Medical Training (Prioritisation) Bill

Debate between Andrew Murrison and Wes Streeting

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.

NHS: Winter Preparedness

Debate between Andrew Murrison and Wes Streeting

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.

Health and Adult Social Care Reform

Debate between Andrew Murrison and Wes Streeting

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.