Medical Training (Prioritisation) Bill

Simon Opher Excerpts

Tuesday 27th January 2026 Commons Chamber

[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.

[Dr Simon Opher (Stroud) (Lab)]

Will the Secretary of State give way?

[Wes Streeting]

I give way to my hon. Friend with significant NHS experience.

[Dr Opher]

I commend the speed with which my right hon. Friend has brought this legislation to Parliament. I have been a GP trainer for 25 years. Fifty per cent of GP trainees are international medical graduates, and there has been some disquiet from them. Will he reassure our international medical graduates that they are welcome and treasured in the health service?

[Wes Streeting]

My hon. Friend is absolutely right about the contribution that international medical graduates make, and I have no doubt that that will continue to be the case for many years to come. I hope it is clear to those going through medical school or aspiring to a career in medicine that, in terms of the future of healthcare in this country, general practice is where it’s at. We are looking to shift the centre of gravity in the NHS out of hospital and 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. I also hope that that message resonates with people who are thinking about a career in medicine, when they think about what kind of career that might be.

--- Later in debate ---

[Dr Simon Opher (Stroud) (Lab)]

I will keep this short, because many of my points have already been made. I think that there are two main problems. The first is about priority for our medical graduates. To be honest, I was a little bit surprised when, about a year ago, I found out that they are not prioritised. That clearly is not reciprocated around the world, and we need to change it. The other problem is our training numbers. If we are training medical students up to graduation, we must ensure that the number training fit into our postgraduate training, because otherwise it is crazy, which is the situation we find ourselves in.

I have been a GP trainer for about 25 years, and many of the doctors I have trained as GPS have gone off to Australia. My favourite went to New Zealand and is staying there, although I keep trying to entice her back by saying how great it is that the NHS is improving. GP training is unique. It involves 18 months in general practice in a one-on-one apprenticeship-type system, and I think the system in the UK is one of the best in the world. It teaches continuity of care for patients, and it also teaches the skills that are bringing back the family doctor. This is about the doctor being the gatekeeper to the NHS, and also protecting the patient against the NHS and from over-investigation.

In fact, I always think an MP is bit like a GP, because a GP has to know a little about absolutely everything, which is the same for an MP. I would like to give a shout-out to my Stroud GP trainers group, who visited Parliament last year, and also to the 8,000 GP trainers in this country, who do a fantastic job, often going above and beyond their responsibilities.

I would like to mention international medical graduates—I have had a number of them. At the moment, 50% of those training in the UK are international medical graduates—I understand that in Teesside the figure is 100%—and we are depending on these people to provide some of our general practice. I have had fantastic trainees from India, Spain, Germany and Algeria, who have all become fantastic NHS GPs. As I have said, we must ensure that they are welcome and treasured in the NHS, because they constitute a large body of GPs in our system. Although we need to prioritise UK graduates, we must not put off international graduates from coming and helping us to deliver a new NHS.

I would like to make another point about medical training. Postgraduate medical training goes through a process, and it is important that we recalibrate this so that the number of training spots exactly matches the number of our medical graduates. That is particularly true for anaesthetists. There are bottlenecks in anaesthetics training, and if we could relieve those bottlenecks, we would get more anaesthetists training and could start to bring down our waiting list. However, that will involve a decent workforce plan, which I understand we are developing, and proper planning for the future, so we can get our waiting lists down and deliver a better NHS for everyone.

To conclude, after years of failure and the neglect of our home-grown talent, this Government are taking action so that our doctors can train, stay and serve the communities that need them most. I urge Members to support the Bill.