Medical Training (Prioritisation) Bill

Jack Abbott Excerpts

Tuesday 27th January 2026 Commons Chamber

[Jack Abbott (Ipswich) (Lab/Co-op)]

It is a pleasure to speak in support of the Medical Training (Prioritisation) Bill. This Bill goes to the very heart of the future of our national health service—the doctors on whom our health service depends. It is about fairness, protecting taxpayers’ money, and building a home-grown NHS workforce that is sustainable in the long term. It is about making sure that those who have trained here have the opportunity to become the next generation of doctors working in our health service.

Every year, it is becoming harder for graduates of UK medical schools to find a place on a foundation or specialty training programme. Since 2019, competition for postgraduate training places has increased by a staggering amount. In 2019, there were about 12,000 applicants for 9,000 places, but in 2025 the situation became even more stark. There are now more than 30,000 applicants, and over 12,000 UK-trained doctors and nearly 21,000 overseas doctors compete for fewer than 10,000 places. That is an enormous and unsustainable change. For some specialties, the competition is much fiercer. Aspiring neurosurgeons, for example, had to compete against 26 others to secure a place, and there were 737 applicants for just 10 cardiothoracic surgery training places.

Those are not abstract statistics, and behind every number is a person who has spent years training, often at great personal and financial cost, only to find their opportunities for career progression drying up. Some take time out, some seek experience abroad and some leave medicine altogether. Many do not have a choice. They are forced by a system that has become so congested that getting a training post in something that they are passionate about and trained in is completely unattainable. Every time a doctor leaves the NHS, there is no guarantee that they will come back.

The Secretary of State is incredibly committed to increasing medical school places, and we desperately need more doctors, but we have to be honest with ourselves: we cannot expand medical school places without addressing the growing crisis of competition for training places. It is within that context that the Medical Training (Prioritisation) Bill must be understood. There has been a direct correlation between the lifting of visa restrictions in 2020 under the Conservatives and the dramatic rise in competition for foundation and specialty training posts. Maybe that was one of the Conservatives’ Brexit bonuses that they so eloquently talked about. This needs to be addressed, because otherwise we risk training doctors for a system that cannot support them. We are recruiting doctors from abroad at a time when there is already a substantial pool of eligible applicants who have trained in the UK or are already working in the NHS. That cannot be right.

General practice is particularly reliant on international doctors, with half of first-year trainees having qualified outside the UK in 2024. Let me be clear, because this point matters enormously: international medical graduates have always played, and will continue to play, a vital role in our NHS. Many of our hospitals and services simply could not function without them. The Bill does not diminish that contribution, and neither does it seek to close the door to international talent, but it does ask fair and reasonable questions. When we are spending almost £4 billion every year to train doctors in the UK, is it right that those doctors are increasingly unable to access the very training posts that they need to progress? Is it right that huge amounts of taxpayers’ money is spent training doctors, only for that investment to be lost when doctors are forced out of the system or choose to go overseas or into the private sector? If we are honest with ourselves, how progressive is it that we poach doctors from countries that desperately need them, while we have our own brilliant and willing recruits who cannot get jobs here?

If we are serious about building an NHS that is stable, resilient and fit for the future, we must also be serious about retention and recruitment, so we must ensure that those we train can stay, specialise and build careers here at home. What is the alternative? We train thousands of talented, hard-working young people at significant public expense, only for them to hit a wall, feel undervalued and leave either the NHS or medicine altogether. Every doctor we train in the UK who chooses to leave is an enormous loss for our health service and our country. It is such a waste of talent and money. We cannot afford to lose our next generation of doctors—the future of the NHS depends on it—yet that is where we are headed unless we do something now. It is urgent.

Prioritisation is not about exclusion; it is about safeguarding public investment and guaranteeing the long-term sustainability of our NHS workforce. It is about ensuring that the NHS remains an attractive place for young doctors to build a career, and that doctors in this country feel valued, which the previous Conservative Government failed miserably on. The Bill sends an important signal to young people in this country considering a career in medicine that we want them to build a long and fruitful career right here in the UK, in our NHS. It says to those currently picking their A-level options or deciding whether a medical degree is right for them that their hard work will be rewarded and we want them to succeed.

The Bill is not a silver bullet. It will not solve every workforce challenge facing our NHS overnight, but it is a sensible and necessary reform that will go a significant way towards dealing with a deeply concerning and growing problem. If we care about the future of our NHS, we must care about the doctors in it and the doctors who will sustain it in the years to come. For the sake of the future health and viability of our NHS, I therefore urge all Members to support the Bill.