

While we welcome the intention to recognise the importance of internationally trained doctors at this point, we cannot accept this this amendment at this time, it would mean the bill is ineffective in delivering on its intention to tackle bottlenecks and ensure we have a sustainable medical workforce that can meet the needs of the population. Remind the House again that the bill does not exclude anyone in particular. There are likely to be opportunities in specialities such as general practice or psychiatry and internal medicine, which historically attract fewer applicants from the groups we are prioritising for 2026.

International medical graduates also continue to have opportunities as locally employed doctor roles, which could lead to NHS experience that might count towards future prioritisation. As we look to make regulations to set criteria for what is considered significant NHS experience from 2027. Regard to amendment ten, which seeks to ensure members of the armed forces are not excluded from prioritisation due to having undertaken medical training while on posting outside the British Islands. We cannot accept this amendment as we believe it is not necessary. That's because medical cadets do not spend time outside the British islands as part of their UK medical degree, whilst cadets would undertake their elective with the military and this may be overseas.

This is no different from other civilian medical students, many of whom undertake electives overseas. As such, we do not believe medical cadets are disadvantaged by the bill on amendment nine. Amendment nine would include all British citizens within the priority groups so that British citizens will be prioritised for the purposes of the Foundation programme and speciality training from 2027 onwards. It has no effect for 2026 speciality training, as British citizens are prioritised by virtue of their immigration status, so we cannot accept this amendment.

To do so would risk a significant increase to the pool of prioritised doctors that would compete with UK trained doctors. This amendment would incentivise the expansion of the market for overseas medical schools, including medical schools, working with foreign governments to grow the overseas campus sector. This could offset any increase in postgraduate training places and undermine workforce planning, while British citizens will be prioritised for speciality training places in 2026, this is a proxy that is necessary for practical reasons and from 2027 we want to prioritise applications with experience and training based in the NHS.

But again, prioritisation does not mean exclusion. International medical graduates who are not prioritised will still be able to apply and will be offered places if vacancies remain after prioritised applicants have received offers. However, it is important we do not incentivise actions which will undermine the bill to reduce competition places for UK trained doctors so that home grown talent can become the next generation of NHS doctors. Turning to amendment eight, this would limit the definition of a UK foundation in clause five to only include programmes where the majority of training has occurred within the UK.

Now, while I can understand the desire to do so, the number of doctors on a foundation programme within the meaning of the Medical Act 1983, and where the majority of training occurs outside the UK, is very small indeed. I understand there's only one such active training programme, where there are fewer than 25 doctors on the programme this year, of which fewer than five doctors applied to continue their training in the UK. And as such there's no material impact on the bill and therefore we don't think an amendment is necessary.

However, we will keep this situation under review with regards to amendments two, three, four and five. They change the procedure for making regulations to set additional priority groups for speciality training from 2027, and these regulations will prioritise additional groups based on criteria indicating a person is likely to have significant experience working as a doctor in the health service or by reference to their immigration status. So, to be clear again on our intention, the bill sets out on its face the groups of people who are to be prioritised for speciality training from 2027 onwards.

The delegated power is limited to adding to this list by reference to significant experience working as a doctor in the health service or immigration status. And so, whilst I'm sympathetic to the desire for more parliamentary scrutiny as outlined by the hon. Lady, we believe that due to the limited scope of the power, the negative procedure is justifiable and therefore I encourage the member to withdraw her amendment on amendment one. This is about the commencement of the bill. It seeks to change the commencement, the bill from being commenced by regulations to being commenced automatically at Royal Assent.

And as my friend, the Secretary of State outlined, the commencement clause is important and I think I have addressed this point. It is a fail safe which, given the tight timeline for introducing the bill, will ensure we're not in a position where a law is enacted that we cannot implement effectively for whatever unforeseen reasons. So there is also a question about whether it is even possible to implement, as I've said, prioritisation. If, for example, the strikes are ongoing, given the strain they put on resources and the impact that could have on delivering the bill, our objective is not just to move quickly but to get this right, and that's why these considerations are key to the commencement of the bill, which is why the government believes it needs the ability to commence the bill when it makes sense to do so.

And for those reasons, we cannot accept the amendment on new clauses one and three. We don't think these are necessary because the data is already published. Or as we've said, we would be seeking to monitor the impact on clause. New clause two would require the allocation of individual candidates to foundation and speciality training places on merit, once the requirements to prioritise certain application applicants have been met. We consider this amendment unnecessary at this time because existing systems, recruitment systems to foundation and speciality training already assess the applicants on many of the merits outlined by the amendment.

The bill does not alter that. It simply ensures that UK medical graduates and other eligible applicants are prioritised. We will keep, we will keep to the gentleman's point, we will keep the current system under review and I think the Secretary of State was clear of that. But we do think that the only changes is best done by the established guidance, rather than through legislation. On the final point, I'd just like to reiterate our support. Again. A lot of hon. Members have raised the issue around our relationship with water and Queen Mary's.

The work that is done there, it's very clear that it's an important relationship. We have a number of work on going with them in the medical field as well as other. Of course, that's an important relationship. We are not excluding anyone. We are making sure that the prioritisation works best and we will of course keep all of that under review. So I really do thank hon. Members for their constructive debate on this

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important legislation. Thank you. Yes. The question is that clause one

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The question is that clause one stand part of the bill. As many as I of that opinion say aye. Of the I of that opinion say aye. Of the contrary, no. I think the ayes have it. The ayes have it. With leave of the committee I will put the the committee I will put the question on clauses two and three stand part together. The question is that clauses two and three stand is that clauses two and three stand part of the bill.

As many as are of that opinion say I. I of the contrary. I think the ayes have it. The ayes have it. We now come to amendment nine to clause four, which has been selected for separate decision. I call Stuart

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Andrew to move amendment nine formally. Formally. Amendment nine proposed clause

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Amendment nine proposed clause four as on the amendment paper. The question is that the amendment be made. As many as I have that opinion say I. I of the contrary, The The question The question is, The question is, as The question is, as on The question is, as on the The question is, as on the Order Paper, as many as are of that opinion, say I. I of the contrary, no. No tellers for the ayes Paul Holmes David Simmonds Tellers for the noes Stephen Morgan Imogen
19:13
None Portrait Division
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Order, Order, order! Order, order!

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The ayes to the right 91. The noes to the left 378.

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noes to the left 378. The eyes, the right were 91. The noes to the left were 378. So the noes have it, the noes have it unlocked. With leave of the committee, I will put the questions on clauses 4 to 6 stand apart together. The question is that clauses 4 to 6 stand part of the bill. As many as are of that opinion say I. I of the contrary, no I think the ayes have it, the ayes have it.

We now come to amendment two to clause seven, which has been selected for separate decision. I call Helen Morgan to move amendment two formally. Amendment two proposed clause seven as on the amendment paper. The question is that the amendment be made. As many as are

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of that opinion, say I. Of the contrary, no. No. The question is, as on the Order Paper, as many as are of that opinion, say I of the contrary, no. No tellers for the ayes Zoe Franklin Claire Young Tellers for the noes Stephen

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Morgan Imogen Walker. Lovely. Thank you. All All the.

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The ayes to the right. 61. The

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Noes to the left 311. The ayes to the right were 61.

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The ayes to the right were 61. The nurse to the left were 311. So the nurse have it. The nurse have the nurse have it. The nurse have it unlocked. The question is that clause seven stand part of the bill. As many as are of that opinion, say I. Of the contrary, no. I think the ayes have it. The ayes have it. We now come to amendment one to clause eight, which has been selected for separate decision. I call Stuart Andrew to move amendment one formally.

Formally, amendment one proposed to clause eight as on the amendment paper. The question is that the amendment be made as many as are of that opinion say aye. Of the contrary, no. no. Division. The The question The question is, as on the Order Paper, as many as are of that opinion. Say I of the contrary, no. No Tellers for the ayes. Paul Holmes David Simmonds Tellers for the noes Stephen Morgan

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Yes.

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Order,

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Order, order!

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Order, order! The ayes to the right 88. The

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The ayes to the right 88. The noes to the left 310.

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Swansea West. The ayes to the right were 88. The noes to the left were 310. So the noes have it, the noes have it unlocked. The question is that clause eight stand part of the bill. As many as are of that opinion say I of the contrary, no I think the ayes have it. The ayes have it. Order, order! That concludes proceedings in committee. Order!

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Whip to report. I beg to report that the committee has gone through the bill

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and directed me to report the same without amendment. Yes.

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Under the order of the House today, we shall now move on to the Third Reading of the Bill. Now.

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Now. Minister, to move Third Reading. Thank you, Mr. Speaker, and I
19:52
Karin Smyth Portrait Karin Smyth MP, Minister of State (Department of Health and Social Care) (Bristol South, Labour)
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>> Thank you, Mr. Speaker, and I beg to move that the bill now be read a third time, and I'm not going to use the time to rehearse any of the arguments today. I think we have had some good discussion today. I would like to take the time to thank the Leader of the House, the Chief Parliamentary Counsel and business managers, the public servants in my department, NHS England, who have worked so hard to bring this together, and the devolved governments for their support.

They really have worked well together to bring this important measure to this place. And I'm also grateful to all colleagues for scrutinising the bill so thoughtfully and thoroughly over the course of today's proceeding. And as I said previously for meeting with me last week to go through some of those provisions, I do think it shows how Parliament can put its shoulder to the wheel and get stuff done in the public interest, because we are acting in the public interest, because we were elected on a mandate to fix our broken NHS and make it fit for the future.

And we will not succeed in that goal without our workforce, who are and who will always be our greatest asset. And when I was working in NHS during the Lansley reforms, I had a front row seat to see the devastating impact of those on staff morale. I saw how patients bore the brunt of some of that collapse in morale, and when our workforce does well, our NHS does well and that is why we're working to restore confidence and renew belief amongst front line staff.

This bill is another step on that journey, and I urge colleagues to come with us and see it through a.

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The question is that the bill be now read the third time. Shadow

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Secretary of State. Thank you.

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Thank you. The question is that the bill be now read the third time. As many as now read the third time. As many as are of that opinion say I. I of the contrary, no I think the ayes have contrary, no I think the ayes have it. The ayes have it. Petition Pippa Heylings. Thank you, Madam Deputy Speaker.
19:54
None Portrait Petition
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I'm pleased to present this >> I'm pleased to present this petition on behalf of Elizabeth Spain and the South Cambridgeshire Climate and Nature Group in my constituency. The petition states that peaceful environmental protesters are being criminalised through excessive charges, harsh sentencing and negative media treatment and that the Public Order Act 2023 has introduced restrictive protest measures which deter people from exercising their right to peaceful protest, undermining the United Kingdom's long standing commitment to freedom of assembly, freedom of expression and non-violent civil disobedience.

The petitioners, therefore, request that the House of Commons urge the government to introduce legislation

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to repeal the Public Order Act 2023. Thank you.

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Petition. Public Order Act 2023. Petition Brian Leishman. Good evening, Madam Deputy

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Good evening, Madam Deputy Speaker. I present this petition on behalf of my constituents from Tillicoultry who have had nowhere Tillicoultry who have had nowhere to call home for two years now, and for those people from across the United Kingdom who also have had their lives impacted by reinforced autoclaved aerated concrete in their homes. I also want to note that this bill is on a similar petition circulated locally, which gathered over 200 signatures showing the strength of feeling in Tillicoultry and beyond.

My constituents deserve answers and accountability and all they ask for is fairness. This petition requests that the House of Commons urge the government to hold a public inquiry into the handling of RAAC by national and local government, to introduce legislation to require the maintenance of a high risk building register. To mandate reporting of building defects by surveyors and other professionals, and to introduce a 60 year liability for developers for building defects, and to consider compensation measures, such as a ban on levying interest on mortgages on homes condemned after discovery of RAAC and the restoration of first time buyer restoration of first time buyer status for affected homeowners.



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Thank you. Petition reinforced autoclaved aerated concrete in

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housing. I beg to. adjourn.

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adjourn. The question is that this House do now adjourn. Richard Fuller.
19:56
None Portrait Adjournment: Impact of East Park Energy on North Bedfordshire constituency
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do now adjourn. Richard Fuller. >> Thank you very much indeed. Madam Deputy Speaker, may I start by thanking you and through you, the speaker, for permitting me to speak on this important constituency matter. And can I also welcome the Minister and for the benefit of those who may be not familiar with the process, the Minister will probably likely be very limited in what he can say specifically about the topic I'm raising today. And the topic, Madam Deputy Speaker, is a proposal by East Park Energy for a large scale ground mounted solar plant and battery energy storage system spanning North Bedfordshire and also the constituency of Huntingdon, which is currently under consideration as part of the nationally Significant infrastructure project process.

East Park Energy spans 1900 acres of land and give some perspective that's larger than Gatwick Airport on what is currently open countryside and engulfs the rural parishes of Pertenhall and Swineshead, Bolnhurst, Kiso, Little Stoughton, Staploe and Dean and Shelton in my constituency, as well as the parishes of Hale, Weston and Great Staughton in Huntingdon. Constituency. 74% of the land is classified as best and most versatile agricultural land, and East Park is one of six nationally significant infrastructure projects impacting North Bedfordshire, and I've called the debate to discuss with the Minister the impact that East Park Energy could have on North Bedfordshire's local residents, landscape and rural character, and to raise with the Minister points specific to the proposal that warrant, in my opinion, serious consideration for its rejection.

Now East Park Energy would permanently and fundamentally change the rural aspect and character, would transform open countryside into industrial land. I think it's an important Madam Deputy Speaker we stop referring to these with the rather cute term of solar farm, because the truth is, they are industrialised complexes and in this case it's one made up of 700,000 solar panels, each up to three metres high, along with fencing, lighting, CCTV, inverter stations, transformer units, battery storage infrastructure and cabling.

That sounds a long way from what we understand as a farm now. Proposed mitigations to plant trees to screen the development are usually insufficient, even if planting to screen the panels succeeds, it will take years for these trees to mature and even at full maturity, large parts of the site would still be visible due to its topography. This will be a huge, permanent, unmissable miles long change to the local environment of this part of England. It won't blend in with the existing environment, it will crush it.

Now it is important to say we're not against solar farms in general in Bedfordshire. In fact, we have 44 solar farms already operational or proposed in both Bedford Borough and Central Bedfordshire, which the two local authorities that traverse my my constituency. But this specific proposal is different now, given my interest in financial matters, I hope I'll have the discretion just to make a couple more general points. Madam Deputy Speaker about finance of solar farms, which I know the Minister will be aware of.

First of all, with these large solar plants, it's important that we know that we are paying the cost of capacity, but not of output, that excessive capital costs or capital costs are excessive because of the inherent process inefficiencies in solar farm. That's fine as long as it doesn't end up on the public purse or investors. But ultimately investors look for return, so indirectly it does end up on us. Second of all, we're paying for the cost of variability of output from solar plants.

The hidden costs of charging, changing the national network to cope with this new factor of energy production. Thirdly, it's important that we note that we're paying the cost of buying energy produced, but not necessarily needed or used, and therefore paying essentially for wasted energy. Now, in addition to those points which I know the Minister will be well with and have already factored in the combination of solar generated energy with energy price arbitrage via battery energy storage systems, in my view, fundamentally changes the economic case for solar, and certainly from a public benefit point of view, returns to investors will already be supercharged by the addition of new capacity in the form of battery storage.

It's a very significant additional investment, but that additional investment only makes sense financially when the purpose is to arbitrage energy costs. Producing energy at low price points to sell at high price points. And that isn't really the intention of trying to get low cost energy, and also the overall structure of the contracts which the Minister inherited from previous administrations. Just being a business person, it directly encourages maximum financial leverage. That means taking on as much debt as you can in order to maximise returns to investors.

And as we've seen in other areas, particularly with Thames Water, the problems that we have when we see parts of our infrastructure, public infrastructure, with the amount of leverage that can be put up and then essentially returns privatised, losses socialised. I'd just be interested in Minister's observations about that. So can the Minister advise if the government has put in place, or has plans to put in place a limit on the debt ratios that large scale solar plant operators can carry? I did a quick check.

I can't see that's in place at the moment. I'd be interested in minister's thoughts about that tied to that point. Again, from financial point of view, Madam Deputy Speaker, is my own understanding about corporate and political risk. In the case of East Park Solar, I am concerned about the corporate history and about financial viability. That's no disrespect to the business, but to say that they have no prior experience in developing or operating such large scale solar projects. There are substantial issues of project failure or poor management, and therefore the risk that the current developer might sell it on to somebody else with a whole new set of investors, a whole new set of objectives.

And I'd also be interested. The Minister may not be able to speak about this, but at least one political party in this House has raised the risk about stranded assets that they might cancel projects in the future. Now, that really is an issue that the government should be taking on board and putting into its consideration, not because they agree with it, but if that there is such a change in government, then it is the people of North Bedfordshire in this instance that will be left with those stranded assets and of a scale essentially three miles that way and three miles that way of solar panels with no economic return and no financial financial viability to remove because I don't believe and again, the Minister will correct me that there is a requirement for an escrow fund to be put in place for the removal of plants should a business go bust.

So can the Minister say what weight is placed on the historical experience of applicants for these large scale plants? In having had experience of installing and operating such plants in the past, does it factor at all or not? Now, in many of the debates and I've reviewed a number of these debates. Madam Deputy Speaker, the issue of best and most versatile land has come up. The Minister must accept that at 74% of land area, which is the proposal of East Park East Park Energy, 74% is best and most versatile.

That's a pretty high proportion, well in excess, I think, of almost every single plant that's been adopted or accepted today. It's a generational loss of arable land, and I'm afraid the proposal from East Park Energy lacks any serious demonstration of seeking lower grade land, or indeed brownfield land. And it appears to be at odds with national policy, which is to avoid using best and most versatile land. And now the Minister himself. Obviously, this is a moving target. I don't mean to quote the Minister Bactrim, because actually he was very sensible.

He said on a debate on the 15th of May of 2025 that I'm not going to put a figure on it right now, but we have clearly said that it is important to find the right balance when it comes to best use of agriculture, best use agricultural land. From Hansard, I think the Minister, he won't say today, but Minister, 74%. Come on now. So can the Minister advise if the use of of best and most versatile land of a proportion of 74%, and at the scale that is East Park Energy will be an issue of weight in the appraisal.

I don't expect you to say yes or yes or no in terms of whether it's right or wrong. But when Ministers have said in the past, in previous debates that it's important not to use best and most versatile agricultural land, that food security is important. And then gone on to say, but solar will only take up 1% of land. It implies both that it matters the use of best and most versatile land, avoiding that it matters not to use it, but also it doesn't matter.

So which is it? At 74%? This seems to me to be quite a central point, but I want to come to two final points Madam Deputy Speaker, which I think are of significant particular significance here, and to make the Minister aware of the broader issues. So there is a issue of consideration, which I think is called cumulative impacts. So I want to put on the record what this proposal for East Park Energy will be coming into in terms of the local context of North Bedfordshire, my constituency and the surrounding area more, more generally.

So, Minister, the first thing that you should be aware of is that Bedfordshire, for the last decade or more, has been growing in terms of housing growth at between 2 and 3 times the national average. If you look at the census of 2011 and census of 2021, and look at the number of households essentially in my constituency, that of my colleague, the hon. Member for Mid Bedfordshire, the level of housing growth is two and a half to three times the national average.

As he will know. That's great for the country, but it does put a strain in terms of what is going on with infrastructure around it. Second of all, Bedfordshire has six nationally significant infrastructure projects on the blocks right now. That's a huge, huge amount. So to to enumerate them for the Minister right now, black Cat roundabout, the A428, which is in the direct area of East Park Energy, that is the country's largest ongoing road project, due for completion in spring 2027 there or thereabouts.

Second of all, east west rail that is the country's third largest railway project, proposed to drive a line between Bedford and Cambridge, cutting through the constituency of my in my north, my North Bedfordshire constituency. Thirdly Universal Studios, this is the most significant inward investment in the country, has one that started under the last government, supported by the opposition at the time, and now it brought home by the government and supported by the opposition. Today, 10 million visitors a year with all the people movements that that entails and also the ancillary development that will come around that further away.

Luton airport expansion to facilitate that, a doubling in size from 18 million to 30 million passengers a year, and then very specifically a new settlement in Thamesford, Madam Deputy Speaker Thamesford, as I say in this house, is currently a village of 400 residents and seven sheep. The government is highly likely this year to take forward the proposal from the New Towns Commission that Thamesford should be the site of at least 40,000 new homes, 400 residents to over 100,000 in land that encompasses and abuts and maybe embraces land for East Park Energy.

And on that specific point itself, it seems to me you can have one or the other, but you can't

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have both. And with that, I'll give way to my hon. Friend. Thank you, thank you, thank my

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Thank you, thank you, thank my hon. Friend, for giving way and for raising this debate this evening. He's giving a very thoughtful and He's giving a very thoughtful and important speech, and he has spoken eloquently about the cumulative development in both of our constituencies. And, of course, that's putting both Central Bedfordshire and Bedford Borough under significant strain. From a planning perspective, does he agree planning perspective, does he agree with me that it would be important for the government to support our local authorities so that we think holistically about these developments and so that we make sure that our landscapes are protected, that our local communities are listened to, and that to the extent possible, we can secure the agricultural land that we need to secure food security into the future.

There's a reason why we have so many farmers in Bedfordshire, and that's because we have fantastic agricultural land. Wouldn't it be a waste to build on all of that land? In the case of

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this East Park Energy on the altar of net zero? Well, my my hon. Friend makes

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Well, my my hon. Friend makes makes an important point, and I think it's two, two important points. First of all, the importance. Certainly if you look importance. Certainly if you look at World War two that London would have starved without agricultural produce produced in Bedfordshire. produce produced in Bedfordshire. But more importantly for the Ministers is for the Minister to recognise that we are supportive. recognise that we are supportive. Actually, we know the government wants has a growth strategy. We may have disagreements on national economic policy, but we want to do our bit.

And in fact the people of Bedfordshire are doing their bit and a lot more. But the Minister appreciate, with so many projects happening all at once, at some point those things are going to break and my hon. Friend makes an important point about that. But turning specifically to East Park Energy documentation about this, I have to say it chose not to be comprehensive in the scope of its evaluations and was insufficient in the depth of its analysis. So, for example, it completely omits any reference to Luton Airport, expansion to universal theme park and any potential new town at Tempsford.

It dismissed the need for an assessment of black Cat on the assumption that construction would be finished before East Park Energy starts, but there will be consequential effects, including further construction from the change of black Cat roundabout. It dismissed the need for an assessment of east west rail on assumption, but this is highly likely there will be overlapping construction periods should East West rail go ahead. It lacked any assessment of medium or long term effects, such as permanent land use change and increased perception of the urbanisation of the area.

It provided no consideration of the overconcentration of solar development in North Bedfordshire. We're part of the 1% club, my constituency, which is constituencies where over 1% of the land area will be covered by solar panels and it ignored the impact of overlapping construction periods that it would be adding to for two and a half years or 30 months. So just imagine all this traffic going over, building Universal Studios, getting construction, because we want to have shovel in the ground and start building at times.

If the government decides to go ahead with that, trying to build east west road, just completely ignore that. So from the point of view of actually understanding the impact of what it is going into the proposal presented fell short very significantly indeed. And finally, Madam Deputy Speaker, I yield to to the Minister. As I said, I fully know that the Minister is very limited in what he can say about specific projects, and that the Secretary of State himself would not be able to comment at all, given his role.

As I mentioned briefly to the Minister earlier, I am perhaps in a small minority on this side of the House who has agreed with the Secretary of State on some of his criticisms of past energy policies, even though I may not agree with everything in terms of his remedies. So I hope the Minister understand that this observation comes from a positive place. Madam Deputy Speaker the role of the Secretary of State or his designated Minister in making a decision is a crucial step in an evaluation process.

It is a step that the public must trust, is one that assesses each proposal individually on its merits, not just on overarching goals. There have been 12 solar panel DCMS for evaluation since July 2024. Each of them have been approved, so I would encourage the Secretary of State for those who may be old enough. Not you, Madam Deputy, but certainly me to remember Oklahoma! The Oklahoma musical, where there was a song. I'm just a girl who can't say no.

No. It's a very old reference, but I'm very old. But the importance of that, Minister, is my encouragement to the Secretary of State to avoid any caricature that he can't say no, because in the case of East Park Energy, my personal view is that

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there are considerable and specific reasons why he can say no. OK.

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Minister. Thank you.

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Thank you. Madam Deputy Speaker. And can I t first of all, in bringing this first of all, in bringing this debate tonight? And I think our are particularly welcome and I'll respond to some of his points. But given the time, I won't be able to respond to them all. I do want to make a general point to begin with, which is that I appreciate many of
20:16
Michael Shanks Portrait Michael Shanks MP, Minister of State (Department for Energy Security and Net Zero) (Rutherglen, Labour)
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these issues, and planning issues in particular are always contentious. I think we all know that as a member, as members of Parliament, these issues are raised regularly. I hope I've always given the impression that although we might make decisions as a might make decisions as a government, that we that people will disagree with, that I always am keen to hear the points that the hon. Gentleman has raised and other hon. Gentleman has raised and other members do, and I want to continue those conversations that, you know, helpfully, the hon.

Gentleman said helpfully, the hon. Gentleman said at the outset that I won't be able to comment on the specific application that he references, and it's worth just for those outside the house just being really clear about why that is, that this decision will come before my department for a decision. I personally, as the Minister with a policy interest in this, don't see the papers for these decisions and I'm not engaged in that. My noble friend Lord Whitehead usually makes these decisions, or my right hon.

Friend, the Secretary of State. But it is important that no Minister that has a role in this speaks about the specifics, and I know the hon. Gentleman understands this. However, I do want to talk in more general terms about how we make sure that solar projects, which are really important, are rolled out sensibly and sensitively. And I think that's really at the heart of many of his remarks. First, I do want to just take his back slightly to the bigger picture here about why solar power is so important in the first place and why it's at the heart of the clean energy mission.

We know that at the moment, energy bills are still being set far too often by the cost of gas and renewables and deploying renewables faster than we have before is the way that we reduce our dependence on volatile fossil fuels and protect billpayers now and into the future. It is also the economic opportunity around how we create thousands of jobs and communities right across the country. And of course, as a government that still cares deeply about tackling the most existential crisis, the planet faces the effects of climate change that we see all too often, and I'll return to this point later are not something we can put off to tomorrow.

They are hugely important that we tackle now. And so this mission is critical. And the reason that solar is right at the heart of this is that it is by far one of the cheapest renewable energy sources that we can deploy, and it's able to be deployed at scale. And so it is critical to our mission. Now, our aim in the Clean Power mission is to achieve at least 45 to 40GW of solar by 2030. We're at around 22GW today. And so if we're going to deliver that, a combination of ground mounted solar, but also a rooftop revolution as well.

And I'll come back to that point. We do need to deploy rapidly. But at the same time, we also have a commitment to doing so sensitively for the communities that host that infrastructure and making sure that those communities also gain a benefit from hosting it on behalf of the country. Now, if I pick just some of the hon. Gentleman's substantive arguments, first of all, the question of how we balance the need for this infrastructure across the country and the fact that it has to be somewhere with the adverse impacts that communities face, but also the potential benefits that communities face from hosting.

Some of this is exactly what the rigorous planning system we have is about. The views and interests of local communities are key to that, and I know the hon. Gentleman has engaged in the process and the specific one, and has made representations already, and he will obviously encourage his constituents to do the same. That feedback is hugely important, and people should feel like that has a serious role in the decision making process because it does, and therefore it is worth participating in that process and making those submissions, turning up to those meetings.

It really does matter. The planning process itself obviously considers many of the issues he raises visual amenity, protected landscapes, land use, food production, safety and traffic conditions in the construction of them. And it does require in the nationally significant project system that considerable community engagement is undertaken before a decision is made, and the level of that engagement and the quality of it is considered during the decision making process, and it is a marked down for these projects. If it's not taken seriously.

The hon. Gentleman raises the really important point about cumulative impact. And I agree, this is a really important issue for us to wrestle with. Now, I don't pretend that we have a single answer to this, but the idea that we should plan holistically, I think the hon. Gentleman made the point earlier to make sure communities are not facing multiple projects, and all the cumulative impact that comes

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from that is something we want to tackle. Now, there are two ways we are doing that, of course. Obviously just on the record,

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Obviously just on the record, when the Minister talks about cumulative impacts on projects, the point I was trying to make is one consideration is solar farms and consideration is solar farms and cumulative impacts. Other is there's a lot of other types of infrastructure going on. Could the Minister be clear that include cumulative impacts include

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cumulative impacts include consideration of both. I'll come to that point, a part of the wider work we're seeking to of the wider work we're seeking to do across government is to holistically, strategically plan where infrastructure is built. The land use work that Defra is doing, for example, is about looking at the whole of the United Kingdom and making sure that we've got a plan in place for what future land use is so that all of those things are taken into consideration. But I'll come to that point in just a moment.

I just want to focus on the legal requirement around a cumulative effect assessment, which is set out in environmental regulations. The government has published advice which summarises the process for undertaking that in relation to Nsps, and the wider point that he raises around the cumulative impact of housing or Universal Studios or or transport is also really important. My department obviously has an interest, particularly in how we plan the energy system, but we are seeking to work much more broadly right across government and the land use consultation, which Defra launched, closed in April of 2025, and the outputs from that and the regional workshops that have been undertaken are now being analysed.

And that is the first time we've really had a national holistic plan to bring all these things together. The second point from an energy perspective, which is what I am responsible for, is the strategic spatial energy plan, which is the first time in our history that we will plan strategically the energy system that we need and make conscious decisions about where do we site energy infrastructure so that we are not needlessly building the grid infrastructure that goes with it? So we are building next to where we need it the most, reducing that impact on on communities and really taking into effect that the cumulative impact of those.

We should have been doing this a long time ago. And I don't blame any particular government for this, but we have rolled out a huge number of renewables projects across the country without doing any of that strategic planning. And I think that is a huge failure in the past. And of course, as a result, we are now spending huge amounts of money building the grid to connect it. We have to do that, but it is a shame we didn't plan it more strategically in the first place.

But we start from where we start, unfortunately, and I'm conscious of time Madam Deputy Speaker. So I just want to quickly refer to the land use point, first of all, and the use of farmland for solar projects, which I know is raised red regularly and is an important point to raise. Food security is also our national security and it is hugely important. The planning policy does make clear that wherever possible, developers should utilise brownfield, industrial, contaminated or previously developed land. I understand the point he made about the particular site, which I cannot comment on, and he but he helpfully quoted me to me and helpfully, I still agree with me that which isn't always the case, but I'm not going to put a specific figure on it for for obvious reasons.

But there is very much a determination in the process that we should be using lower quality land wherever possible. But that does not mean that we can always do that. And I think we do need to realise that there are projects where that's just not possible. But if we zoom out just a little bit Madam Deputy Speaker even in our most ambitious deployment scenarios, only 0.4% of UK land would be devoted to solar in 2030. Just in concluding, there are a number of other points that I won't be able to come to, but I'll write in with some responses on them in the context of what we're seeking to do.

I'm not complacent about the impact that these projects have on communities. I genuinely understand it, and I read all of my correspondence from people who write to me about these points. And the hon. Gentleman is obviously absolutely right to raise these issues. But what we are seeking to do is to build the infrastructure the country needs in a way that takes into account the local impact. Communities may feel that hasn't been done, and for that I apologise. But we are seeking to build a strategic system going forward that deals with many, many of these issues into the future so that communities feel this energy is not done to them, but is actually something that is part of their community and that they welcome and at the same time helps us deliver our missions as a government.

Solar power in this country remains hugely popular, and despite the number of issues, the planning process is rigorous. There is not an automatic yes coming out of the planning system. We look very carefully at every single one of these applications. They take a huge amount of consideration and it is important that communities feel that, and that they know that these applications are taken seriously. And if they don't feel that, then we have to do more as a government to make sure they have confidence in that system.

But as we deliver this clean power mission, solar will play a really important role.

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We want to bring communities with us, and I commit to doing more to make sure that that is the case. Hey.

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Hey. The question is that this House do now adjourn. As many as are of that opinion say I. I the ayes have that opinion say I. I the ayes have
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