Medical Training (Prioritisation) Bill

Debate between Simon Opher and Wes Streeting

2nd reading
Tuesday 27th January 2026 Commons Chamber

[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.

[Dr Simon Opher (Stroud) (Lab)]

Will the Secretary of State give way?

[Wes Streeting]

I give way to my hon. Friend with significant NHS experience.

[Dr Opher]

I commend the speed with which my right hon. Friend has brought this legislation to Parliament. I have been a GP trainer for 25 years. Fifty per cent of GP trainees are international medical graduates, and there has been some disquiet from them. Will he reassure our international medical graduates that they are welcome and treasured in the health service?

[Wes Streeting]

My hon. Friend is absolutely right about the contribution that international medical graduates make, and I have no doubt that that will continue to be the case for many years to come. I hope it is clear to those going through medical school or aspiring to a career in medicine that, in terms of the future of healthcare in this country, general practice is where it’s at. We are looking to shift the centre of gravity in the NHS out of hospital and into the community, with care closer to people’s homes and, indeed, in people’s homes, with GPs as leaders of a neighbourhood health service. I hope that gives encouragement to GPs serving today about the future of their profession, about which they care enormously. I also hope that that message resonates with people who are thinking about a career in medicine, when they think about what kind of career that might be.

Resident Doctors: Industrial Action

Debate between Simon Opher and Wes Streeting

Wednesday 10th December 2025 Commons Chamber

[Wes Streeting]

That is a very thoughtful and appropriate question. Just to reassure the House, the Minister of State for Health and I have been working with Agenda for Change unions, particularly Unison, the Royal College of Nursing and GMB, to ensure that we are dealing with the structural reform of Agenda for Change that they are seeking. We have been exploring how we can deliver fairer pay for other parts of the NHS workforce and an improvement to the conditions and status of the nursing profession specifically, while maintaining fairness for all NHS workers. That is one of the considerations I have had to bear in mind when it comes to what we can offer the BMA and resident doctors. I have been very clear with the resident doctor reps about that privately, and I am happy to restate that publicly.

Doctors have not had a bad deal from this Government, frankly, and I have a responsibility to all parts of the NHS workforce, especially those who are lowest paid and who often lie awake at night worrying about their bills.

[Dr Simon Opher (Stroud) (Lab)]

On international medical graduates, I commend the Secretary of State. It is something we have discussed in the past, and bringing forward emergency legislation is absolutely crucial here, so I thank him for that. I also want to mention trainers in the NHS. I can reassure the Conservatives that we will make this happen. I have been a GP trainer for 25 years. We will work to make this happen; that is what we do in the NHS.

I have many resident doctor friends who do not like this action. Can we urge those doctors to talk to their fellows and try to call off this strike? It is not generally well supported among resident doctors, and it is something that we can change.

[Wes Streeting]

My hon. Friend makes a really good point. Sometimes during ballots people who are opposed to industrial action choose not to cast a ballot at all because they know that the turnout threshold is material. In the coming days, it is absolutely vital that every resident doctor makes their voice heard. This is their chance to tell me and their reps how they want to proceed on this deal. I respect the fact that the resident doctors committee has chosen today to present the deal in neutral terms to its members so that they can make a choice. I really do respect that. Now I urge resident doctors to make their views known and take the opportunity in front of them so that we can move forward together to make real changes to their lives.

NHS England Update

Debate between Simon Opher and Wes Streeting

Thursday 13th March 2025 Commons Chamber

[Wes Streeting]

I am grateful to the Liberal Democrats for those questions. Much of the change needed can be delivered without the need for primary legislation, which is a relief because, as right hon. and hon. Members will have noticed, this Government have come into office with the most ambitious legislative programme of any incoming Government. Time is at a premium, given the business of this House and the other place. We will work immediately to move forward without changes to primary legislation, but we will need to make them. I am working with the Leader of the House and business managers to ensure an appropriate timetable that enables us to do the things that we need to do in a timely way, but that also safeguards the ambitious legislative programme that has already been set out.

The hon. Lady is right to talk about the importance of social care. She asked where the urgency is. It was to be found in the immediate steps that the Chancellor took on coming into office to stabilise the finances of my Department, with an immediate release of funding. It came with the Budget, which delivered an extra £26 billion for the Department for Health and Social Care, protected funding specifically for social care and boosted spending power for local authorities. It came with the biggest expansion of carer’s allowance since the 1970s, and an £86 million increase in the disabled facilities grant not just from next year but released in January for the remainder of this financial year. The urgency is reflected in the Employment Rights Bill, which makes provision for fair pay agreements to deal with the work- force crisis—work with employers and trade unions to prepare for that legislation and the introduction of fair pay agreements is already under way.

I regret that we have not convened cross-party talks. That is genuinely due to practicalities on the part of a number of parties involved. We will be in touch over the next week to make arrangements for Baroness Casey to engage with parties across the House.

[Dr Simon Opher (Stroud) (Lab)]

I thank my right hon. Friend for his excellent statement. As he knows, I am a working GP in Stroud. We clinicians are simply fed up with the micromanagement of our caring clinical role, and many hospital colleagues feel the same. We want to be free to deliver excellent clinical care. Does he think that the abolition of NHSE will reduce the admin task for doctors?

[Wes Streeting]

I do think that is the case. I also think that this is not just about form and function but about the opportunities for productivity gains through modern technology and practices. One of my frustrations is that whenever we talk about the exciting frontiers of life sciences and medical technology—this country’s competitive advantage, and how we need to build on that position— I am greeted with a weary sigh from poor frontline NHS staff, and managers for that matter, who say, “That’s lovely, and we agree with you, but we’d just like a machine that turns on reliably, and it would be nice to use systems that do not require seven passwords to deal with a single patient.” I feel their pain. We will prioritise that investment in technology.

Finally, we do want to liberate the frontline, and I am grateful for the leadership that GPs have shown in agreeing a contract with the Government for the first time since the pandemic, which contains substantial reform to benefit them and, even more importantly, their patients. We also have to liberate management in the NHS. As Lord Darzi said, it is not the case that there are too many managers, but there are layers and layers of bureaucracy between me as the Secretary of State and frontline staff. We have to liberate frontline staff and managers to help them be more effective, to manage their resources more efficiently and, most importantly, to deliver better and safer care.