Nuffield Trust response to the Medical Training (Prioritisation) Bill

Ahead of the House of Commons debate and vote on the Medical Training (Prioritisation) Bill today (Tuesday 27 January), Nuffield Trust Fellow Lucina Rolewicz said:

“The ongoing dispute with resident doctors is about far more than just pay, and we have long called for measures targeted at those early in their careers to make the NHS a more attractive workplace. The state invests around £245,000 for someone to complete medical school in the UK, so it's sensible and cost effective to try to ensure that these domestically trained doctors carry on working within the NHS.

“However, the NHS has previously relied on international graduates to fill a big proportion of general practice training places, so if this Bill deters them from applying for jobs that are less popular with UK graduates, it could torpedo efforts to expand general practice, especially in poorer areas. The government has acted swiftly with a desire to end the dispute with resident doctors but given the speed at which this Bill is progressing, the possible adverse consequences may not have been fully considered.

“The impact of prioritising UK graduates might be limited. While there has been a massive increase in applications from both UK and international medical graduates for specialty training places – creating the 'bottlenecks' we so often hear about – actual job offers for doctors trained overseas have not increased at the same rate. This policy also does nothing to make less popular specialties and locations more attractive to UK graduates, and some vacancies will always be much more competitive than others.

“The burden of expectation for the forthcoming NHS workforce plan is very heavy. It will need to go further on tackling the key issues facing resident doctors, improve the training pipeline and stem high attrition rates.”