Medical Training (Prioritisation) Bill

Baroness McIntosh of Hudnall Excerpts

Committee stage & Report stage
Monday 23rd February 2026 Lords Chamber

[Lord Mohammed of Tinsley (LD)]

My Lords, Amendment 14 would ensure that all regulations under the Bill are subject to the affirmative resolution procedure—or, in simple terms, that both Houses of Parliament get to have a say in and have a vote on any changes that a future Minister or Government make. This is not a narrow technical point; it goes to the heart of parliamentary accountability and to the fair and transparent governance of medical training policy.

The Bill confers broad powers to Ministers to determine key aspects of how prioritisation will operate. These include potentially definitions for eligibility, scoring frameworks, exemptions, transitional arrangements and other detailed rules that will shape the careers of tens of thousands of doctors. In Committee, noble Lords expressed concerns about the breadth of delegated powers in the Bill and the limited parliamentary oversight of these powers. In Committee, it was evident from the debate that Members of your Lordships’ House share the view that regulatory decision-making powers are vast and open-ended, yet the Bill envisages only the negative procedure for most regulations, meaning that the regulations can come into force unless actively annulled.

This falls short of the level of scrutiny appropriate for measures of such significance. It is precisely because of the impact of this legislation on individuals’ careers and NHS workforce planning that the affirmative resolution procedure is the right standard. Ministers should be required to lay each statutory instrument before both Houses and obtain explicit parliamentary approval before they can take effect. This would give the House the opportunity not merely to debate but to approve or reject the detailed rules that give effect to the policy, ensuring that changes are made not by default or through omissions but by the conscious decisions of Parliament.

Medical training policy is not static. It will evolve in response to workforce needs, technical standards and educational practices. There is nothing wrong with working with flexibility. There is something wrong with flexibility exercised without open scrutiny. Doctors plan years ahead; they make life choices on the basis of published criteria. To allow Ministers to adjust those criteria by regulation without positive endorsement by this Parliament risks unpredictability and unfairness.

The use of the affirmative resolution procedure does not prevent Governments acting. It simply ensures that Parliament is properly informed and engaged, strengthening trust in the process and respecting this House’s role in scrutinising public policy. Given the far-reaching nature of these measures that could be set in regulation, the affirmative resolution procedure is not just desirable but necessary. For these reasons, I hope that noble Lords will back my amendment.

[The Deputy Speaker (Baroness McIntosh of Hudnall) (Lab)]

My Lords, I should advise the House that if this amendment is agreed to, I cannot call Amendment 15 by reason of pre-emption.

[Lord Kamall (Con)]

My Lords, I thank the noble Lord, Lord Mohammed of Tinsley, for opening the debate on this group—and the numerous noble Lords who spoke to it.

I redeclare my interests. I am a professor of politics and international relations at St Mary’s University, Twickenham, where I teach a module on healthcare policy and strategy, and I have been helping with its new medical school. I also work with the Vinson Centre for the Public Understanding of Economics and Entrepreneurship at the University of Buckingham, which has a medical school, although I have no direct connection with the medical school there. I hope I have touched on all potential conflicts.

Amendment 14, from the noble Lord, and Amendment 16, in my name, were debated in Committee, so I do not intend to repeat the arguments that were made then. However, I think it would be helpful if we reminded ourselves that we are dealing with emergency legislation. This is key. The Constitution Committee has warned against the Government’s overuse of emergency legislation, not least because when we legislate in this way we risk creating unintended consequences. We should be very careful and selective in using emergency legislation. In that context, it does not seem unreasonable that your Lordships’ House should be given an opportunity to scrutinise secondary legislation in more detail through the affirmative procedure. I hope the Minister will take on board the concerns about using the affirmative procedure rather than other procedure.

Turning to Amendment 16, I have retabled this amendment for debate today because I am afraid that I was not completely satisfied with the Minister’s response in Committee. I am sorry to say that but, at Second Reading, the Minister explained that the Government’s view is that commencement may not happen with Royal Assent because the changes introduced by the Bill are “a major undertaking” and

“there is a material consideration about whether it is even possible to proceed if the strikes are ongoing”.

However, in the same speech she explained that this is “emergency legislation” which is being brought forward

“as quickly as possible, rather than wait … another year to do so”.

On the one hand, this is a major undertaking that, in the words of the Minister,

“cannot be switched on overnight”.—[Official Report, 4/2/26; col. 1681.]

yet at the same time it is emergency legislation that cannot wait.