What’s in the Medical Training (Prioritisation) Bill?

Some Bills do manifestly sensible things for reasons that give you pause.

The measures in Medical Training (Prioritisation) Bill was a key demand in negotiations between the British Medical Association (BMA) and the Secretary of State for Health (Wes Streeting.). The fact that it is now not only published but subject to a “fast-track” process suggests that negotiations are at a stage where such a promise will add value for the government to negotiations.

The BMA is not completely happy. It is concerned about the availability of training for doctors who have worked for several years in the UK under these new plans, and fundamentally feels that genuinely new doctor jobs are needed in the NHS to deal with demand. However it has said that: “The introduction of emergency legislation does give us some hope that this Government is finally waking up to the urgency of the situation.”

The plans as published are straightforward, and with just eight clauses very short (there’s also an explanatory note): UK and Irish medical school graduates will have priority for foundation training, which is the first post-graduation step to becoming an NHS doctor.

For speciality training – a second stage allowing doctors to specialise in anything from general practice or emergency medicine, to anaesthetics or pediatrics – posts starting in 2026 would be available as a priority for graduates from medical schools in the UK and Ireland, people who have completed previous training in the UK, and people who are British citizens or people with leave to enter or remain.

From 2027 this priority list for speciality training will be expanded to include those likely to have significant experience of working in the NHS. And in all of the above cases international agreements mean that prioritisation will also apply to graduates from providers in Iceland, Norway, Lichtenstein, and Switzerland.

Not everything is on the face of the bill – regulations will define those with NHS experience for the purposes of the bill, and regulations can exempt certain speciality programmes from the prioritisation scheme as required.

The growth of UK medical provision at undergraduate level over the past few years has put pressure on the ability of the NHS to offer the next stage of training. Prioritising UK graduates helps derive the maximum value from this recent expansion while leaving open the possibility that places can be offered for others as needed.

The BMA is right that the measures do nothing to increase capacity for training places within the NHS – though 671 additional places were created in 2024-25 because of the increase in demand. What the Medical Training (Prioritisation) Bill brings is the ability to manage availability for UK graduates should demand once again increase.

Assent is required by no later than 5 March 2026 (the guidance has a misprint of 2025!) in order to affect training starting from August 2026, so the expedited process will see bill stages come thick and fast over the next few weeks including several stages in one day.