Lord Clement-Jones (LD)

My Lords, it has been many years since I last spoke in a health debate. There is a sense of déjà vu in seeing the noble Earl, Lord Howe, on the Opposition Front Bench. It is also an absolute pleasure to hear from the noble Lord, Lord Darzi, and to hear the arguments he has made, which are very consistent with those we will be making later in the group of amendments from the noble Baroness, Lady Gerada. I rise to speak to the amendments in this group, but particularly to Amendment 2, in the name of the noble Baroness, Lady Coffey, and the amendments tabled by the noble Lord, Lord Patel. On Amendment 2, while I understand the intent of the noble Baroness to protect the domestic workforce, we on these Benches cannot support the introduction of citizenship as a primary filter for medical training priority. To do so would undermine the central logic of this Bill, which is to protect the taxpayers’ investment in training, not to police the passport of the trainee. If a non-UK citizen comes to this country, trains in our medical school for five years, often paying significant international fees—my noble friend made an extremely good point about the value of that to our universities—they cross-subsidise our universities and then commit to the NHS. They are a UK medical graduate in every sense that matters to workforce planning. Their training is identical; their clinical exposure is identical. We on these Benches believe that to deprioritise them, based purely on nationality, would send a disastrous signal to the global talent pool that our NHS has always relied upon. It would also contradict the argument we will make later regarding the amendments from the noble Baroness, Lady Gerada, on the Queen Mary University of London Malta Campus: that it is the content and quality of the qualification that matters, not the geography or the nationality. Regarding the amendments in the name of the noble Lord, Lord Patel, I sympathise with his desire to ensure that UK graduates are prioritised. That is, after all, the purpose of the Bill, and while we can argue about the definition of a UK graduate, we must be careful not to make the legislation so rigid that it removes any flexibility for the Secretary of State to address shortages in specific specialties, or where international talent is essential. Several noble Lords have mentioned that we have all received correspondence from doctors in hard-to-fill areas who warn that absolute exclusion could leave rotas empty. Prioritisation must not constitute a blockade.