I remind Members that in Committee they should not address the Chair as “Deputy Speaker”. Please use our names. Madam Chair, Chair or Madam Chairman are also acceptable.
Clause 1
UK Foundation Programme
Question proposed, That the clause stand part of the Bill.
Amendment 6, in clause 2, page 1, line 16, at end insert—
“(e) persons within subsection (3),”.
This is a paving amendment for amendment 7.
Amendment 7, page 2, line 6, at end insert—
“(3) A person is within this subsection if they—
(a) were actively employed as a doctor in the NHS or Health and Social Care Northern Ireland on 13 January 2026; and
(b) had submitted a valid application for a UK specialty training programme for a start date in 2026 before the day on which this section comes into force.
(4) For the purposes of subsection (3), “actively employed” includes, but is not limited to, persons on fixed-term Trust Grade, Clinical Fellow or Staff, Associate Specialist and Specialty Doctor contracts.”
This amendment would require applications to specialty medical training in 2026 from those already employed in the NHS to be prioritised.
Clause 2 stand part.
Clause 3 stand part.
Amendment 10, in clause 4, page 3, line 2, at end insert—
“unless that time was spent outside the British Islands as part of a posting with the UK armed forces.”
This amendment would include within the definition of a UK medical graduate anyone who spent all or part of their training on a military posting outside the British Islands.
Amendment 9, page 3, line 3, after “are” insert
“a British citizen or are”.
This amendment would require British citizens to be prioritised for places on UK Foundation programmes and for interviews and places on speciality training programmes from 2027 onwards.
In the interests of time, I will address the amendments at the end of proceedings, when I have heard from them—I think we have the gist of most of those issues. I restate our firm commitment to the Bill and all clauses.
Let me turn to clause 4 and clarify how we are defining “UK medical graduate” and “the priority group” for the purposes of the Bill. “UK medical graduate” in this context excludes those who have spent all or the majority of their time training for their medical qualification outside the British isles. This means that if a person has obtained a primary UK qualification but has studied mainly overseas, they will not be eligible for prioritisation as a UK medical graduate unless they fall into another group that is to be prioritised under the Bill. While internationally educated graduates from overseas remain an important part of the workforce and can continue to be recruited under the Bill, we are committed to growing home-grown talent, who are more likely to work in the NHS for longer, and to be better equipped to deliver healthcare tailored to the UK’s population.
Clause 8 sets out the territorial extent of the Bill and deals with commencement. The Bill extends to England, Wales, Scotland and Northern Ireland, and we have worked closely with the devolved Governments to ensure that it meets all needs and provides consistency. We are grateful to them for their support in bringing these measures forward so quickly. The Bill will engage the legislative consent motion process, and the devolved Governments have committed to commence this process in their Parliaments.
To ensure that the systems, planning and operational capacity required for successful implementation are in place, the Bill will be commenced
“on such day or days as the Secretary of State may by regulations appoint.”
As the Secretary of State outlined on Second Reading, this is an important fail-safe to ensure that we are not in a position in which a law is enacted that we cannot implement effectively at the time. I am happy to expand on that after we have discussed the amendments, but the key issue is the ability of the NHS and training providers to deliver the measure. That is why we have a fail-safe; we first need to be very clear that the NHS is in a position to deliver. Members have talked about the strikes. Those would be one consideration, and there are many others. We are asking the NHS and training providers to do something very difficult very quickly, and in order to ensure that they have the capacity and capability to do it safely, we are reserving the right to commence the Bill at a later date, rather than at the end of this Session. I will come back to the amendments when I close the debate.
I will speak to the amendments tabled by the Opposition. First, amendment 9 would require that from 2027, priority is given to British citizens on UK foundation programmes, and that they are prioritised for interviews and places on specialty training programmes. Clause 4 defines a UK medical graduate as a
“a person who holds a primary United Kingdom qualification within the meaning of the Medical Act 1983 (see section 4(3) of that Act)”.
However, it does not include
“a person who spent all or a majority of their time training for that qualification outside the British Islands.”
The Secretary of State has stated his intention to prioritise UK medical graduates, but he has failed to protect all British citizens in doing so. Our amendment would ensure that British citizens who study on an eligible medical course overseas were still prioritised in the Bill. There are many scenarios in which we may need to ensure that we protect British citizens. Consider, for example, a spouse, partner or child of a serving member of the UK armed forces who completes relevant training overseas while their relative is posted in Cyprus; a student at Queen Mary University of London who has completed the bachelor of medicine and bachelor of surgery course at its Malta campus but received a UK medical degree; a young British citizen who has studied in the US or France, owing to a family relocation; or, given that the largest bottleneck is not in training places but in getting a place in medical school at all in some cases, a British student who has gone to study overseas because of their fervent desire to become a doctor.
Those are all entirely possible and plausible scenarios in which British citizens have completed their relevant training, and wish to bring their skills back and to relocate in their homeland for the rest of their career, but may not be covered by the Government’s prioritisation model. The Government’s prioritisation model is based on where the degree was taken, rather than also considering who did it. The Secretary of State must ensure that we do not overlook our own citizens if we are to fairly address the competitive landscape for training posts. The Opposition therefore urge the Government to accept amendment 9.
The amendments in my name raise concerns about the Bill’s impact on fairness, transparency and the smooth functioning of the NHS, notwithstanding the Liberal Democrats’ overall support for the Bill.
Clause 7(1) would allow Ministers to change who is eligible for prioritisation through the negative procedure, meaning that such changes could be made unilaterally, without meaningful scrutiny. In practice, that hands the Secretary of State the power to redraw the boundaries of opportunity, and to decide who gets prioritised for medical training places, without Parliament ever having a say. That is unacceptable for a decision that affects people’s lives and careers, as well as the future capability of our health service. While I do not doubt the intentions of the Secretary of State and the Front Bench team, it opens the door to the risk of political whim or prejudice influencing who gets access to career-defining opportunities in the future. That is why the Liberal Democrats have tabled amendments 2 to 5 to reverse this, and to ensure that any changes must be subject to full parliamentary consent.
On the timing of the Bill’s implementation, the Government intend to apply the new prioritisation rules midway through the 2026 specialty recruitment cycle. Let us reflect on what that means in practice. Doctors already working in the NHS have entered this cycle under one set of rules. They have paid for exams, secured visas, arranged travel, uprooted their families and committed themselves to the NHS. To change the rules halfway through the process would not only be potentially destabilising for services, but very unfair to those individuals, many of whom are plugging urgent staffing gaps right now.
We already face real workforce pressures, so the last thing our NHS needs is a wave of dedicated doctors forced out by uncertainty, or pushed to leave the country because the Government moved the goalposts after applications had already begun. For this reason, we believe that the Bill should come into force from 2027. We must protect frontline services and protect the integrity of the applications process. To address the problem directly, we have tabled amendments 6 and 7 to safeguard those already in the 2026 application cycle, ensuring that they are not deprioritised, because that is a simple matter of fairness.
Last year, research by the Royal College of Radiologists found that 76% of English cancer centres had patient safety concerns due to workforce shortages. While we welcome the Government’s recent commitment to ending the postcode lottery of cancer care, does my hon. Friend agree that the Government need to publish an assessment of the Bill’s impact on doctor numbers, broken down by speciality, to ensure that cancer treatment is not delayed because of staff shortages?
I thank my hon. Friend for her point, which I agree with fully. That is why we have tabled new clause 1. It will require the Government to publish a report on the Bill’s impact on the number of applicants to foundation and speciality training programmes and, crucially, to break that down by speciality. If applications fall as a result of these changes, the Government would be required to assess the impact on the total number of fully qualified doctors entering the NHS. This report would be produced annually after three years, allowing time for a full training cycle to complete. It is a sensible safeguard, one that ensures that we do not inadvertently exacerbate the very workforce shortages that we are trying to address. To return to the core principle that is at stake, we are not opposed to the Bill’s objective. We support the principle of prioritising those who have trained in the UK, but that principle must be implemented fairly, transparently and with proper oversight.
I will touch briefly on the amendments tabled by the official Opposition. Amendment 9
“would require British citizens to be prioritised for places on UK Foundation programmes and for interviews and places on speciality training programmes from 2027 onwards”,
while amendment 8
“would require a UK Foundation Programme to be a programme for which the majority of training takes place inside the United Kingdom.”
I am not convinced that these two amendments are consistent with each other. Surely the purpose of the Bill is to ensure that the £4 billion spent every year on training doctors in the NHS is an investment in the NHS, and that those who are prioritised for specialty training have experience of both the workings of the NHS and the epidemiology of the UK and their own locality. In that context, amendment 8 looks broadly sensible, but amendment 9 would prioritise British citizens regardless of their place of training or NHS experience, which seems potentially counterproductive to that aim. As such, we will not be supporting amendment 9.
In conclusion, amendments 2, 3, 4 and 5—which stand in my name—would strengthen parliamentary scrutiny by replacing the negative procedure with the affirmative procedure, ensuring that any future changes to eligibility receive proper examination. Amendment 5 would also ensure that devolved nations also give consent before any changes are laid before Parliament. Amendments 6 and 7 would ensure the fairness of the process in the current year, and new clause 1 seeks to ensure that the Bill meets its objectives of lessening the workforce crisis by specialty. These changes would not undermine the Bill, but strengthen it. They protect fairness, protect parliamentary sovereignty, and protect the NHS workforce from unpredictable and disruptive changes. As such, although we support the Bill, we urge the Government to adopt these amendments, which would ensure that the legislation works for patients, staff and the long-term strength of our NHS.
As always, Mrs Cummins, it is a pleasure to serve under your chairmanship. I rise to speak to new clause 2, which stands in my name and is supported by many other Conservative Members. I declare again that I am now a non-practising doctor and my wife is a doctor.
I believe that ambition should be encouraged, and success should be dependent on the talent and hard work of the individual. However, in a vocation where we really want to encourage and support the brightest and the best, the signal being beamed out by the NHS and its various arms and quangos is unfortunately quite different. We have already seen this over the years in how the NHS treats competence and excellence among doctors—someone could be the best doctor in the world and be treated exactly the same as someone who is just about competent. No other operation would approach employment, and celebrating and supporting success, in that way.
I do not think, though, that I have ever seen as egregious and extreme an example of completely ignoring talent and merit as the preference informed allocation system. The shadow Minister, my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), has laid out some of the details behind that system, but I encourage Members across the Committee to read about how preference informed allocation works—about the soulless, computerised, algorithmic method by which it allocates human beings a random number. That random number is then the sum total of those people’s dreams, hopes and ambitions when it comes to placements as they take their first steps into their medical career. To me, PIA looks better suited to the dystopian sci-fi programmes that I enjoy watching—better suited to “Logan’s Run” or “The Prisoner”, in which people are allocated numbers. It is not the way that we should be treating people in this country, and it is outrageous that such a system has been brought into force. We in this House should stand up for merit, and I really hope the Minister will affirm from the Dispatch Box today that the Government will dismantle this awful scheme.
I am grateful to Members for their contributions to the wider debate at this hour and for their considered amendments. I will respond briefly to their points and the amendments that have been tabled.
Amendment 6 and 7 would widen the scope of who is prioritised for specialty training starting in 2026 by prioritising applicants who worked as a doctor in the health service on 13 January. Although we welcome the intention to recognise the importance of internationally trained doctors, we cannot accept the amendments at this time. They would mean that the Bill was ineffective in delivering on its intention to tackle bottlenecks and ensure that we have a sustainable medical workforce that can meet the needs of the population.
I remind the Committee again that the Bill does not exclude anyone. In particular, there are likely to be opportunities in specialties such as general practice, core psychiatry and internal medicine, which historically attract fewer applicants from the groups we are prioritising for 2026. International medical graduates also continue to have opportunities in locally employed doctor roles. That could lead to NHS experience that might count towards future prioritisation as we look to make regulations to set criteria for what is considered “significant” NHS experience from 2027.
Amendment 10 would ensure that members of the armed forces are not excluded from prioritisation due to having undertaken medical training while on posting outside the British islands. We cannot accept that amendment as we believe it is not necessary. That is because medical cadets do not spend time outside the British islands as part of their UK medical degree. While cadets undertake their elective with the military, which may be overseas, that is no different from other civilian medical students, many of whom undertake electives overseas. As such, we do not believe that medical cadets are disadvantaged by the Bill.
Amendment 9 would include all British citizens within the priority groups so that British citizens will be prioritised for the purposes of the foundation programme and specialty training from 2027 onwards. It has no effect for 2026 specialty training, as British citizens are already prioritised by virtue of their immigration status. We therefore cannot accept the amendment. To do so would risk a significant increase in the pool of prioritised doctors who would compete with UK-trained doctors. The amendment would incentivise the expansion of the market for overseas medical schools, including medical schools working with foreign Governments to grow the overseas campus sector. That could offset any increase in postgraduate training places and undermine workforce planning. While British citizens will be prioritised for specialty training places in 2026, this is a proxy that is necessary for practical reasons. From 2027 we want to prioritise applications with experience and training based in the NHS.
I am coming to the hon. Gentleman’s point. We will keep the current system under review—I think the Secretary of State was clear about that—but we think that any change is best made through established guidance rather than through legislation.
Many Members raised the issue of our relationship with Malta and Queen Mary, and the work that is done there. That relationship is clearly important. We have a great deal of work ongoing with Queen Mary, in the medical field as well as others. We are not excluding anyone. We are making sure that the prioritisation works in the best way possible, and we will of course keep all that under review. I thank hon. Members for their constructive debate on this important legislation.
Question put and agreed to.
Clause 1 accordingly ordered to stand part of the Bill.
Clauses 2 and 3 ordered to stand part of the Bill.
Clause 4
“UK medical graduate” and “the priority group”
Amendment proposed: 9, page 3, line 3, after “are” insert
“a British citizen or are”.—(Stuart Andrew.)
This amendment would require British citizens to be prioritised for places on UK Foundation programmes and for interviews and places on speciality training programmes from 2027 onwards.
I beg to move, That the Bill be now read a Third time.
I will not use this time to rehearse any of the arguments made today. We have had some good discussions. I want to thank the Leader of the House, the Chief Whip, parliamentary counsel and business managers, the public servants in my Department and NHS England, who have worked so hard to bring this together, and the devolved Governments for their support. They really have worked well together to bring this important measure to this place.
I am also grateful to all colleagues for scrutinising the Bill so thoughtfully and thoroughly during today’s proceedings and, as I said previously, for meeting me last week to go through some of the provisions. It shows that Parliament can put its shoulder to the wheel and get stuff done in the public interest. We act in the public interest because we were elected on a mandate to fix our broken NHS and make it fit for the future, and we will not succeed in that goal without our workforce, who are and will always be our greatest asset.
When I worked in the NHS during the Lansley reforms, I had a front-row seat to see their devastating impact on staff morale. I saw that patients bore the brunt of some of that collapsing morale. When our workforce does well, our NHS does well. That is why we are working to restore confidence and renew belief among frontline staff. The Bill is another step on that journey, and I urge colleagues to come with us and see it through.
Question put and agreed to.
Bill accordingly read the Third time and passed.
Clause 4 stand part.
Amendment 8, in clause 5, page 3, line 30, at end insert
“,provided that the majority of training for the programme takes place in the United Kingdom.”
This amendment would require a UK Foundation Programme to be a programme for which the majority of training takes place inside the United Kingdom.
Clause 5 stand part.
Clause 6 stand part.
Amendment 2, in clause 7, page 5, line 1, leave out paragraph (a).
This amendment, taken together with amendment 4, would provide that regulations made under Clause 3 are subject to the affirmative procedure.
Amendment 3, page 5, line 24, leave out “section 3 or”.
This amendment is consequential on amendments 2 and 4, which provide that regulations made under Clause 3 are subject to the affirmative procedure.
Amendment 4, page 5, line 40, after “under” insert—
“section 3 (regulations describing persons who may be prioritised for specialty training programmes from 2027 onwards)”.
This amendment, taken together with amendment 2, would provide that regulations made under Clause 3 are subject to the affirmative procedure.
Amendment 5, page 6, line 19, at end insert—
“(6) Before laying before Parliament a draft statutory instrument containing regulations under section 3 the Secretary of State must obtain the consent of—
(a) the Welsh Ministers, if the draft regulations contain provision which would be within the legislative competence of Senedd Cymru if it were contained in an Act of the Senedd;
(b) the Scottish Ministers, if the draft regulations contain provision which would be within the legislative competence of the Scottish Parliament if it were contained in an Act of the Scottish Parliament;
(c) the Department of Health in Northern Ireland, if the draft regulations contain provision which—
(i) would be within the legislative competence of the Northern Ireland Assembly if it were contained in an Act of that Assembly, and
(ii) would not, if it were contained in a Bill for an Act of the Northern Ireland Assembly, result in the Bill requiring the consent of the Secretary of State.”
This amendment would require the Secretary of State to obtain the consent of the relevant devolved government before laying draft regulations under section 3. It is consequential on amendments 2 and 4.
Clause 7 stand part.
Amendment 1, in clause 8, page 6, line 23, leave out from “on” to the end of line 24 and insert
“the day on which it is passed”.
This amendment would bring the Act into force on the day on which it receives Royal Assent.
Clause 8 stand part.
New clause 1—Report on impact—
“(1) The Secretary of State must lay before Parliament an annual report on the impact of the provisions of this Act.
(2) A report under this section must include—
(a) an assessment of the impact of the provisions of this Act on the number of applications for places on—
(i) UK Foundation Programmes, and
(ii) UK speciality training programmes, and
(b) if the assessment under paragraph (a) concludes that there has been a decrease in the total number of applications attributable to the provisions of this Act, an analysis of the potential impact of that decrease on the number of fully qualified doctors working in the NHS and Health and Social Care Northern Ireland, including specific analysis of the impact on the number of general practitioners and on each medical specialism.
(3) The first report under this section must be laid before 31 December 2029.”
New clause 2—Allocation of individual places on merit—
“(1) This section applies to the allocation of individual candidates to specific places on a UK Foundation Programme or a UK specialty training programme, whether that allocation takes place in the course of deciding offers of places or otherwise.
(2) A person who has a function of allocating places on a UK Foundation Programme or a UK specialty training programme must ensure that, once the prioritisation requirements set out in sections 1 to 3 of this Act have been applied, those allocations are based on an assessment of the applicants’ merits.
(3) For the purposes of the assessment of the applicants’ merits, a person may take into account—
(a) the candidates’ educational achievements,
(b) the candidates’ clinical performance,
(c) structured assessments of relevant skills and knowledge,
(d) the candidates’ research, leadership, management, quality improvement, and teaching skills, and
(e) the candidates’ knowledge relating to the place being allocated.”
This new clause would require the allocation of candidates to specific training places to be decided on an assessment of the candidates’ merits, after the prioritisation requirements in clauses 1 to 3 of the Bill have been met.
New clause 3—International students—
“(1) The Secretary of State must report annually to Parliament on the impact of the provisions of this Act on the numbers of international students at UK medical schools.
(2) This report must include an assessment of the financial impact on medical schools.”
This new clause would require the Secretary of State to report to Parliament annually on the impact of the measures in this Act on the numbers of international students studying at UK medical schools.
Amendment 10 is a probing amendment to explore the effects of the Bill on military personnel. As a Member of Parliament representing an area with a large armed forces community, I know that medical trainees are an integral part of our serving community. The world is becoming an increasingly dangerous place, and junior trainees may be sent abroad earlier in their career than is currently the case. It is clearly wrong to penalise people who are doing brave work caring for our armed forces. They ought to be provided with optimal opportunities, and the Secretary of State has a duty to ensure that they are not overlooked. I would be grateful if the Minister covered that in her response.
New clause 3 would require the Government to make an annual report to Parliament about the Bill’s impact on the number of international students at UK medical schools, and the financial impact on UK medical schools. We talked about the bottleneck, and the balance between UK and international students training at UK medical schools; clearly, becoming a UK graduate will now come with a significant premium. What impact will that have on British children getting to make their choices and become doctors if they want to? What incentives does it provide to universities to increase the number of international students, and what effect will that have overall on UK medical schools?
New clause 2, tabled by my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer), is about places for UK foundation and speciality training programmes, and the importance of allocation on merit, because we all want the very best doctors. When I became a doctor—believe it or not, it was 25 years ago this year, Madam Deputy Speaker—I applied for a job as a junior house officer, as it was called then. I applied for the jobs I wanted, I was interviewed by the consultants who would have been supervising my training, and then I was offered the jobs.
The experience of students today is very different. They are allowed to put in a preference and say which deanery or foundation area they would like to work in, but that is all. After that, the application goes into a computer system, which gives them a single rank that is not based not on anything they have done at university, or on whether they got good results or worked hard, or anything like that. The computer system will do a first pass, and if the first choice is available, it will give the student their first choice. If it is not available because by the time its gets to that student those places have gone, the computer system will miss the student and go on to the next one. When it has completed its full pass of the list, it will start again, and when it comes to that student next time, it will give them the highest preference that is still available.
Once the student has been allocated a foundation deanery, the process starts again within the locality, and I mean “locality” in the loosest possible sense. Take those applying for the Trent rotation; they could be posted in Lincoln, Boston, Nottingham, Derby or Burton. The doctor has no control over where they will go, and very little ability to express a preference. My hon. Friend the Member for Weald of Kent (Katie Lam) spoke about a student in her locality who had not been able to get a place, despite being at the top—third, I think—of their university class. It is clearly not fair to give people no opportunity to control their future. By the way, there is no right of appeal, so having been given their place, the choice for the student is: that place or no place.
The hon. Member for Sunderland Central (Lewis Atkinson) spoke about ordinary children from the north-east. Having once been an ordinary child from the north-east, I agree that it is important that people have opportunity, but it is equality of opportunity, not equality of outcome, that matters. I worry that the system creates equality of outcome. We therefore support new clause 2, tabled by my hon. Friend the Member for Runnymede and Weybridge.
Amendment 1 would require the Bill to take effect on the date of Royal Assent, as opposed to a date at the discretion of the Secretary of State for Health and Social Care. The Bill is deemed necessary emergency Government legislation to prioritise medical graduates in the United Kingdom for places on medical training programmes. When he announced the Bill in an attempt to avert industrial action by resident doctors in December, the Secretary of State told the House that he had been working intensively with his team to
“to see how quickly we could introduce legislation”—[Official Report, 10 December 2025; Vol. 777, c. 430.]
However, the Bill does not commit to a date when these measures will be enacted. Instead, the power lies in the hands of the Secretary of State, giving him a clear bargaining chip for future negotiations. It is clear that the Government intend to pass this legislation urgently, as they have said. However, without a commencement date, there are clear concerns that the Bill is just a negotiating tactic to prevent industrial action by resident doctors, and can be scrapped at a later date. There remains the prospect of further industrial action, despite the legislation being introduced. The Secretary of State should not be asking Parliament to pass a Bill that he has no intention of enacting if the British Medical Association plays ball and holds off on strikes. Either the Secretary of State thinks that this is emergency legislation that we need to get on with and enact, or he does not.
It is vital that the legislation is enacted straight away, because students are due to be given their training programme places now, and they need to decide where they are going to live. They cannot put their life on hold, and measures to prioritise UK doctors cannot be held off, until the Secretary of State has finished dangling a carrot in front of the British Medical Association. The Opposition are clear: while we are supportive of the principles of the Bill, it must be used for offers made this year.
Amendment 8 would clarify that under clause 5, a UK foundation programme is a programme where the majority of training takes place inside the United Kingdom. A foundation programme is defined as
“an acceptable programme for provisionally registered doctors”
in section 10A of the Medical Act 1983. It is vital to clarify that a UK foundation programme is a programme where a majority of training takes place inside the United Kingdom. That is because the General Medical Council can approve foundation programmes overseas. If it is not explicit that a foundation programme needs to be in the United Kingdom, a loophole is created whereby a foundation programme could be approved overseas, creating a back way into the system and circumventing the measures that the Government have tried to put in place. I encourage the Minister to look at that carefully as the Bill progresses.
In summary, we support the Bill, but we have concerns about some of the clauses, so we have tabled amendments that we hope the Government will look at carefully.
We have also tabled amendments to improve the transparency and long-term impact of the Bill. Across the NHS, we face severe shortages, not just in general practice but in radiology, oncology, mental health services and many other specialities.
Again, prioritisation does not mean exclusion. International medical graduates who are not prioritised will still be able to apply and will be offered places if vacancies remain after prioritised applicants have received offers. However, it is important that we do not incentivise actions that will undermine the Bill. This Bill will reduce competition for places for UK-trained doctors so that home-grown talent can become the next generation of NHS doctors.
Amendment 8 would limit the definition of a UK foundation programme in clause 5 to include programmes only where the majority of training has occurred within the UK. Although I understand the desire to do that, the number of doctors on a foundation programme within the meaning of the Medical Act 1983, but where the majority of training occurs outside the UK, is very small. Indeed, we understand that there is only one such active training programme. There are fewer than 25 doctors on that programme this year, of which fewer than five applied to continue their training in the UK. As such, there is no material impact on the Bill, so we do not think amendment 8 is necessary. However, we will keep the situation under review.
Amendments 2, 3, 4 and 5 would change the procedure for making regulations to set additional priority groups for specialty training from 2027. The regulations would prioritise additional groups based on criteria indicating that a person is likely to have significant experience of working as a doctor in the health service or by reference to their immigration status. To be clear on our intention, the Bill sets out the groups of people who are to be prioritised for specialty training from 2027 onwards. The delegated power is limited to adding to that list by reference to their having
“significant experience of working as a doctor in the National Health Service”,
or immigration status. Although I am sympathetic to the desire for more parliamentary scrutiny, as outlined by the hon. Member for North Shropshire (Helen Morgan), we believe that, due to the limited scope of the power, the negative procedure is justifiable. I therefore encourage her not to press those amendments to a Division.
Amendment 1 would change the commencement of the Bill—from being commenced by regulations to being commenced automatically on Royal Assent. As my right hon. Friend the Secretary of State outlined, the commencement clause is important, and I have addressed that point. It is a failsafe that, given the tight timeline for introducing the Bill, will ensure that we are not in a position where a law is enacted that we cannot implement effectively for whatever unforeseen reason.
As I have said, there is also the question of whether it is even possible to implement prioritisation if, for example, the strikes are ongoing, given the strain that they put on resources and the impact that could have on delivery of the Bill. Because our objective is not just to move quickly but to get this right, these considerations are key to the commencement of the Bill, which is why the Government believe that we need to be able to commence the Bill when it makes sense to do so. For those reasons, we cannot accept the amendment.
We do not think that new clauses 1 and 3 are necessary, because the data is already published, or, as we have said, we would be seeking to monitor the impact. New clause 2 would require the allocation of individual candidates to foundation and specialty training places on merit, once the requirements to prioritise certain applicants had been met. We consider the new clause to be unnecessary at this time because existing systems for recruitment to foundation and specialty training already assess the applicants on many of the merits outlined by in it. The Bill does not alter that; it simply ensures that UK medical graduates and other eligible applicants are prioritised.