Medical Training (Prioritisation) Bill

Andrew Murrison Excerpts

2nd reading
Tuesday 27th January 2026 Commons Chamber

[Wes Streeting]

Students studying in Malta will not be prioritised in the Bill, but they will still be able to make applications. Queen Mary University’s Malta website is clear that Queen Mary does not administer the UK foundation programme and cannot control whether or on what basis applicants are accepted into the programme, and no one is guaranteed a post on qualification.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

Will the Secretary of State give way?

[Wes Streeting]

I will make some progress because, with respect, I have not yet set out the measures that we are to debate today. Let me take the intervention from my hon. Friend the Member for Hitchin, then I will set out the Government’s rationale and take further interventions.

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[Dr Murrison]

The Bill is basically a good one, and we all share the intent to encourage home-grown talent to remain in our national health service, so could the Health Secretary explain why he appears to have set his face against British students who for various reasons train at, for example, St George’s in Cyprus or St George’s in Grenada and who then want to come back and practise in our national health service? They want to come back and practise at home. Amendment 9 would deal with that conundrum. Why will he not support it?

[Wes Streeting]

We set UK medical school places based on future health system needs. We cannot control how many places the overseas campus universities create, whether they are UK-based universities or not. Prioritising those graduates in the way that the right hon. Gentleman suggests would undermine sustainable workforce planning. It would also undermine social mobility and fair access. Those campuses are commercial ventures; they receive no public funding and students are generally self-funded. The nature of prioritisation is that we set priorities, and these are the priorities that this Government are setting out. We must break our over-reliance on international recruitment.

As I have said, I am proud of the fact that the NHS is an international employer, and it is no coincidence that the Empire Windrush landed on these shores in 1948, the very year our NHS was founded. We are lucky that we have people from around the world who come and work in our health and care service. Since Brexit, however, under the last Government, we have begun to see something much more corrosive, with the NHS poaching staff from countries on the World Health Organisation’s red list because their own shortages of medical practitioners are so severe. The continued plundering of doctors from countries that desperately need them while we have an army of talented and willing recruits who cannot get jobs is morally unacceptable. If some Opposition Members want to defend that record and dismiss the morality argument, I would point out that that 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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[Wes Streeting]

It is important that the Bill is workable. A number of factors may well interrupt our ability to move at the pace at which I want to open up those places. One of those factors is the ongoing risk of industrial action. We know that the BMA is balloting for further industrial action at the moment. We respect the process that it is undertaking, and we are not closing the door to discussions while it does so. However, we are clear that that is a further disruption risk. I hope that we will be in a position to open up a new application round very shortly for current applicants, but that will depend on our ability to expedite the passage of the Bill through both Houses, and to ensure that the system is ready to implement it. That is why bringing forward the Bill on this timescale has been particularly important.

[Dr Murrison]

I am grateful to the Health Secretary; he is being generous with his time. Is he saying that he intends to use this as some sort of lever or bargaining chip in his discussion with the BMA?

[Wes Streeting]

I am clear that this is about whether the system will be ready to implement the measures in the Bill. I must say that I view the Conservatives’ amendment on this issue with a degree of cynicism. Not so long ago, 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 am sure that that is not remotely cynical and is for entirely noble reasons, but I will wait for the shadow Health Secretary, the right hon. Member for Daventry (Stuart Andrew), to make his case. Let’s just say that I am not entirely convinced.

The Bill implements the commitment in our 10-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 are allocated to other eligible applicants.

For specialty training, the Bill effectively reduces the competition for places from around four to one, where it is today, to less than two to one. That is a really important point for resident doctors to hear, not least because in the debate we had on the Government’s previous offer to the BMA, that point was lost amid some of the broader and, frankly, more contested arguments between the Government and the BMA around pay. It is not just the provision of additional training posts that reduces the competition ratio; it is also the measures in this Bill. I hope that that message is heard clearly by resident doctors as they think about their own futures immediately or in the coming years. For posts 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.

In the 10-year plan, we committed to prioritising international applicants with significant NHS experience for specialty places in recognition of the contribution they have made to our nation’s health. This year, we will use immigration status as a proxy for determining those who are eligible, so that we can introduce prioritisation as soon as possible. From next year, under the terms of the Bill, we will set out in regulations how we are defining significant NHS experience.

--- Later in debate ---

[Stuart Andrew]

No, I am most definitely not defecting.

In the spirit of being constructive, I will start by saying that the Opposition support the principle behind the Bill. Doctors trained in Britain and 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, yet too many are leaving—not because they want to, but because they cannot access the training places they need. That wastes talent, damages morale, and ultimately affects patient care. However, support in principle is not a blank cheque; the Bill must work in practice, not just look good in a headline. We should also be honest about why we are here. Much of what is in the Bill has been promised by the Government since their election in plans, reviews and ministerial statements, and the fact that it is only being brought forward now suggests that this is catching up, not leading.

The first test is delivery. We cannot solve a shortage by changing the queue. Unless the Government deliver the 4,000 new specialist training places that they have promised, including the 1,000 places that are needed early, the Bill will not fix the bottlenecks; it will simply shift frustration from one group of doctors to another. 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. We welcome the focus on foundation training; prioritising UK and Irish graduates for foundation training is sensible, as it strengthens the pipeline and improves workforce planning. However, it will only work if there are enough placements and the system is transparent. That is why amendment 8 would clarify that a UK foundation programme must mean a programme in which the majority of training takes place in the United Kingdom. That is a necessary safeguard against loopholes.

Amendment 9 would ensure that from 2027, British citizens on UK foundation programmes are prioritised in a meaningful way. Prioritisation must apply not only at the final offer stage, but at interview, which is where selection decisions are often made. The amendment addresses many of the points that Labour Members have been raising, so I encourage them to support amendment 9 when we divide on it.

We are also concerned about doctors serving overseas with the armed forces. I was pleased to hear the Secretary of State talk about them, since they certainly should not be penalised because part of their training takes place abroad on service. As such, amendment 10 would expand the definition of a UK medical graduate to include those undertaking placements as part of an armed forces posting outside of the British Isles. I hope the Secretary of State will consider accepting that amendment to give reassurance to our armed forces, which I know is something he cares about. These are practical changes that would improve fairness and operability, and we hope the Government will adopt them.

We also support new clause 2, tabled by my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer), which would make clear that once priority groups are established, training places should be allocated on merit. That allocation should be based on academic achievement and clinical performance, rather than a lottery or a computer-generated ranking divorced from real performance. Again, I hope the Government will seriously consider the new clause. When the Minister for Secondary Care sums up, will she 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 rely on international students. New clause 3 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. If those numbers fall, what funding model would replace them? When she sums up, will the Minister for Secondary Care outline what assessment has been made of the impact on medical school finances? How many international places do the Government expect to fund in future, and on what basis?

The 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. 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.

Our approach is straightforward. We will support measures that are fair and practical, that strengthen patient care and that respect staff. We will press the Government where we feel that proposals are rushed, underfunded or left vague. Backing doctors means giving them a route to progress and ensuring that the system is properly planned and properly resourced. I repeat that, in principle, we support the Bill. We want doctors trained in Britain to build their careers in the national health service.

That brings me to enactment. As we have heard, the Government propose that the Bill should take effect when the Secretary of State decides, rather than on the date of Royal Assent. When he said that he wanted to introduce this Bill, and that it would be urgent, I said that we encourage that and support it. However, if this Bill is truly urgent, and 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 is not right for doctors, including those not involved in industrial action, to be treated as bargaining chips, and it is not right 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. Will the Government support amendment 1, so that the Bill takes effect on Royal Assent? Will they commit to enacting the Bill as quickly as possible?

When does the Secretary of State intend to commence the Bill? If the Minister for Secondary Care 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? If industrial action is paused, will the Government still honour their commitment to prioritise UK medical graduates?

Many doctors took industrial action because they felt that their career progression was blocked. This Bill could play a part in rebuilding that trust, but that will only happen if Ministers deliver, publish the detail and follow through. 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.

[Dr Murrison]

I think the Secretary of State has perhaps misunderstood how traumatic the process is for the young medical graduates going through this performance. Does the shadow Secretary of State agree that the sooner this legislation comes into force, the better it is for those young people, some of whom are finding the current situation incredibly difficult? They do not know what the successor scheme will look like, and the delay is adding to that unhappiness.

[Stuart Andrew]

I absolutely agree with my right hon. Friend. I said right at the outset that we would be constructive, but we have heard from many who are anxious about their future and do not know what will happen. The sooner that we can give them that certainty, the better. That was the premise on which we offered to support the Bill. I am grateful to him for making that point.

I am conscious that others want to speak, so I will end by saying this. Prioritisation without capacity will not fix the workforce crisis. Promises without delivery and headlines without planning will not retain the doctors whom our NHS needs. The Government must fund the extra places, set out the operational detail, and begin this reform without delay, because that was the premise that the Secretary of State identified. When he came to Parliament just a few weeks ago, he said that we needed to get on with this urgently, and that he would encourage business managers to provide the time. Well, if that is the case, let us get on with the job.

[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.

NHS: Winter Preparedness

Andrew Murrison Excerpts

Monday 15th December 2025 Commons Chamber

[Wes Streeting]

My hon. Friend can rest assured that he has my support as he keeps his eye on the temporary nature of this closure. I share his desire for it to be temporary.

I would make this point, too. There is a view among some in the BMA that somehow these strikes are consequence-free for patients and the NHS on the basis that we can just cancel some operations and it is okay because consultants will be covering. That is quite a cavalier attitude to take to fellow frontline staff who will be having their annual leave cancelled and finding themselves recalled right now. It also really minimises how patients feel when they cannot access a walk-in service, such as my hon. Friend’s, or indeed have waited, often for far too long, for a diagnostic test, scan or operation. They will have psyched themselves up and be ready for that appointment, but then find it cancelled because of strikes. The BMA might try to kid everyone else that the strikes are consequence-free for patients, but BMA members really ought not to kid themselves.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

Will the Health Secretary ensure we have clarity on advice regarding the use of face masks, particularly where they are mandated? He will be aware that conflicting advice is issued by various agencies, which confuses people and reduces confidence. Will he ensure that advice is rigorously evidence-based?

[Wes Streeting]

The right hon. Gentleman is right to call for an evidence-based approach. That is why the Government are not mandating mask use across the NHS or social care. We are supporting leaders in providers to make their own judgments based on the situations in their trusts as to whether wearing of masks by patients and visitors is necessary, given the pressures they are under. Even in those cases, there is an understanding that people may not wish to comply, but I hope that, if asked to do so, they would comply.

Budget Resolutions

Andrew Murrison Excerpts

Tuesday 2nd December 2025 Commons Chamber

[Helen Morgan (North Shropshire) (LD)]

The NHS continues to face a historic crisis after years of mismanagement by the last Conservative Government. Their dire legacy is still felt across the country, with hospitals crumbling and dental deserts across England—not least in my constituency—as well as a mental health crisis and many people struggling to access their GP, waiting hours for an ambulance or suffering in crammed hospital corridors. The British people deserve better.

The Liberal Democrats welcome efforts to bring down the sky-high waiting lists left by the previous Government, and there have been green shoots of recovery across the country. In the Shrewsbury and Telford hospital trust, which serves my constituents, performance against the 28-day faster diagnosis standard has reached 80.1%—the highest on record. I thank all the hard-working hospital staff there and across the country, who are working tirelessly at the moment to improve the situation.

There are some welcome announcements in the Budget. The prescription price freeze is clearly the right thing to do, and we strongly support protecting victims of the infected blood scandal and their families from inheritance tax. It is an unacceptable injustice for bereaved families to lose out just because their loved ones died waiting for compensation. We also support the lifting of the two-child benefit cap, because it is the type of investment that will reap savings in the future and correct a moral injury.

I am afraid, though, that overall this Budget does not meet the moment. The Government are treading water on their spending commitments, and hundreds of millions of pounds are set to be drained from services to fund a medicines price hike. From the Office for Budget Responsibility’s report, it is not clear whether frontline NHS services will be raided to pay higher prices for branded medicines at the behest of President Trump, on top of the billions already anticipated in the spending review. No. 10’s briefing suggests that the money will come from the NHS budget, yet we have just heard from the Secretary of State that it will not. A statement to this House to clarify the details would be most welcome.

Yesterday we learned that the Government have capitulated to the US Government and will increase spending on medicines by 0.3% of GDP—more than the value derived from some trade deals—or from about 9.5% of the NHS budget to 12%. We desperately need to understand how that will be paid for; I hope it will not be by cutting frontline services. The Secretary of State has previously said that he would not allow the NHS to be ripped off by drug companies, and I hope the Minister will confirm that position.

The life sciences sector is vital to the UK. Rather than defunding vital NHS services, the Liberal Democrats urge the Government to take real actions to strengthen it by implementing a new, bespoke customs union with the EU to slash red tape, along with a major boost to research and development funding so that new drugs can be brought online as quickly as possible. NHS spending should be targeted at where our health service really needs it: ending the crisis in GP services so that everyone has a right to see a GP in seven days, or in 24 hours if it is urgent; guaranteeing that 100% of patients are treated for cancer within 62 days of an urgent referral; and ending unacceptable and degrading corridor care. I urge the Government to adopt these proposals without delay in order to protect patients and prevent trust in our NHS from being irreparably broken.

One of the most visible symptoms of decline is our crumbling hospitals and the degrading scenes that became commonplace under the Conservatives. Those patients falsely promised a new hospital by the Conservatives will continue to be bitterly disappointed. We all know that the 40 new hospitals promised to patients did not number 40, that they were not necessarily new, that they were not all hospitals, and that there was no plan to fund them. However, this Government have chosen not to pledge new investment, which means that the maintenance backlog will continue to balloon at eye-watering levels, having climbed from £13.8 billion in 2023-24 to an astonishing £15.9 billion in 2024-25.

The Chancellor should have guaranteed that no patient, doctor or nurse faces the indignity of substandard, broken and, frankly, unsafe estates. We appreciate that there is pressure on the public finances, but holding back on these improvements is a false economy when a fortune is being spent papering over the cracks to keep substandard buildings that should be condemned limping on. The repair backlog at the sites of new hospitals is set to reach nearly £6 billion by the time construction is due to start. The Liberal Democrats will continue to champion investment in our crumbling NHS buildings in order to protect patients, hard-working NHS staff and the taxpayer.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

The hon. Lady is outlining an extensive programme of capital expenditure on the national health service. Between last year and this year, we have had the largest set of Budget increases in the history of this country, but are the Liberal Democrats proposing that we should tax the British public even further to pay for the kind of thing that she has just described?

[Helen Morgan]

If the right hon. Gentleman had listened to our leader’s response to the Budget, he would understand that the Liberal Democrats do not propose to tax the British taxpayer further. We would sign a customs union deal with the EU and create £25 billion in extra tax revenue every year without going back to the British taxpayer.

The crisis in our NHS is perhaps most acute in our community services. For all the welcome promises on shifting care from hospital to community and treatment to prevention, the truth is that local health services are on their knees, with record waits to see a GP. Liberal Democrats have championed new investment and we welcome the Government’s announcement on neighbourhood health centres, but unless we see health centres in every community, with investment to ensure that everyone can see a GP within a week as a legal right, and the restoration of public health funding, this risks being an expensive failure.

--- Later in debate ---

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I will start on a positive note by commending the lines on productivity in the Red Book, and the recent comments that various Ministers have made about that. Productivity has to be the No. 1 objective in getting our NHS to where it needs to be to deliver for our constituents. I have to say to the Health Secretary that objectives two and three are probably dentistry and adult social care, and on those, I have heard less positive news.

Dentistry in particular is still struggling as a result of the units of dental activity created by Gordon Brown back in the day—a system that has bedevilled the provision of dentistry in this country and is in urgent need of reform. Without that reform, we will make no progress at all on one of the principal issues in the health service that concern my constituents at the moment.

I think that a degree of humility is important when we talk about the NHS, and I say that with all due respect to the Health Secretary, because otherwise he will be setting himself up for a fall. Reform in the NHS is fiendishly difficult, and we all remember the ghost of PFI, which still stalks the corridors of our hospitals and clinics and will do so for some time to come.

The day before the Chancellor of the Exchequer gave her pre-Budget speech, her boss—the Prime Minister, no less—took the very unusual step of personally moving the Second Reading of a Bill. The Bill was admittedly a very important one indeed, and the Prime Minister might have thought, perfectly understandably, that it was too important to be delivered by his Justice Secretary. It was the Public Office (Accountability) Bill, which begins its Committee stage today.

At the heart of the Bill is a new duty of candour, and despite its name, it extends well beyond the holders of public office. It carries a legal obligation to act transparently, creates new criminal offences of misleading the public, and contains new codes of conduct based on the Nolan principles of selflessness, integrity, objectivity, accountability, openness, leadership and honesty, and it imposes appropriate sanctions. Lying is a very strong test, Madam Deputy Speaker, and you would call me out of order if I applied it to any right hon. or hon. Member, but this Government, through their Bill, are insisting on another test. They are insisting on a test of candour, and a duty of candour is a noble principle, but nobility cannot be confined to one area of the public realm; it has to be universally applicable, and it has to be applied from the top.

Now, I am not accusing anyone of lying, but it should be abundantly clear that in preparing for this Budget, the Chancellor of the Exchequer did not approach her duties with the candour that she and her colleagues are demanding of others—which the public have a right to expect—and that is incorporated, in principle at least, in the Bill that the Prime Minister introduced on Second Reading just a few days ago. I suggest that before that Bill comes back to the Floor of the House, the Chancellor might like to reflect on the duty of candour as far as it applies to Ministers. I feel that a new clause that would make it more difficult for her and her successors to stray into the kind of shenanigans that we have seen over the past couple of months would be greatly welcomed by the House.

[Madam Deputy Speaker (Caroline Nokes)]

Order. I think that the right hon. Gentleman means to be discussing the Budget, not the Bill that is in Committee.

[Dr Murrison]

I am grateful for your guidance, Madam Deputy Speaker.

What has unfolded since September reflects badly not just on the Chancellor of the Exchequer, or the Prime Minister, or the Government, but on all of us. On 17 September, the OBR—

[Madam Deputy Speaker]

Order. I call Marie Rimmer.

Terminally Ill Adults (End of Life) Bill

Andrew Murrison Excerpts

Report stage
Friday 13th June 2025 Commons Chamber

[Dr Andrew Murrison (South West Wiltshire) (Con)]

Will my hon. Friend give way?

[Gregory Stafford]

I will make a little progress before taking another intervention.

No safeguards can prevent complications from taking medicines. As I am sure the hon. Member for Bury St Edmunds and Stowmarket (Peter Prinsley) knows, there can always be complications. In this case, those could include regurgitation of the drugs, regaining consciousness and seizures.

--- Later in debate ---

[Dr Murrison]

My hon. Friend was right to table his amendment, which I certainly support. Does he agree that the Medicines and Healthcare products Regulatory Agency would insist that a barbiturate or any other substance used in medicine should be approved for a specific cause? We cannot translate that to a completely different cause or reason for using it. Would he also agree that the way to deal with the issue is for it to be properly regulated through the MHRA?

[Gregory Stafford]

I entirely agree. Some of the amendments tabled by my hon. Friend the Member for Gosport (Dame Caroline Dinenage) may address that.

Access to NHS Dentistry

Andrew Murrison Excerpts

Thursday 22nd May 2025 Commons Chamber

[Dr Andrew Murrison (South West Wiltshire) (Con)]

Thank you, Madam Deputy Speaker. I prefer Ben— I have never enjoyed Andrew—but Andrew will do.

Quite honestly, NHS dentists are saints. As my right hon. Friend the Member for New Forest East (Sir Julian Lewis) has said, the reason why we do not have any NHS dentists is that it is far more remunerative to do expensive dental work than the sort of grinding service work that NHS dentistry implies. The reason for that, fundamentally, is the so-called new dental contract introduced in 2006. That is the problem. Units of dental activity have plagued the dental profession and the provision of NHS dentistry all these years.

I am delighted that the Government are revising the dental contract that their Labour predecessor introduced 20 years ago, but, unless they are prepared to underwrite it, I am afraid that we will still be more or less in the same position. It is not as if we are not training dentists—we are training more and more dentists and there are more and more dental schools, and rightly so—but if those professionals are going to practice in the NHS, they need to be incentivised to do so.

[Sam Rushworth (Bishop Auckland) (Lab)]

I agree with the right hon. Gentleman about the 2006 NHS dentistry contract, which clearly needed revision. Why did his party not do that in 14 years in government?

[Dr Murrison]

I am sorry that the hon. Gentleman has destroyed the consensual way in which I was trying to introduce my remarks.

If I may, I will explain that I think there has been a conspiracy of silence all these years on NHS dentistry. What Government have to get to grips with is whether they intend that dentistry should continue to be a universal part of our NHS and whether it will be exempted from the universality that has characterised the provision of healthcare services in this country since 1948.

The Government could decide that dentistry is a bit like ophthalmic optics, which in the 1940s was deliberately excluded from NHS provision. I am not recommending that, but I am recommending to the Minister that we are at least honest with the public. At the moment, we have this pretence around NHS dentistry that says, “Of course you have the right to have your teeth fixed at no cost to you at all up front.” In reality, in most parts of the country, mine included, that is a complete fiction.

When the Government come to their new arrangements, which I welcome very much, can we first have some honesty? Can we have some money behind them? Can we have some idea about what part of current NHS provision the Government intend to deprioritise, if that is their intention, to ensure that we have truly universal provision of NHS dentistry going forward?

NHS Pensions

Andrew Murrison Excerpts

Tuesday 1st April 2025 Commons Chamber

[Karin Smyth]

My hon. Friend makes absolutely the right point. As I have said, Lord Darzi has helpfully outlined the breadth of the mess that we inherited back in July, and it makes for stark reading. We have still not had an apology from the Conservative party, so I am happy to take an intervention now if anybody decides to provide one. In these issues, we are seeing the depth of the destruction that the Conservatives have caused widely across Government. We will continue to fix that on behalf of the British people.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I declare my interest as a practising doctor and a public sector pensioner who has been through the McCloud process. Does the Minister understand that we will not improve productivity in the NHS as far as doctors are concerned if they continue to retire routinely in their mid-50s—in their prime? They do so because their accountants tell them that they would be foolish not to, given the fiscal environment and the structure of the NHS pension scheme.

[Karin Smyth]

I understand that point. Obviously, it is a source of much discussion. The change came about during the pandemic to encourage people to return to work, and it is a complex issue. We want to continue to use the skills of doctors at all stages of their careers, and we shall continue to work with them, the British Medical Association and others to make sure that there is no detriment to their returning to service in the NHS.

Prevention of Drug Deaths

Andrew Murrison Excerpts

Thursday 27th March 2025 Westminster Hall

[Several hon. Members rose—]

[Dr Andrew Murrison (in the Chair)]

Order. There is a lot of interest in this debate. I will not set a firm limit on speeches, but I suggest that an indicative three minutes should get most people in, but probably not all. I remind Members that if they want to speak, they have to indicate that they wish to do so.

[Grahame Morris (Easington) (Lab)]

It is a pleasure to serve under your chairmanship, Dr Murrison. I congratulate my good and honourable friend, the hon. Member for Strangford (Jim Shannon), on securing this really important debate. Not for the first time, I find myself agreeing with what he said.

Drug deaths are at a record high. They are mainly from opioids, but deaths from cocaine have risen by almost a third. As the hon. Gentleman said, synthetic opioids such as Fentanyl and the nitazenes present an increasing and alarming threat, which has not been properly quantified. We have seen the growth in the number of deaths across the Atlantic, and I suspect the problem is much bigger here than we think.

There is no doubt that this is a public health crisis. Sadly, the north-east of England has the highest rate of drug deaths in England—three times higher than London. In the latest stats, released in October 2024, the north-east recorded 174 deaths per million, compared with an England average of 90. Too often, in the communities I represent, I have seen people turn to drugs because of deprivation and despair. Once addiction takes hold, it often leads to crime. It is no coincidence that drug deaths are highest in the areas of greatest deprivation. The data is clear: communities struggling with poverty and inequality are those hit hardest by addiction.

This is not a new problem—certainly, it is complex—but it is being exacerbated by disinvestment in harm reduction and drug treatment programmes. If we are serious about tackling this problem, we need to do something different. To some, a tougher crackdown may seem the obvious response, but we have more than 50 years of evidence showing that punitive drug policies do not work. The war on drugs has failed, not just in the UK but globally. We cannot simply arrest our way out of this crisis. That is why today I want to offer a different perspective, which moves beyond outdated, one-size-fits-all approaches.

Abstinence-based recovery is one path, but it is not the only one. If we truly want to reduce drug deaths and support recovery, we must reduce harm, reduce stigma and invest in treatment provision, with protected, ringfenced and sustained long-term funding. That funding could support solutions such as opioid substitution treatment, which saves an estimated 1,000 lives annually; medically supervised overdose prevention centres, like the Thistle safer consumption facility in Glasgow; heroin-assisted treatment; and increased availability of drug testing. Those measures are crucial in addressing the current crisis and saving lives.

As chair of the drugs, alcohol and justice all-party parliamentary group—supported by treatment providers Via, Waythrough and WithYou—I recently had the honour of chairing a meeting at which Professor Sir Michael Marmot, the leading expert in health inequalities, laid out the stark reality. He told us:

“Social injustice is killing on a grand scale.”

He made it clear that areas of the greatest deprivation suffered the deepest cuts during austerity, exacerbating addiction and its consequences. I encourage the Minister and all Ministers to consider how we as a nation can adopt the Marmot principles—principles that foster a fairer, more equitable society in which everyone is given the best possible start in life and we work to prevent “deaths of despair”.

I am conscious of the time, but I want to mention a dear friend of mine who is no longer with us—the late Ron Hogg, who was the police and crime commissioner in Durham. He was a true pioneer of drug policy reform. He was bold, compassionate and unafraid to challenge the status quo. He introduced heroin-assisted treatment and diversion schemes at a time when they were far from popular, but popularity was not his goal. He was seeking to reduce harm, save lives and ease the burden on our criminal justice system.

The evidence is clear: investment in treatment works; harm reduction saves lives; and tackling stigma is essential. We must stop seeing addiction solely as a criminal justice issue and instead treat it as a public health emergency.

[Dr Andrew Murrison (in the Chair)]

Short speeches mean that more colleagues get in.

--- Later in debate ---

[Leigh Ingham (Stafford) (Lab)]

It is a pleasure to serve under your chairmanship, Dr Murrison. I thank the hon. Member for Strangford (Jim Shannon) for securing this debate, as the prevention of drug-related deaths affects many in all our constituencies across the country.

Drug misuse is a complex problem with many causes and impacts, but one thing is clear: the current rates of death are completely unacceptable. In 2022, there were 7,912 alcohol-specific deaths. In 2023, 5,448 deaths related to drug poisoning were registered in England and Wales. That is the highest number since records began and a tragedy that has to stop. We cannot allow this crisis to continue unchecked.

In last week’s business questions, I spoke about how important community services are in supporting people with substance misuse issues. One example that stands out in my constituency of Stafford, Eccleshall and the villages is Chase Recovery, a truly innovative, community-based, peer-led rehabilitation programme. I recently had the privilege of visiting and saw at first hand the incredible impact the programme is having on the lives of those seeking recovery from substance misuse. It is not just a treatment programme but a lifeline for those who need it most. It offers a holistic, supportive environment where individuals can recover, rebuild their lives and develop new skills and confidence. Truly, I could not describe it as anything more than a really welcoming and supportive community.

During my visit I had the pleasure of meeting Paul and Cara, who run the organisation. They are incredibly passionate people who lead the programme with incredible dedication. Their drive and commitment to helping others is truly inspiring. They are making a difference every single day, and I have no doubt that the work they are doing is helping people to achieve long-term recovery and to rebuild their lives in a meaningful way.

Programmes like Chase Recovery prove how community- based, peer-led services can play a vital role in sustainable, long-term recovery, but those programmes need support from the Government to ensure that they can continue their vital work and reach even more people in need. It only takes one helping hand to change someone’s life. I encourage the Minister to outline what the Government are doing not only on prevention but on community-led treatment.

[Dr Andrew Murrison (in the Chair)]

That was commendably brief.

National Cancer Plan

Andrew Murrison Excerpts

Tuesday 4th February 2025 Commons Chamber

[Andrew Gwynne]

My hon. Friend makes a very good point, and it relates to not just cancer but a whole range of conditions, including cardiovascular disease, strokes and so many others—it is the same areas that have the worst outcomes, because there are endemic health inequalities that we have not shifted the dial on for decades. Life expectancy is much lower, and healthy life expectancy is much worse, than in less deprived areas. It is part of our health mission to drive forward better health outcomes for people living in the poorest areas, and our national cancer plan will be a key part of that.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

In his remarks yesterday, the Minister for Data Protection and Telecoms, the hon. Member for Rhondda and Ogmore (Chris Bryant), implied that he was discussing the future with AstraZeneca, which has had some bad news this week. AstraZeneca makes immunotherapies, among other things, and therefore is very important in allowing people to live better for longer. What discussion will the Minister be having as part of his plan with the pharmaceutical sector, since plainly the national health service cannot do this alone?

[Andrew Gwynne]

The right hon. Gentleman makes a very good point. I have certainly had a number of roundtables with the pharmaceutical sector in the UK about how we can support it, how we can grow our life sciences sector and how Britain can be at the cutting edge of new treatments and clinical trials. Indeed, we had a Delegated Legislation Committee yesterday on regulations to make it easier to carry out clinical trials in this country. Some of the latest advances in pharma are quite remarkable; I think particularly of the work being done on mRNA technology to look at having specific cancer treatments pertinent to a person’s genomics—it could be a game changer.

NHS Backlog

Andrew Murrison Excerpts

Monday 6th January 2025 Commons Chamber

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

I thank the hon. Member for North Shropshire (Helen Morgan) for securing this important and timely debate. I must begin by declaring my interests: I am a non-practising NHS consultant psychiatrist and my wife is an NHS doctor.

Christmas and the festive period is always a taxing time for the NHS, especially for those working on call, as indeed it is for all those in the various emergency services and those outside the public sector who are on call. It is important to pay tribute to them for all their hard work over the past couple of weeks.

Much of the correspondence that I have received from constituents over the past few years has concerned the difficulty of obtaining GP appointments. Interestingly, the demand for GP appointments has risen since before the pandemic, following the advent of virtual appointments and different means of contact. Patients are now finding it more difficult to see someone in a general practice, although overall performance in general practices has improved since before the pandemic. It is important that we support our GP practices as much as we can, to ensure that they deliver the high-quality care that our patients expect. Our local practices are fantastic: they are working very hard, in tricky circumstances, to deliver for patients.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

My hon. Friend is, of course, absolutely right. Does he agree that part of our duty is to support our general practices? Our constituents often say, “I cannot see my GP”, but if we probe, we find that it is a question of whether they are prepared to accept a telephone consultation, which is probably just as good for most of them. Radiology was mentioned earlier. The issue for the future, surely, is embracing technology rather than outsourcing. In many cases, AI reading of films and scans is probably as good as, if not better than, a reading by a radiologist in India, Shropshire or anywhere else.

[Dr Spencer]

I entirely agree with my right hon. Friend about the use of AI to improve productivity in the NHS, and with what he has said about general practices.

I generally take a neutral, honest-broker approach when people raise concerns about general practices. Of course it is important for us to ensure that our practices are performing well, to support them, and to respond to our constituents’ concerns more broadly. However, given that the bulk of care is coming through general practice—and I was interested to hear, in recent days, about the renewed focus on patient choice, particularly in respect of secondary and tertiary care—I think that one of the challenges posed by our current general practice system relates to the absence of patient choice. Effectively, general practices, which, as the Minister will know, are private organisations, have a monopoly in terms of the patients who are in their catchment area. It is very difficult for patients to move to different practices when the ones that they are currently using are not meeting their needs: when seeking an appointment with a GP, they are stuck with their own practice, or else they must go through various mechanisms to obtain care elsewhere.

Health and Adult Social Care Reform

Andrew Murrison Excerpts

Monday 6th January 2025 Commons Chamber

[Wes Streeting]

I am grateful to my hon. Friend for his question. That is why in the Budget the Chancellor delivered a big uplift in the spending power of local authorities, with £880 million ringfenced specifically for social care. We are also delivering through measures such as the disabled facilities grant to deal immediately with the pressures—[Interruption.] It is no good the right hon. Member for Beverley and Holderness (Graham Stuart) complaining. He voted against the investment, so he cannot very well complain about it.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

The previous Labour Government did a hatchet job on community hospitals, including in Wiltshire, with a consequent uptick in the amount of delayed discharges in the acute sector, notably at Bath, Salisbury and the Great Western in Swindon. Will the Casey commission look at that and find ways of unpicking the damage that was done?

[Wes Streeting]

The previous Labour Government delivered the shortest waiting times and the highest patient satisfaction in history.