Dr Luke Evans MP for Hinckley and Bosworth, and Shadow Parliamentary Minister for Health and Social Care.
Most people agree on a basic truth: if you train as a doctor in the UK, you should have a fair shot at building your career here.
That is why the UK Medical Training Bill has real merit.
At its heart, the Bill seeks to prioritise UK-trained doctors for NHS training posts, particularly at the early stages of their careers. That matters. Training places are limited, competition is intense, and too many UK graduates feel pushed aside after years of hard work and public investment.
This concern is not hypothetical. In recent years, the NHS has expanded both domestic and overseas recruitment. That was understandable in the aftermath of the pandemic, with record backlogs and workforce shortages. We needed all hands on deck.
But the balance has tipped. In 2025, 15,723 UK-trained doctors and 25,257 overseas-trained doctors competed for just 12,833 training posts at the next stage of British medical training. UK graduates were, quite simply, squeezed out. Looking ahead to 2026, more than 47,000 applicants have already entered the system. The Government is right to conclude that something has to change.
This is not a criticism of international medical graduates, who play a vital and valued role in our NHS. But after the previous Government expanded medical school places at home, it is now necessary to rebalance recruitment as part of a long-term workforce plan—one that, frustratingly, has once again been delayed.
On principle, then, this Bill is reasonable. It speaks to fairness, workforce planning, and respect for the doctors we train.
But there is a serious problem hidden in the detail.
The Bill contains an implementation clause that allows the Health Secretary to decide when its main provisions take effect. In plain terms, it can be switched on when it suits the Government—and held back when it does not.
Clause 8 states that the Act will come into force “on such day or days as the Secretary of State may by regulations appoint,” and allows for transitional or saving provisions at his discretion. That may sound technical. It is not. It is political.
If the Health Secretary genuinely believes this reform is right for the NHS and right for doctors, it should be implemented clearly, promptly, and without ambiguity. What possible justification is there for delay?
The uncomfortable conclusion is that this clause creates space for the Bill to be used as leverage, particularly amid ongoing industrial tensions. It gives Wes Streeting an on-off switch that only he controls.
That is not how serious workforce planning should be done.
The NHS needs leadership, not performative pressure. Doctors need certainty about their futures. Patients need a health service focused on care, not tactics.
This Bill could mark a step towards a stronger, fairer medical workforce. But the way it is being handled risks undermining its intent. Reform should not be a bargaining chip. It should be an act of leadership.
