Medical Training (Prioritisation) Bill

Helen Morgan Excerpts

Tuesday 27th January 2026 Commons Chamber

[Helen Morgan (North Shropshire) (LD)]

I am pleased to welcome this Bill, broadly. It seeks to prioritise graduates from UK and Irish medical schools for foundation and specialty training places. On this point, the Liberal Democrats support the Government, but we have some concerns about how that will be delivered, and about the real-world consequences for our NHS, patients and the doctors who keep our health service going.

Taxpayers invest around £4 billion every year in training young doctors, yet far too many are left competing for too few posts. In 2025, around 12,000 UK-trained doctors competed with 21,000 international doctors for just 9,500 specialty training positions. Many highly skilled young doctors, who were ready to serve in the NHS, were left without a pathway into specialist practice. That is clearly unfair and unsustainable. It is hardly surprising that so many doctors decide to leave the country altogether and seek opportunities elsewhere, where their training and wellbeing are valued. This is a tragedy for them and a tragedy for patients, so prioritisation is right, fair and long overdue.

However, reorganising a queue does not shorten it or make it move any faster. The reality is clear: the NHS has a deep workforce shortage, with crises in some specialties, and this Bill alone cannot solve it. A detailed long-term workforce plan, which ensures that training provides the skill mix that the NHS needs for the future, is required as soon as possible. I look forward to the Minister confirming when that will be delivered.

Shortly before Christmas, the Government committed to 4,000 additional specialty training places in their negotiations with the British Medical Association, including 1,000 that were brought forward, but following the collapse of those negotiations, it remains unclear whether those places will materialise. Patients cannot wait for certainty, and neither can exhausted staff. Will the Minister confirm those places, and go further by addressing other issues that have prevented doctors from working in the NHS, such as restrictive rotas, workplace violence and inflexible working? Dealing with such issues might prevent doctors who have secured specialty training places from moving abroad once their training is completed, ensuring that taxpayers’ money is not wasted, and that doctors with local, relevant experience remain in the NHS.

I turn to the details of the Bill. We have concerns about clause 7(1), which allows Ministers to change eligibility for prioritisation through the negative procedure. That will enable sweeping changes, without proper parliamentary scrutiny, to who can access training places. Given the scale and sensitivity of the NHS workforce pressures, such decisions must not be made behind closed doors, or at the whim of a future Health Secretary with less desirable motives than the current one. That is why the Liberal Democrats have tabled amendments that would require Parliament to approve any future changes through the positive procedure.

We are also troubled by the Government’s decision to apply the new rules part of the way through the 2026 specialty recruitment cycle. The Bill allows for prioritisation at the offer stage for medical specialty training places in 2026. I would like the Minister to clarify in her closing remarks whether this means that international doctors already working in our NHS—who have paid for exams, secured visas and maybe uprooted their life and their family—will 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 would also be grateful if, in the Minister’s closing remarks, she outlined the expected impact on NHS service provision if people who are deprioritised during the application process decide to leave en masse. Will she give my constituents in North Shropshire reassurance that patient safety and patient outcomes will not be impacted? The Liberal Democrats would prefer implementation to begin in 2027, at the interview stage; that would protect both fairness and patient safety.

Would the Minister elaborate on the impact of the Bill on universities that offer medical degrees elsewhere in the world? I think we have all been contacted by Queen Mary, University of London; the implications for the university may be serious if graduates, who have always been considered UK graduates, undertaking NHS training, and a UK medical qualification registered by the General Medical Council, suddenly have their expectations changed.

As I have mentioned, retention is just as critical as recruitment, but unfortunately it is outside the scope of this limited Bill. In the year to September 2023, 10.7% of NHS staff—about 154,000 people—left their role. Burnout is rife, morale is low and too many staff are working in buildings that are crumbling around them. We have been contacted by GP trainers who are worried that the doctors they are training plan to leave for Australia or Canada as soon as they qualify. The promised workforce plan must address this problem.

International comparisons lay bare the scale of the problem. England has just 3.2 doctors per 1,000 people, which is well below the OECD and EU average of 3.9. We would need 40,000 more doctors to meet that benchmark. Prioritising UK graduates is sensible, but it will not on its own deliver the workforce that patients urgently need. That is why the Liberal Democrats have tabled an amendment requiring a specialty by specialty workforce assessment. Shortages are acute in general practice, radiology, cancer care, mental health and more, and transparency is essential if training places are to be directed at where the need is greatest.

It is 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 in which shortages sit alongside unemployment. The Government’s decision to raise national insurance has only exacerbated the problem, forcing some practices into lay-offs or closure. In my North Shropshire constituency, several GP practices have told me that they cannot take on additional doctors because they are constrained by the outdated physical space in which they operate. The Liberal Democrats would fund 8,000 more GPs, ensuring that every patient could see a GP within seven days, or 24 hours if the need was urgent, because we cannot fix the NHS without fixing the front door.

NHS staff are the backbone of our health service, and 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 parking charges, so that staff are not penalised for simply turning up to care for us. We will always stand up for our NHS and the people who make it work. While we support this Bill, we will push to ensure that its implementation strengthens our health service as much as possible.