Medical Training (Prioritisation) Bill

Gregory Stafford Excerpts

Tuesday 27th January 2026 Commons Chamber

[Anneliese Dodds (Oxford East) (Lab/Co-op)]

rose—

[Gregory Stafford (Farnham and Bordon) (Con)]

rose—

[Wes Streeting]

I will take an intervention from the hon. Gentleman. I will come to my right hon. Friend in a moment.

[Gregory Stafford]

The Secretary of State mentioned the need for more medical staff across the world and, of course, in this country as well. At the general election, he pledged to double the number of medical school places by 2030. Is that still a commitment, and how far has he got with it?

[Wes Streeting]

With respect, I think the hon. Gentleman has got his chronology slightly wrong. As shadow Health Secretary, I proposed that we should double the number of undergraduate medical school places. That policy was poached by the then Conservative Government, who made modest progress with it. We then came into government, looked at their long-term workforce plan and concluded that it was not a particularly long-term workforce plan, and we are revising it as we speak. The number of medical school places will be determined by future need. We will publish our long-term workforce plan in the not-too-distant future.

--- Later in debate ---

[Gregory Stafford (Farnham and Bordon) (Con)]

At the heart of the Bill is a simple test: does the Bill improve care for patients? Every delay in training, every cancelled clinic and every rota gap caused by workforce instability ultimately lands on the patient. It means longer waits, greater travel distances and, in too many cases, care that comes too late.

I was recently contacted by my Farnham and Bordon constituent, Dr R, as I will call her, who is a UK-trained medical graduate. Like thousands of others, she completed her studies in good faith, expecting a clear and credible pathway into the NHS. Instead, she now finds herself in a system where non-training posts are disappearing, competition ratios for training places are rising sharply and the holding pattern roles that once allowed junior doctors to remain clinically active while reapplying have all but vanished.

This is not a niche concern affecting a handful of individuals; it is a systemic failure that directly impacts patients. When trained doctors are unable to progress, fewer reach consultant and GP level in the years ahead. Services become overstretched, continuity of care is lost and waiting lists grow even longer. That is why I support the intention behind the Bill. Prioritising UK medical graduates, ensuring that the UK foundation programme is genuinely delivered in the United Kingdom and restoring confidence in the medical training pipeline are all necessary steps if we are serious about rebuilding NHS capacity for the benefit of patients.

I have supported amendments to this Bill because they strengthen those aims. They ensure that UK medical graduates are properly recognised as such, that training programmes are UK-based in substance rather than just name, and that allocation of training places is grounded firmly in merit, clinical knowledge, aptitude and performance. Patients, quite rightly, expect their doctors to be selected on ability and doctors expect fairness, and those principles should command support across this House. I also welcome new clause 2, tabled by my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer), which addresses growing concern among doctors and patients about the erosion of merit-based progression. When merit is undermined, morale suffers; when morale suffers, retention suffers, performance suffers, and ultimately patient safety suffers.

As such, the context of this Bill matters. Resident doctors have received cumulative pay rises approaching 30% over recent years—among the highest in the public sector. Despite this, industrial action has continued. It is increasingly clear that the BMA is determined to extract every possible concession from the Government, using sustained disruption as leverage. While I do not align myself with some of the Secretary of State’s more inflammatory language, I do share the realisation he has belatedly reached: that repeated above-inflation pay settlements have not brought this dispute to an end, and that further concessions risk rewarding brinkmanship rather than restoring stability for patients.

However, in pressing its case so aggressively, the BMA has inadvertently shone a spotlight on a genuine and serious problem in the system: a broken training and progression pathway that leaves UK doctors without secure routes into the NHS. That problem is real, it affects patients, and it must be addressed regardless of the outcome of pay negotiations. That is precisely why this Bill matters and why it must not be treated as a bargaining chip, yet that is exactly the risk created by the way in which the Bill is drafted. It will come into force only when the Secretary of State gives permission. In theory, that may appear sensible; in practice, it allows a patient-benefiting reform to be delayed, diluted, or deployed as leverage in negotiations.

Before Christmas, Ministers openly discussed this legislation in the context of talks with the BMA. The implication was clear: progress on training reform was conditional. Now, months later, with industrial action ongoing, it appears that the same dynamic may be emerging again. That approach undermines confidence among doctors and, far more importantly, undermines care for patients. If a measure will improve the NHS for patients and doctors alike, it should be implemented because it is right, not because it is tactically useful. That leads me to a number of questions for the Minister to answer when she responds, which are all grounded in patient outcomes.

Patients need capacity and certainty. They need more doctors progressing through training, not further delays and ambiguity. If the Government genuinely believe that prioritising UK graduates will strengthen the workforce, why is the commencement of this Bill discretionary at all? What assurance can the Minister give patients that these reforms will not be delayed indefinitely while negotiations continue? Patients have already endured significant disruption from industrial action—hundreds of thousands of appointments and operations have been cancelled or rescheduled. Without further pay concessions, can the Minister explain how this Bill will reduce the risk of future disruption, or is she effectively accepting that patients may face continued instability?

There is also the question of scale. The BMA itself has said that the Bill does not go far enough to close the gap between applicants and available training posts. What assessment has been made of how many UK graduates will still be unable to access foundation or specialty training even after this legislation is passed, and what will that mean for patient access to care in the coming years? Patients in many parts of the country already struggle to access GPs, psychiatrists and emergency medicine specialists. How will the Secretary of State and the Minister ensure that these reforms do not inadvertently worsen shortages in hard-to-recruit specialties or underserved areas?

Finally, there is the question of credibility. If this Bill is genuinely good for patients, good for workforce stability and good for the NHS, why should its implementation depend on a ministerial decision at some undefined point in time? Why not give doctors and patients certainty by bringing it into force immediately on Royal Assent? This House has a responsibility to put patients first, not leave patient care hostage to industrial negotiations. That is why I strongly support amendment 1, which would ensure that the Bill comes into force at the moment of Royal Assent. It removes unnecessary delays, ambiguity, and the risk that these reforms will be postponed indefinitely while workforce and pay disputes continue. UK medical graduates, hospitals and training bodies need certainty that the rules will apply from day one, so that allocations, protections for those trained on military postings, and fairness measures can begin to operate without delay. The amendment would ensure that reforms designed to strengthen transparency, meritocracy and the workforce will take effect when they are needed most. That clarity is particularly important given the absence of a published NHS workforce plan.

We need certainty for doctors that delivers stability for services, which in turn delivers better patient care and better outcomes. That is the standard by which this Bill should be judged, and it is the standard it must meet.