Medical Training (Prioritisation) Bill

Baroness Coffey Excerpts

2nd reading
Wednesday 4th February 2026 Lords Chamber

[Baroness Coffey (Con)]

My Lords, I start by welcoming the noble Lord, Lord Roe, to the House. I am sure that his experience will be informative in many ways, including now as chair of the building safety regulator. I am sure his insight will be very valuable to the R&R committee in a variety of ways. At some point I would love to have a conversation with him about his experience, including not having retained firefighters in London and what more we could do to try to get every firefighter across this country to potentially become a first responder; again, making sure that the blue-light services work together.

Turning to the Bill, I think there are a number of issues in it. By and large, I support the principle, but in terms of prioritisation, my sense is that it does not really prioritise, certainly not by making sure that UK students get priority ahead of other people in the different priority groups. Discussion has been had about Switzerland, Liechtenstein and Iceland; I assume there is some historic international treaty. It is clear in the way that the Government have brought this legislation forward that there is no such agreement or treaty when it comes to Malta, but I am more sympathetic to the Government on this issue than perhaps some other people on these Benches are.

This may seem unimportant, but this was rushed through in a day in the Commons by the right honourable Wes Streeting. Normally this sort of legislation is genuinely for emergencies, very specific situations, so it beggars belief that the Government seem to be using this as leverage with the BMA on strikes. Indeed, the Secretary of State mentioned this. When he was asked whether this was so urgent—and it will please students who are members of the BMA—he stated:

“It is important that the Bill is workable. A number of factors may well interrupt our ability … One of those factors is the ongoing risk of industrial action”.—[Official Report, Commons, 27/1/26; col. 805.]


I am not sure that that is a valid reason for the Bill not to be commenced immediately, and it would certainly reduce the uncertainty for some of the other situations, including the 2026 application.

I just wanted to check my understanding on something. I am not suggesting that the department is cooking the books in any way, but the impact statement provides analysis that does not help us to get into the core detail. I would be grateful if the Minister would consider releasing more raw data. I ask that because we lump all our international medical graduates into one category in this analysis, and the Bill is asking us to have more categories of IMGs.

The noble Lord, Lord Patel, was accurate in his understanding. I think there has been quite a lot of debate in the Commons, given that the UK Government have paid a lot of money—I think we heard it was about £4 billion a year on the clinical elements. I assume that is a combination of the NHS tuition fee bursary and other elements provided to medical schools. International students do not get that bursary. At the moment, it seems that by paying the £40,000 to £50,000 a year for being trained in a UK degree at a UK medical school, international students could well get priority. Within UK medical graduates, or indeed persons in the priority group which we just referred to, there is no actual prioritisation for UK students—by that, I mean UK nationals.

I think it is fair about the relationship with the Republic of Ireland; that is a historic relationship, and I do not object to that. But in the specialty training programmes, Clause 2(2)(e) covers, basically, people from the European Union and I am trying to understand why that is necessary. We just keep coming back to the fact that none of this is really prioritising UK students in UK medical schools. I would be grateful if the Minister could set out how the Government intend to prioritise all the different categories. Is it the intention that the prioritisation will start with (a), then (b), then (c) and then (d)? It would be useful to understand that.

At the moment, the Bill would allow people under paragraph (d)—to be set out in regulations—to get priority ahead of UK medical graduates. It is unclear, therefore, how this might work.

I appreciate that what happened with visas has been cited as part of the problem. There is another way, however, in that the Government could adjust the skilled worker visa to address some of these issues. Have they considered that? I would be grateful if the Minister would write to me and the House. Generally speaking, though, I intend to support this Bill.