Earl Howe (Con)

My Lords, the amendments in this group seek to change the definition of the priority group. We debated the principle behind the amendments tabled by the noble Baroness, Lady Gerada, and the noble Lord, Lord Darzi, in Committee. I shall come back to the amendment tabled by the noble Baroness, Lady Gerada, in a moment. Meanwhile, the amendment tabled by the noble Baroness, Lady Lister, seeks to include a new group of people who should be prioritised for medical specialty training places. We have not, as she said, debated this precise issue before. She argued the case very powerfully. However, we need to come back to the object of the Bill, which is to resolve the specific problem of UK medical graduates having insufficient priority in accessing medical specialty training in UK workforce planning. Our prime focus should be on those young UK doctors who have put so much effort into their studies and who now want to progress further in the NHS. I appreciate the force of everything that the noble Baroness, Lady Lister, said. I observed earlier that we are not living in an ideal world. However, for the reasons that I have given, I am not convinced that including an additional group—in this case, those who have come to the UK from Afghanistan, Ukraine, Syria or Hong Kong—will necessarily improve the Bill’s effectiveness in resolving the problem that it is designed to address. Those doctors are not, and surely cannot be, part of the NHS’s workforce planning framework. That said, I think we can all agree that, where an individual comes to the UK through a safe and legal route as a legitimate refugee and has skills to offer our country, we should welcome them offering those skills. It would therefore be helpful to know from the Minister what support her department is giving and will give to medically trained people who have come to the UK legally and who wish to serve in the NHS. I will say some brief but important things about the amendment from the noble Baroness, Lady Gerada, without, I hope, repeating what has been said. The merits of her case were ones which she powerfully presented in Committee, and she has done so again today. I want to highlight three key points. First, QMUL’s campus on Malta and Newcastle University’s campus in Malaysia are not “foreign institutions”. Yes, they may be physically located abroad but, constitutionally, both are UK institutions and the qualifications they award are UK qualifications based on a UK-prescribed medical curriculum. Doctors have made career plans based on that long understanding. Therefore, badging graduates from those overseas campuses as international medical graduates, which is the implication behind the Government’s position, does them a grave injustice. In my submission, they are not international medical graduates in the sense that we normally understand the term—a point well made by the noble Baroness, Lady Finlay.