Medical Training (Prioritisation) Bill

Stuart Andrew Excerpts

Tuesday 27th January 2026 Commons Chamber

[Stuart Andrew (Daventry) (Con)]

Let me start by saying at the outset that—

[Alex McIntyre]

You are not defecting?

[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.