Contribution
There is some merit in the hon. Gentleman’s proposal, not just for medical training but across the clinical workforce. As Members have acknowledged, we pay significant sums of public money training clinical staff, but the graduates incur significant student debt. If a UK-trained undergraduate student decides to work abroad, the UK taxpayer will have invested a significant amount in their training, and that is then lost. It strikes me that there is an opportunity for the Government to think about the sort of incentive that the hon. Gentleman describes as part of wider workforce planning.
That is pertinent to my next point about the importance of the medical workforce reflecting our wider society, particularly the working class communities of the north-east of England. I want to ensure that a young person doing well at a state school in Sunderland has as much encouragement and access as anyone else in the country to study medicine and, crucially, progress through the ranks to the highest grades. We have heard some talk of international medical schools, but I can absolutely assure Members that there are not state school-educated kids in Sunderland thinking that they will pay privately to study in Grenada or anywhere else.
As the Secretary of State rightly pointed out, there have been welcome improvements on diversity in the NHS, but we often fail to consider socioeconomic background in that. The first line of the NHS constitution states:
“The NHS belongs to the people.”
But sometimes it can feel like it is staffed by a pretty unrepresentative slice of the people, particularly in medical roles.
In that spirit, I recognise the excellent work of the University of Sunderland medical school, which has placed widening access at the heart of its mission. Building on a 100-year history of wider clinical training, the school opened in 2019, shortly before the covid-19 pandemic—a period that starkly exposed our over-reliance on overseas recruitment and underlined the importance of growing our own workforce. By 2022, 47% of the University of Sunderland’s intake were local students, and it now ranks sixth in the UK for student satisfaction.
However, it is no good universities like Sunderland in my constituency doing excellent work on widening participation at recruitment stage if when we get to foundation training and specialty training those students are disadvantaged in competition. In my view, the Bill will help to ensure that talent nurtured by institutions like the University of Sunderland is retained and prioritised for the benefit of our NHS.
I highlight that medical schools such as Sunderland are increasingly placing a huge emphasis on training their medical students in a multidisciplinary environment alongside the trainee nurses and trainee pharmacists of the day, so that they are prepared to work in the multidisciplinary environment that our NHS rightly demands. I am not sure that all international undergraduate courses are always so advanced, so it is right to prioritise this UK-based training approach for the multidisciplinary ethos of the NHS in the future.
Other Members have mentioned the wide variation in specialist training fill rates, and GP recruitment has been mentioned as part of that. It is also worth saying that the national statistics about specialty training mask significant regional variations. The GP specialty training fill rate has been as low as 62% in the north-east of England, and as we have heard, over 73% of applicants for GP specialty training in 2023 were international. That has a disproportionate effect in regions like mine. My constituents want to have the confidence that there will be a stable GP workforce as part of our community for the long term. I cannot tell them in all candour that the status quo delivers that, so we must make changes of the type that the Bill sets out.
I hope that by introducing effective, regulated training pathways, the Bill will improve retention and strengthen workforce planning in our communities, including in areas such as women’s health, where training provision has not kept pace with rising demand. When I look at the shape of the NHS elective waiting list, it is no coincidence that some of the trickiest waiting time problems are in specialties such as gynae, where we have had recruitment and training challenges in recent years.
To close my remarks, I re-emphasise the link between capacity and demand, which I hope the Minister will touch on in advance of the workforce plan. Will she also say a little about the medical training review and the phase 1 report for NHS England and how the Government will work with that?