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In a poignant address, Health Secretary Wes Streeting has raised alarm over the potential exodus of British doctors from the National Health Service (NHS) if urgent changes to specialty training are not implemented. He emphasised the need for prioritising UK and Irish medical graduates in the allocation of vital training positions, a move aimed at addressing growing concerns about the future of resident doctors within the health system.
Urgent Need for Change
Streeting’s remarks come as he introduces the Medical Training (Prioritisation) Bill, which is set to be discussed in the House of Commons on Tuesday. This legislation seeks to ensure that medical graduates from the UK and Ireland receive precedence in both specialty and foundation training—essential steps for doctors to specialise in their chosen fields. With the number of applicants for these training posts escalating from 12,000 to nearly 40,000 since 2019, the pressure on available slots has become unsustainable.
“Resident doctors are often met with unacceptable treatment, and their concerns about career progression are entirely justified,” Streeting stated. He expressed his solidarity with their grievances, acknowledging that many feel their career paths are obstructed by the overwhelming number of applicants competing for limited positions.
The Growing Competition
Recent data from the Department of Health and Social Care highlights a significant rise in applications for training. In 2025, of the 33,123 doctors who applied for specialty training, only 37 per cent were homegrown UK graduates, with the remainder hailing from overseas. This stark contrast underlines the increasing reliance on international recruitment, a trend Streeting is eager to reverse.
While acknowledging the NHS’s role as a global employer, he insisted, “We must break our over-reliance on international recruitment.” The focus should shift to prioritising those who have trained domestically, he argued, reinforcing the importance of nurturing local talent to sustain the NHS.
A Call for Understanding
In his discussion with Members of Parliament, Streeting urged both the British Medical Association (BMA) and resident doctors to approach negotiations with a spirit of compromise. He noted, “There remains a gap between the expectations of the BMA and what the government can afford,” suggesting that flexibility from both sides could lead to a more fruitful resolution.
The BMA is currently balloting its members to decide whether to continue industrial action, with the current mandate set to expire this month. An extension could be considered if the ballot yields a positive outcome. Streeting has expressed respect for this democratic process, but the urgency of the situation cannot be overstated.
Political Reactions
The Conservative shadow health secretary, Stuart Andrew, voiced support for the principles behind the proposed legislation but cautioned that it must be practical and actionable. He raised concerns about ensuring that doctors who train with the armed forces overseas are not unfairly disadvantaged due to their training locations. Andrew also stressed the need for the bill’s provisions to take effect immediately upon royal assent rather than at the discretion of the health secretary, highlighting the importance of timely action in addressing the current crisis.
Why it Matters
The issues surrounding specialty training in the NHS are not merely administrative; they reflect a broader crisis in the healthcare system. As the demand for medical professionals surges, the potential disenchantment of British doctors could lead to a significant workforce shortage. The proposed changes aim to bolster local training opportunities and ensure that the NHS can continue to provide high-quality care to patients. If these concerns are not adequately addressed, the repercussions could extend beyond the healthcare workforce, ultimately affecting the delivery of essential health services across the nation.
