Medical Training (Prioritisation) Bill

Preet Kaur Gill Excerpts

2nd reading
Tuesday 27th January 2026 Commons Chamber

[Preet Kaur Gill (Birmingham Edgbaston) (Lab/Co-op)]

I welcome the Bill. I have long argued that a strong state must be rooted in work, contribution and fairness, and that principle stands behind the Bill. For too long, medical training pathways have drifted away from that principle. Taxpayers invest heavily in medical education, clinical placements and postgraduate training, but we have not been honest about who ultimately benefits from the investment. 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 are dealing with. The taxpayer invests more than £4 billion every year in medical education, with more than £1 billion invested in undergraduate clinical placements, and more than £3.3 billion invested in postgraduate foundation and specialty training. That is public money, spent so that British patients have the doctors they need. However, since the lifting of visa restrictions in 2020, we have seen a fundamental shift in the way that medical training places are allocated. In the 2025 recruitment cycle, more than 25,000 overseas-trained doctors applied for training posts, and more than 15,000 UK graduates were competing for the same—nearly 13,000—round 1 and round 2 positions. As we heard from the Secretary of State, there are more than 47,000 applicants in 2026. That is a dramatic surge.

The Bill does one straightforward thing. It prioritises UK medical graduates for training posts, both foundation and specialty, where the NHS has already invested heavily. In my constituency, we see this clearly. University Hospitals Birmingham NHS foundation trust is one of the largest NHS trusts in the country. Just under 30% of my constituents work in the health sector. That figure is double the national average. We are home to the University of Birmingham medical school, one of the best in the country. The scale of public investment in training, supervision and infrastructure is enormous, and rightly so. However, the Bill recognises the basic truth that when the taxpayer pays, the public should see the return. Prioritising those who are 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.

[Dr Murrison]

I entirely agree with the Chair of the Select Committee that we need to keep Brits working in our national health service. Does she agree that we need to add to the priority list British nationals who, for one reason or another, are training in medical schools outside the United Kingdom—in Prague, in Malta, in Cyprus and in the Caribbean? The reasons why they are training in those places are many and varied, but they are British, and their intent is to practise in the national health service. However, they are being deprioritised by this measure.

[Preet Kaur Gill]

I am not the Chair of the Select Committee, and I think that the Secretary of State set out his position. This is really important. This is about UK taxpayers’ money being invested in training doctors, and we must ensure that UK trainees are able to secure training places once they graduate. That is the issue that we are discussing.

Let me be clear: this is not a criticism of international staff. The NHS would not and could not function without the dedication, 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. However, a mature, confident country can value that contribution while also saying that we cannot replace long-term workforce planning with a permanent reliance on overseas recruitment. That is not fair on British trainees, not fair on source countries, and not fair on the NHS. As we heard from the Secretary of State, the World Health Organisation has estimated that by 2030, there will be an 11 million shortfall in health workers, as every country competes for the same limited workforce. This Government understand that putting British workers first is not something for which we will apologise. 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; we must shape our domestic workforce to ensure that the NHS can continue to function. The same principle should apply wherever we are overly dependent on skilled migration because domestic training was neglected for 14 years under the Conservatives. Investing in people in the UK, 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 in the west midlands were filled. Will the Secretary of State outline how he intends to use the powers in this Bill and work with the integrated care boards to ensure that access to training matches regional workforce needs and health demands?

Above all, this Bill is about respect—respect for the taxpayer, respect for the NHS workforce, and respect for a health service that must be planned for the long term, not patched up year on year. This is exactly the kind of reform that the public expect from a Labour Government who are serious about work, contribution and the future of our NHS.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

Puberty Suppressants Trial

Preet Kaur Gill Excerpts

Wednesday 17th December 2025 Commons Chamber

[Wes Streeting]

I can absolutely assure the hon. Member that we are doing that wider research and that of course we will take into account high-quality international evidence, as well as the research we are undertaking domestically. It is so important that we recognise that, for many young people with gender incongruence, even if approved, puberty blockers will never be the right medication. One of the things I have been most saddened by in the discourse among adults in this debate, many of whom should know better, is the elevation of puberty blockers to the status they have received in public discourse and debate; many young people out there think not only is this the gold standard of care, but that it is the only care available, and, of course, that is not true.

NHS England has opened three new children and young people’s gender services in the north-west, London and Bristol, with a fourth planned for the east of England in 2026. We aim to have a service in every region of England in the coming years. These services use a different model with multidisciplinary teams, including mental health support and paediatrics, within specialist children’s hospitals to provide good clinical care. The new services will increase capacity and reduce waiting times so that patients can be seen sooner and closer to home. We have also commissioned additional support for young people waiting to be seen through local children and young people’s mental health services.

[Preet Kaur Gill (Birmingham Edgbaston) (Lab/Co-op)]

I thank my right hon. Friend for his leadership. As a former children’s services manager, I am concerned that credible safeguarding warnings from clinicians and academics about puberty suppression in children are not being heard. Will the Secretary of State meet those experts and review the younger age limit for participation in this trial, given that children as young as 10 are currently set to be involved?

[Wes Streeting]

Let me reassure my hon. Friend and the House that I am absolutely open to receiving representations and evidence from clinicians involved in the care of children and young people, with insight, expertise and data, including those who might be critical of the approach that the trial team is setting out or, indeed, critical that the Cass review included this recommendation. That is important because the many things that have gone horribly wrong in this area have included the silencing of whistleblowers and the silencing of rigorous debate and discussion.

We have to have this debate with due care and sensitivity for young people in this vulnerable group in particular and for the wider trans community, who feel extremely vulnerable in this country at the moment, including as a result of decisions I have taken as the Health and Social Care Secretary. We have to consider all of that in the round, but we must make sure that at all times we are following the evidence, that we are open to scrutiny and challenge, and that where we are making these finely balanced judgments, we are doing so with rigorous debate, testing the arguments, the evidence and the data. That is why I welcome the urgent question and this discussion.

Tobacco and Vapes Bill

Preet Kaur Gill Excerpts

Report stage
Wednesday 26th March 2025 Commons Chamber

[Dr Johnson]

My hon. Friend makes a fair point. We know the black market exists, but the amendment would enable the Government to understand the scale of that black market and the changes in it, so that regulation could be enforced more robustly.

On amendment 90, as currently drafted the legislation will ban all forms of advertising of nicotine and non-nicotine vapes, nicotine products and sponsorship that promotes those products. Adverts will no longer be permitted on posters, billboards or the sides of buses, and sports teams will be prevented from being sponsored by a vaping company. As a Member of Parliament and a children’s doctor, I have been very concerned by the sharp increase in children addicted to vaping and, more recently, the other nicotine products such as pouches that have begun to flood the market. Schoolteachers have reported that children are unable to concentrate or even to complete a whole lesson without visiting the bathroom to vape.

Action to tackle the rise in vaping is welcome, and I support steps that restrict the appeal of vapes to young people, including through flavours and packaging. However, as the Minister mentioned in her opening speech, vaping can be a useful smoking cessation tool for adult smokers trying to quit; in my view, that should be their only purpose. Within the context of proposed advertising restrictions, amendment 90 would ensure that vapes that are targeted solely as a quit aid, to help adults stop smoking, can continue, in recognition of their role in bringing down smoking rates.

Finally, new clause 20 would introduce a requirement on online vaping products to operate an age verification policy, as is currently the case in Scotland. Whether someone is buying vaping products online or in store, robust provisions must be in place to ensure that the purchaser is of legal age, and businesses must have a robust policy in place. As we have seen through recent tragedies, the age verification process for online sales on age-restricted products has not always been effective. The new clause would be an important step towards protecting children from accessing products online that they should not be able to buy.

In closing, the Conservative party has a strong record of action on tobacco control. It was under a Conservative Government that plain packaging was introduced for all tobacco products and that minimum pack sizes for cigarettes and rolling tobacco were introduced—policies that have been demonstrably effective at reducing smoking rates. I have personally campaigned passionately on the issue of tobacco and vapes for over two years, and I am pleased that some of my original amendments to the Bill have made it beyond Committee stage and are with us today. I was also glad to see some of the new Government amendments introduced on Report that were born of debates we had in Committee, which have strengthened the Bill.

Our amendments are designed to highlight some of the difficulties in the Bill. We oppose the Government’s power-grab—creating powers to ban smoking and vaping wherever they choose by regulation, but without consultation or enough notice. We have concerns about how the Bill will operate in practice, especially the burden on small businesses, and the potential for unintended consequences, such as a growth in the black market for tobacco products, so we ask that the Government seriously consider our amendments today.

[Preet Kaur Gill (Birmingham Edgbaston) (Lab/Co-op)]

I welcome the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), to her role. It is a great pleasure to speak in the debate and to support this genuinely world-leading piece of public health legislation, which will help to consign smoking to the history books.

Unless we act to help people to stay healthy, the rising tide of ill health in our society threatens to overwhelm our NHS. Paring back public health, as the last Government did, was the definition of penny wise, pound foolish. It is vital that we tackle the causes of ill health, not just the symptoms, so that we can save the taxpayer billions of pounds and, most importantly, save lives.

We know that prevention is better than cure. As we have heard today, smoking remains the single biggest preventable cause of ill health in our country, causing 80,000 deaths a year. It is responsible for one in four cancer deaths, and it is a factor in over 70% of lung cancer cases. In my own constituency alone, nearly 12,000 people smoke. They are more likely to leave the workforce due to ill health. Many will suffer strokes, heart attacks and conditions such as chronic obstructive pulmonary disease. On average, they will lose 10 years of life expectancy.

However, the real tragedy is how many thousands of those smokers will have started when they were children, when they did not know any better, and have simply never been able to quit. Most smokers report wishing that they had never started, which is why it is incumbent on us all to support this legislation to help stop the start. According to ASH, in my constituency alone the cost of smoking exceeds £90 million every year, including £56 million in lost productivity, £4 million drained from the NHS and £30.7 million in social care. The costs of smoking to our society are enormous, and that is why it is time to stub it out.

Even today, in 2025, hundreds of young people a day take the first drag of a habit they will never manage to kick, and will regret for the rest of their lives. I was proud to lead the Opposition’s response to the last Government’s Bill through Committee in the last Parliament and, as I said then, there is no freedom in addiction. It is a shame that the leader of the Conservative party allowed her ideology to blind her from that fact when she voted against the legislation in the last Parliament, and against this Bill in this one. Where the last Government failed to get their Tobacco and Vapes Bill over the line, this Government will get the job done.

I am proud that the Government have vastly improved on the legislation that the previous Government drew up. First, the introduction of a new licensing regime to cover tobacco and nicotine products, including vapes, is hugely welcome. That was a key recommendation of the Khan review in 2022, which the last Government largely ignored and which retailers and the public overwhelmingly support, according to surveys conducted by ASH. The status quo, where there was no requirement to obtain a licence to sell those products, is a major gap in enforcement, particularly when we consider that the sale of alcohol is licensed, while nicotine and tobacco are not.

Secondly, I am pleased that the Government are taking forward an amendment I tabled in Committee during the last Parliament, for the introduction of £200 on-the-spot fines for retailers selling products to under-age people. In 2019 to 2020, 50% of the councils that undertook test purchasing reported that cigarettes or tobacco products were sold to children who were under 18 in at least one of their premises. That proves that the current regime is not enough of a deterrent. The introduction of new on-the-spot fines, which are double the amount proposed by the previous Government, will be much easier to issue and much harder to ignore. Does the Minister agree with me that double the fine is double the deterrent?

Thirdly, I commend Ministers on the action they are taking on vapes. Under the last Government, youth vaping trebled in two years. An estimated one in three vapes on the market were illicit, and products often contained harmful chemicals, heavy metals or even drugs. Gaping loopholes were left to sit on the statute book for years, putting children at risk. The promulgation of dangerous illicit vapes in shops, schools and on our streets is a real concern. Recently, in Birmingham, trading standards officers and the police led raids on retailers under Operation Cloud, when they seized nearly £6 million-worth of illicit vapes, tobacco and drugs. One raid alone, the biggest ever in Birmingham, clawed £1 million-worth of goods out of criminals’ hands. That shows the extent of the problem of the illicit market and the incredible job that council trading standards teams do to keep the public safe.

I thank the Government for getting behind trading standards with a £10 million boost to support their work next year. In particular, I welcome the new Government’s introduction of clauses to this Bill to set up a testing regime for vapes, a proposal that I championed in the last Parliament. It is shocking that under the current rules, unlike with tobacco, there is no testing regime for vaping products. That means that dodgy products can be rubber-stamped by the British regulator and wind up on our shelves, undermining the valuable enforcement work that trading standards do to identify and seize un-notified products.

As testing of vapes marketed at young people has shown, a significant proportion of vaping products are not what they say they are. Some market themselves as 0% nicotine when they are not, leading to accidental addictions; others contain harmful substances, such as heavy metals and even anti-freeze, as evidenced by research undertaken by Inter Scientific. That is why during the last Parliament I tabled amendments that would have established a new testing regime for vapes. Unfortunately, the Conservatives voted them down. I commend Ministers for introducing powers that the previous Government snubbed. Nearly 3 million people have quit smoking using vapes. Clearly vapes have a role to play in the transition to a smokefree future, but if they are to be used as stop-smoking aids, we need confidence that the products people buy are safe, which is what routine testing would do.

Finally, I commend the Government on the amendments that have strengthened this Bill; they close the loopholes on vape vending machines and ban vape advertising, promotions and sponsorships. The new clauses will ensure that these products are kept away from the impressionable eyes of young people, so that the next generation are not simply substituting one nicotine addiction for another. There were significant holes in the last Government’s plan, and I am glad that the new Government are slamming them shut.

The health crisis facing our country has never been confined to the running of its hospital wards, doctors’ surgeries and dental practices. We are a sicker nation, and that public health challenge needs confronting. Life expectancy was extended by three and a half years over the course of the last Labour Government, but in the 14 years under the Tories, it grew by just four months. In this Bill, we see the epitome of the future-facing approach that only a Labour Government can deliver. By stopping the start and ensuring that the next generation never develop an addiction to nicotine, we can protect their health and wellbeing and protect our NHS for many years to come.

[Madam Deputy Speaker (Judith Cummins)]

I call the Liberal Democrat spokesperson.

Health and Social Care: Winter Update

Preet Kaur Gill Excerpts

Wednesday 15th January 2025 Commons Chamber

[Wes Streeting]

I confirm that we are absolutely up for looking at co-location of different public services, to deliver both better integration and co-operation between different services—particularly the blue-light services that the hon. Gentleman mentioned—and better value for taxpayers. I will ensure that one of my ministerial colleagues makes contact with him.

[Preet Kaur Gill (Birmingham Edgbaston) (Lab/Co-op)]

The Health Secretary will know that University Hospitals Birmingham in my constituency recently declared a critical incident, which I am pleased has now been stepped down. Does he share my view that shifting the focus of healthcare from hospital to community as we rebuild our NHS would have a consequential impact on the number of people in hospitals, which are under immense pressure?

[Wes Streeting]

My hon. Friend is absolutely right. May I, through her, thank health and care staff in her city for the work they are doing to get the people of Birmingham through this particularly challenging winter? What we really need to do to make our health and care system more effective and more sustainable is shift the centre of gravity out of hospital and into the community. We need better and faster access to diagnostics and treatment, as well as a bigger focus on prevention—primary prevention to keep us all healthy and active, and secondary prevention so that fewer people need to call on health services, and particularly emergency departments, which are stretched at this time of year.